City of Mukilteo Finance Department
Attn: Business Licenses
11930 Cyrus Way
Mukilteo, WA 98275
(425) 263-8035
croberts@mukilteowa.gov
STANDARD BUSINESS LICENSE APPLICATION
NEW APPLICATION
UPDATE APPLICATION/ADDRESS or OWNER CHANGE
INSTRUCTIONS:
a. Answer all questions on page 1 completely.
b. Answer all questions on either page 2 or 3 completely, depending on the type of business.
c. Calculate fees payable using the Business License Fee Calculation Worksheet for your business type.
d. Return the completed application, printed copy of the fee calculation worksheet, and applicable fees to the
Mukilteo City Hall at the above address for processing.
BUSINESS TYPE:
GENERAL
(Business at a fixed location within City)
(page 2)
(Please read each type
HOME OCCUPATION
(Business office/operations located within a Mukilteo residential dwelling)
before selecting one)
(page 3)
SECTION 1 - BUSINESS INFORMATION
BUSINESS NAME:
STREET ADDRESS:
MAILING ADDRESS:
CITY/STATE/ZIP:
BUSINESS PHONE:
EMAIL ADDRESS:
WA STATE TAX (UBI) NO:
FEDERAL TAXPAYER ID:
DESCRIBE IN DETAIL YOUR BUSINESS ACTIVIES, PRODUCTS OR SERVICES:
OPENING DATE OF BUSINESS:
TYPE OF BUSINESS (Check all that apply):
Retail
Manufacturing
Construction Groups
Real Estate Leasing/Rentals
Wholesale
Services
Financial/Insurance
(Attach Form A: Canvasser, Peddler or Solicitor - REQUIRED)
Canvassing, Peddling or Soliciting
Other (Specify):
TYPE OF OWNERSHIP (Check all that apply):
Sole Proprietor
Partnership
Corporation
Association
LLC
Non-Profit
Note: Non-Profit organizations must provide copy of Federal (IRS) or State certification.
ON-SITE PRIMARY CONTACT INFORMATION (Individual who is responsible for managing the business in Mukilteo):
FULL NAME
(including middle)
HOME ADDRESS:
CITY/STATE/ZIP:
PHONE:
DRIVER’S LICENSE #/STATE:
DATE OF BIRTH:
Is business regulated, licensed or certified by any other governmental or professional agency (i.e. Dept. of Labor & Industry, DSHS):
NO
YES
If YES, please provide a copy of your current and valid license or certification.
FOR OFFICE USE ONLY Date ___________________
Amount Paid
______________________LIC #
_______________
1