Laserfiche WebLink
City of Kirkland KIR4 <br /> Business License Application for ° `<p <br /> Businesses Located Outside Kirkland City Limits 1; 1,n o <br /> City of Kirkland Phone 425.587.3140 °_ <br /> Customer Accounts/Licensing www.kirklandwa.gov S,�INc <br /> 123 5th Avenue license@kirklandwa.gov <br /> Kirkland, WA 98033-6189 Fax 425.587.3110 <br /> INSTRUCTIONS: <br /> Please print or type. FOR OFFICE USE ONLY: <br /> Application must be signed. 4313 <br /> If form is not fully completed, a delay in processing the 4314 <br /> application will occur. 4312 <br /> License Fee: Check # <br /> •Please refer to the Business License Application Fee Receipt # <br /> Worksheet for fee calculations. <br /> •Return application and check made payable to City of Kirkland. <br /> •Payment Accepted: Check, Cash, Visa or Mastercard <br /> 1. Business Organization: Sole Proprietor ❑ Partnership Corporation ❑ LLP E LLC <br /> 2. City of Everett <br /> Legal Entity DBA(Doing Business As) Business Phone <br /> 3. Everett Animal Shelter, 333 Smith Island Rd, Everett, WA 98201 <br /> Business Address <br /> Mailing Address (if different from business address) <br /> 6 0 1 2 4 8 <br /> Unified Business Identifier Number(UBI) <br /> 4. List names of owners partners, or officers: (ONLY LIST 3) <br /> (1) (2) (3) <br /> Name: Mayor Ray Stephanson <br /> Address: 2930 Wetmore <br /> City/State/Zip: Everett, WA 98201 <br /> Home Phone: N/A (Vendor contact: 425-257-6013 <br /> 5. Specifically describe your business activity. Provide Animal Sheltering Services for the City of Kirkland <br /> 6. Are you a utility company? ❑ Yes 121 No Specify type <br /> 7. Number of employees including owner/manager working in the City of Kirkland. 1200+ <br /> BUSINESS OWNER MUST ENSURE COMPLIANCE WITH ALL LAWS: <br /> Do not engage in business until you receive an approved license. When the City issues a business license, the City <br /> is not representing that the business is in compliance with all local, state and federal laws. <br /> DECLARATION: <br /> I declare under penalty of •erjury nderrt�th- laws of the State of Washington that the foregoing is true and correct. <br /> Applicant's Signature: i„ �Ifil.�_�I�' Title: Date: 12' •11 -7-eq- <br /> . <br /> • <br /> q• OVED AS • FO <br /> r <br /> 1 <br /> JAMES D ILES.Cits Ati.urne� <br />