Business License Addendum Form - City Of Richland
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1
2
3State of Washington
UBI
Business Licensing Service
PO Box 9034
Owner name
Olympia WA 98507-9034
City of Richland
1-800-4517985
Business License Addendum
Note: This form must be submitted with a completed Business License Application form.
Application subject to approval by City of Richland.
Please type or print in dark ink.
A
General business information
1. Check all of the following that apply:
New business in Richland
Location change in Richland
Remodeling premises
2.
Name of local emergency contact person
Emergency contact telephone number
Emergency contact address Street or route, city, state, zip code
3. Do you plan to conduct any part of this business from your Richland home? ...............................
Yes
No
If Yes, please read Page 2 of this form concerning Richland’s Home Occupation regulations.
Your signature on the Business License Application certifies that you understand those
regulations and agree to operate your home occupation in accordance with them.
4. Is this business a daycare? ...........................................................................................................
Yes
No
If Yes, please indicate the number of children covered by license: _______
5. Is this a federally exempt non-profit organization? ........................................................................
Yes
No
If Yes, please attach a copy of your Federal Tax Exemption Certificate 501(C)3, 4, or 5 and
provide your Federal Tax ID number. Without this information, you will be charged a city license
fee.
6. If this is a real estate, beauty shop, barber shop, day care center or home day
care business or you are a contractor, please indicate your Washington State
professional/occupational license number ................................................................
Note: It is illegal to occupy or use the building or tenant space at which you are applying for a business license until the
city’s full approvals are given, including the sign-off by all city departments and a valid certificate of occupancy through
the city’s Building Permit Office. Please check with the Building Permit Office before you apply for your business license,
as some buildings (and/or zoning districts) cannot be used for certain businesses.
B
Fee calculation
1. Indicate your business license category:
-
40
(see Richland category sheet)
$
2. Number of working owners at this location .....................................
* ..........
Number of Full-time Equivalent Employees at this location
Subtract 2 free working owners or employees ................................
Total Number of Working Owners and Employees ...........
X $12 =
$
*
(Employee calculation: Total number of persons employed on last
working day of each of the last 12 months. Divide by 12, drop fractions.)
3. Number of Rental Units (if applicable)
X
$2 =
$
Total License Fee
$
(Add 1, 2 & 3, then enter this amount in Section 2 of the Business License Application)
Note: Businesses must comply with all City of Richland regulations. If you have questions, please contact:
Zoning: 840 Northgate Dr ..........................................................................................................(509) 942-7794
Building & Safety Inspection:840 Northgate Dr .......................................................................(509) 942-7794
Fire: Central Fire Station (across from Richland City Hall) .........................................................(509) 942-7551
Police: Main floor of Richland City Hall ......................................................................................(509) 942-7360
For assistance or to request this document in an alternate format, visit or call 1-800-451-7985. Teletype (TTY) users may call 360-705-6718.
BLS-700-361 (5/23/11) Page 1 of 2
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