Business License Application - City Of Burlington, Washington - 2012
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1
2
3BUSINESS LICENSE APPLICATION
833 S. Spruce St.
Burlington, WA 98233
Telephone (360) 755-0531 Fax (360) 755-9565
NOTE: PLEASE REPORT LOCAL SALES AND USE TAX TO THE DEPARTMENT OF REVENUE
UNDER LOCATION CODE #2902 AT A RATE OF .017. All information below must be provided and
returned with remittance to the above address before a City license will be issued. IT IS UNLAWFUL
TO CONDUCT BUSINESS IN THE CITY OF BURLINGTON WITHOUT FIRST HAVING
OBTAINED A LICENSE TO DO SO (BMC 5.04.090).
APPLICATION DATE
, 20
NEW
ACCT #
UBI/CONTRACTOR #
BUSINESS NAME
PLEASE COMPLETE ALL PORTIONS OF THIS
APPLICATION AS IT APPLIES TO YOUR
MAILING ADDRESS
BUSINESS, SIGN AND DATE, AND RETURN IT
WITH THE APPROPRIATE FEE.
CITY, STATE, ZIP
FOR CITY USE ONLY:
LOCATION ADDRESS
LICENSE CODE (AMT)
OWNER/MANAGER
BILLING ADDRESS
LICENSE TYPE (CAT)
CITY, STATE, ZIP
BUSINESS PHONE (
)
HOME PHONE (
)
# OF EMPLOYEES:
Full Time
Part Time
{
} SOLE PROPRIETOR
{
} PARTNERSHIP
{
} CORPORATION
NATURE OF BUSINESS:
{ } RETAIL
{ } MANUFACTURING
{ } SERVICE
{ }
{ } REAL ESTATE
{ } WHOLESALE
{ } OTHER
BUILDING/CONSTRUCTION
BRIEF DESCRIPTION OF BUSINESS ACTIVITY
OPENING DATE:
I hereby certify that the statements on this application are true and complete to the best of my knowledge and belief, and that I
will comply with the applicable City of Burlington ordinance concerned with doing business in Burlington. I will notify the
office of any changes regarding address, nature of business and discontinuance of business and understand that a signature
and date are required to receive a current business license.
Date ____/____/____
Signature
Title
Revised 02/22/12
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Parent category: Financial