Form Bls 700-060 - City Business License Addendum Page 3
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1
2
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4State of Washington
UBI
Business Licensing Service
PO Box 9034
Owner name
Olympia WA 98507-9034
1-800-451-7985
business.wa.gov/BLS
City Business License Addendum
Side A: For a business physically located inside city limits (resident)
This form must be submitted with a completed Business License Application and required fees.
For faster service - Apply online
Refer to the instructions and list of cities on page 1 of this form.
A
Complete this section for a city license if your business is physically located inside city limits.
1. From the city names and fees listed on page 1 of this form, indicate the city where your business is physically
located and the associated fee amount:
City name
Fee amount
$
2. Total number of employees at this business location:
3. First date of business in the city indicated:
4. Have you held a business license in this city?
Yes
No
Prior license #(if known)
5. Check any of the following that can be found at this business location:
Automatic smoke detection system or fire sprinkler system installed
Any compressed gases (oxygen, helium, acetylene, propane, nitrous oxide, etc)
Discharges to the sewer from business or business processes other than domestic sanitary discharges.
Any flammable/hazardous/toxic materials (gasoline, oil, cleaning solvents, pesticides, etc.)
Average gallons or pounds kept on premises:
None
6. Are you conducting the business from a residence? ............................................................
Yes
No
If yes, how many customers will be visiting the residence per week?
Some cities have special home occupation regulations, please contact the city for more information.
7. Square feet of floor space utilized by your business at this location:
8. give the name and phone number of two after-hours emergency Contact persons for this business location:
Name
Phone number
(
)
Name
Phone number
(
)
9. Are you applying as a nonprofit organization? .....................................................................
Yes
No
If yes, attach a copy of your IRS tax exemption certificate issued under section 501(c) of the IRS code.
10. Are you a general or specialty construction contractor? .......................................................
Yes
No
If yes, provide the Dept. of Labor & Industries registration number (if known):
11. Mark any of the following activities that will be conducted at or from this business location:
Sexually Oriented Business
Charging Admission
Amusement Devices / Arcades
Adult entertainment
Taxi or For Hire Service / Dispatch
Ambulance Service / Dispatch
gambling
Health care/Medical
Painting
Retail/Wholesale Sales
Storing/Warehousing
Repairing
Dispensing
Utility (telephone/cellular/ISP, cable, gas, electric, garbage)
Recycling
Manufacturing, assembling, producing, packaging
Civic, social, religious gathering with food/drink consumption,
Care Provider for adults or children
transportation, entertainment, etc.
SPOKANE ONLY
Use the City Fee Calculation worksheet on Page 2 to indicate the total number of employees working at this business location
X
=
# of employees
Fee per employee
Total employee fee amount
For assistance or to request this document in an alternate format, visit or call 1-800-451-7985. Teletype (TTY) users may use the Washington
Relay Service by calling 711.
BLS 700-060 (07/11/13) PAge 3 OF 4
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