Form Bls 700-060 - City Business License Addendum - Washington Department Of Licensing Page 2
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1
2Master License Service
UBI
UBI
Department of Licensing
PO Box 9034
Owner name
Owner name
Olympia WA 98507-9034
Telephone (360) 664-1400
City Business License Addendum
This form must be submitted with a completed Master Business Application form and required fees.
Please note:
•
Read the instructions on section A of the form before completing this page.
•
Select cities from the list below to which you will travel to conduct business. Use the other side of this form to apply for
the city license for the city in which your business is physically located.
•
You must apply for business licensure directly with cities not listed on this form. Contact the Master License Service
regarding the City of Richland.
•
In Section 2 of the Master Business Application, write the city name and fee for each city you selected below.
Complete this section for city licenses if there is no physical location inside the city limits.
Complete this section for city licenses if there is no physical location inside the city limits.
B
1. From the cities noted below, list all the cities where you will travel into to conduct business.
Anacortes .......... $30
Fircrest .............. $65
Long Beach ..... $125
Spokane Valley .. $13
Bellevue ............. $30
Gig Harbor ......... $20
Marysville .......... $50
Stanwood .......... $35
Blaine ................. $75
Ilwaco ............... $100
Prosser .............. $50
Sultan ................. $75
Bonney Lake ..... $60
Issaquah ............ $60
Ruston ............... $40
Sumner .............. $40
Covington .......... $39
Lake Stevens ..... $40
Sammamish ...... $15
Tumwater ........... $50
Duvall ................. $55
Liberty Lake ...... $26
Skykomish ......... $50
Previous city license number
City name
First date of business
(if known)
Fee amount
$
$
$
$
$
$
$
$
$
$
Total due for non-resident cities $
2. Are you applying for your business as a nonprofi t organization? . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, attach a copy of your IRS tax exemption certifi cate issued under section 501(c) of the IRS code.
3. Are you a general or specialty construction contractor? . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, provide the Dept. of Labor & Industries registration number (if known): ___________________
4. Do you provide utility service (telephone/cellular/ISP, cable, gas, electric, garbage)? . . . . . . . .
Yes
No
The Department of Licensing has a policy of providing equal access to its services.
BLS 700-060 (R/10/09) Page 2 of 2
BLS 700-060 (R/10/09) Page 2 of 2
If you need special accommodation, please call (360) 664-1400 or TTY (360) 664-8885.
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