Alexandria, VA · City of Alexandria
Establishment Permit Application
Businesses use this application to request or renew permits for food establishments, pools, spas, mobile food establishments, and other operations in Alexandria.
What this form is
Use this application to request a permit for a new establishment, renew a permit, update information, or report a change of ownership. It covers food establishments, seasonal and year-round pools or spas, mobile food establishments, and other operations. The application asks for establishment, operation, contact, and owner information, along with the applicant’s signature and date; the health department completes the second page.
Who needs it
Owners or applicants seeking a new permit, renewal, information update, or ownership change for an establishment covered by the application should complete it.
How to submit it
Return the completed application and fees to the Alexandria Health Department, Environmental Health Division, 4850 Mark Center Drive, Fourth Floor, Alexandria, VA 22311. The application states that fees are non-refundable.
About notarization
This application does not require a notary; the applicant signs and dates it, and no notarized or sworn attachment is identified.
How to submit this form
- 1
Download The Application
Download the Establishment Permit Application PDF.
- 2
Complete The Application
Select the application and permit types, then provide establishment, operation, contact, and owner details.
- 3
Sign And Date
Attest to the information provided, then sign and date the application.
- 4
Submit The Application
Return the completed application and fees to the Alexandria Health Department address printed on the form.
Frequently asked questions
- Do I need a notary for the Establishment Permit Application?
- No. The applicant signs and dates this application; it does not identify a notarized or sworn attachment.
- How do I submit the Establishment Permit Application?
- Return the completed application and fees to the Alexandria Health Department, Environmental Health Division, at 4850 Mark Center Drive, Fourth Floor, Alexandria, VA 22311.
- What permit types can I apply for?
- The application lists food establishments, seasonal or year-round pools and spas, mobile food establishments, and other permit types.
- What information does the application request?
- It asks for establishment, operation, manager or contact, and legal owner information. The applicant also attests to the information and signs and dates the application.