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1 ^r % cvcre —cid j/ ©!� (cvG,rec�lc IODIIl'3II . �ILa+�o:� ��CCNa71L <br /> .. .�~ OUSIiJESs TAX DIVISION A !J UC /1 �i�/j' N <br /> -- Y Y Y fr�i Y �l,/1 <br /> ORDINANCE NO. 3rO2t C C 1 V 1i O <br /> FIIE THE FIRST COPY AND $1.00 FEE WITH BUSINESS TAX DIVISION, CITY HlLtfty <br /> Please Print or Type rr"^ t, Washington <br /> 1.Issue license to <br /> J 2.Tendo nasus , <br /> J.Busmenaddress at;t t t/r street / U—moi mno z p c e ey(tmle_s e <br /> yIr slrrol number r r7 r J �� %• <br /> f e.Residence address Pmt muse zip toes I emieMtf pnona <br /> l I <br /> S.Type of business I <br /> 6.Opening date of business _ G <br /> 7,Have you ever had an Everett <br /> business license? n Yes F1 No Business Ih:ense number <br /> B.Stale wof er in iri sea, torpor <br /> .Ia CL'lN <br /> an or orlnarthl <br /> E Ii partnership list partners. If <br /> corporation Ilsl officers giving btia. <br /> address. phone l / �0 <br /> 2 <br /> 16.Former business operator <br /> 11.Former huslnesf operator Business license number <br /> i present Street number i pmt mane <br /> address � till case yn,pnf <br /> 17.Did you Coke over? Entire business ❑ Portion thereof <br /> '�`"` 1 <br /> L13.Remarks � �J7 S <br /> le.Nome/address parent compnny <br /> 1 <br /> 15.utilities (water. sewer) ere/will be 1-1 Business address ❑ Owner's address ' <br /> billed to LJOther (expl6in <br /> f mato num er pi--Iul6Tms <br /> employees working in city % 50.20 = monthly transit tax I <br /> Be sure all Information is complete before filing this application. If additional space Is needed, attach supplementary <br /> sheets of this s.ze. If business is conducted in more than one location within the City of Everett, complete schedule of <br /> business locations below(block 17).There a no charge forodditional business licenses for branch locations.Blocks 15 and <br /> 16 provide information for computation of thu transit tax (Ordinance 45.69). <br /> 17.Name under v nich operated Street number post Office Where bods are kept <br /> The undersigned certifies that the above information is complete, trtfe <br /> and accurate to the best of his owledge. <br /> Date • ed _�/t_ 7 Trade name <br /> Signed by <br /> i <br /> Do not write bel, w this line — office use only Office or title { <br />