City Of Kent Commercial Business Application

Ordinance No. 3035

City of Kent Commercial Business Application

Fee Must Accompany Application

Opening

City of Kent Customer Services

(Circle One)

July 1 or after

220 Fourth Avenue S.

New Business

$154.00

$104.00

Kent, WA 98032-5895

New Owner

$154.00

$104.00

(253) 856-5210 Fax (253) 856-6200

Indep. Contractor

$100.00

$50.00

Non-Profit

No Charge

501(c)(3)Req

PLEASE TYPE OR PRESS FIRMLY

Relocation in Kent

No Charge

Black or Dark Blue Ink Only

Prior Kent Address: _____________________________

All licenses expire December 31. Renewal invoices mailed in December.

1. WA State UBI# _________________ Name of Business ______________________________________________

Address

_________________________________ Suite ______________

2. Date Opened in Kent ____/ ____/____

Kent, WA Zip ______________________

Phone (

) _______________________ Fax (

) _______________

3.



Indiv.



Partnership



LLC



Corporation

Provide ownership information; include supplemental list if needed.

Owner(s) Name(s)

Home Address

City

State

Zip

Phone

____________________

________________________ ____________ _____ __________

(

)__________

____________________

________________________ ____________ _____ __________

(

)__________

4. Contact Person: _______________________________________________________________________________

5. Name of Business Center/Apartment Complex, if Applicable ______________________________________________

6. Parent Company Name, if Applicable: ______________________________________________________________

7. Independent Contractor?



Yes



No

8. Billing Address: _________________________________________ City/State__________________ Zip _________

9. Description of Business: _________________________________________________________________________

10. Type of Business: (Check those which apply)



Wholesale Trade



Retail Trade



Service



Manufacturing



Construction



Govt.



Transp./Commun./Util.



Finance/Insur./RE



Education



Health Industry



Sales/Mktg.



Rental Housing # Units __________



Other _________________________________________________

11. Do You Share a Location with Another Business?



No



Yes

Who? _______________________________

12. Include Working Owners—Total # Full Time Employees: _________ Total # Part Time Employees: __________

13. Emergency Information for Fire & Police Departments: TWO after hours LOCAL names & phone numbers:

Name ____________________ Phone _____________ Name _____________________ Phone ______________

14. Type of Building Occupied:



Single-Tenant



Multi-Tenant



Single-Tenant Warehouse



Multi-Tenant Warehouse



Mixed-Use-List mixed-uses:

15. Floor Space Occupied by Business in Square Feet_______________________________________________________

16. Address(es) of Warehouse/Distribution Centers in Kent __________________________________________________

17. Are there any hazardous materials used or stored at location



Yes



No

If Yes, explain _________________________________________________________________________________

18. Will your business engage in selling, giving away, distributing, dispensing, exchanging for anything of value, planting,

growing, processing, packaging, storing, or any other act relating to marijuana as that term is defined in RCW

69.50.101? Yes ___ or ___No.

I hereby certify that the statements and information furnished by me on this application are true and complete to the best of my

knowledge. I also acknowledge that the statements and information furnished by me on this application are public records and

are available for public inspection pursuant to State of Washington RCW 42.17.260. I understand that issuance of this license is

conditioned upon compliance at all times with all applicable ordinances, regulations and statutes of the City of Kent and the State of

Washington. The issuance of this business license does not imply compliance with the Zoning, Uniform Fire and Building Codes.

_________________________________

__________________________________

____________

__________

Signature

Print Name

Title

Date

INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

FOR OFFICE USE ONLY: Business License # __________________________________ Date Rec’d ________________Amt. Paid __________________

ficsW03319_5_11

White: BL File

Canary: Applicant’s Receipt Copy