Fillable BUSINESS LICENSE APPLICATION 06 2019 (City of Everett)

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BUSINESS LICENSE APPLICATION 06 2019 (City of Everett)

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The BUSINESS LICENSE APPLICATION 06 2019 (City of Everett) form is 2 pages long and contains:

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  • 19 check-boxes
  • 50 other fields

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File type: PDF

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Page 1 of 2
REV. 6/2019
CITY OF EVERETT
General Business License Application
Once you have completed, please mail with a check or visit our office to pay by credit card.
Effective July 1, a 2.3% service fee will apply to all debit and credit card payments.
Current license fees are available at everettwa.gov/businesslicense
PLEASE PRINT OR TYPE – COMPLETE BOTH SIDES OF THE APPLICATION
[
1]
LEGAL ENTITY NAME
BUSINESS PHONE
BUSINESS OR TRADE NAME (DBA)
WEBSITE
PHYSICAL ADDRESS (Street Number, Street, City , State, Zip)
IS THIS YOUR RESIDENCE?
□ YES
□ NO
MAILING ADDRESS (Street Number, Street, City, State, Zip)
ZONE OF PROPERTY
(for physical locations inside Everett city limits)
PRIMARY BUSINESS CONTACT
PHONE
EMAIL ADDRESS
PRIMARY TAX CONTACT
PHONE
EMAIL ADDRESS
[
2]
REASON FOR FILING THIS APPLICATION
STARTING BUSINESS IN EVERETT
ADD LOCATION TO EXISTING EVERETT LICENSE
INCORPORATING AN EXISTING BUSINESS
CHANGE OF OWNERSHIP OF EXISTING BUSINESS
CHANGE IN CORPORATE ENTITY
FOR CHANGE OF OWNERSHIP:
NAME, FIRM NAME, & ADDRESS OF PREVIOUS OWNER
ACCOUNT NUMBER UNDER PREVIOUS OWNER
[3]
DATE OF FIRST BUSINESS
ACTIVITY IN EVERETT BY THIS
ENTITY
ESTIMATED ANNUAL EVERETT
REVENUE
16-DIGIT UBI NUMBER
[
4]
NATURE OF BUSINESS
(1)(2)
[
CHECK ALL THAT APPLY
]
Retail Manufacturing-Extracting
Service Utility
Wholesale Gambling Activity
Printing/ Charging Admission for
Publishing Events/Shows
Non-Profit
DETAILED DESCRIPTION OF PRINCIPAL BUSINESS ACTIVITY IN
EVERETT (Please be detailed and include a description of products
and / or services)
FOR PHYSICAL LOCATIONS INSIDE EVERETT CITY LIMITS:
Walk-in Customers? YES NO
Storage on Site? YES NO
Business Tax Division
2930 Wetmore Ave, STE 1-A
Everett, WA 98201
425-257-8610
Fax: 425-257-8741
everettwa.gov/businesslicense
businesstax@everettwa.gov
If yes, you must read the Home
Occupation Regulations.
Page 2 of 2
REV. 6/2019
CITY OF EVERETT
General Business License Application
SOLE -
PROPRIETOR
OWNER’S LAST NAME FIRST MIDDLE
SPOUSE FIRST MIDDLE
OPERATED BY BOTH SPOUSES? E-MAIL
YES NO
PARTNERSHIP
FIRST PARTNER LAST NAME FIRST MIDDLE
E-MAIL
SECOND PARTNER’S LAST NAME FIRST MIDDLE
E-MAIL
THIRD PARTNER’S LAST NAME
(3)
FIRST MIDDLE
CORPORATION
OR
LLC
NAMES & ADDRESSES OF CORPORATE OFFICERS
PRESIDENT
E-MAIL
ADDRESS
PHONE
VICE PRESIDENT
E-MAIL
ADDRESS
PHONE
SECRETARY
E-MAIL
ADDRESS
PHONE
TREASURER
ADDRESS
PHONE
[6]
The undersigned certifies that the above information is complete, true and accurate to the best of
his/her knowledge. Further, the undersigned certifies that he/she understands that a business
license is issued for the express purpose of taxation and shall not be construed as a license or permit
to operate a business in violation of any City of Everett ordinance, rule, or regulation.
FOR HOME OCCUPATIONS ONLY
By checking this box, I affirm that I have read and understand the City of Everett Zoning Code Home
Occupation regulations and that I agree to operate my business in compliance with these regulations.
APPLICANT SIGNATURE PRINT NAME TITLE DATE SIGNED
[7]
FOR OFFICE USE ONLY--------------------------------------------------------------------------------------------------------------------->
TR #
APPLICATION ENTERED
NAICS NUMBER
LICENSE NUMBER
LICENSE ISSUED
(1) Additional licenses or endorsements may be required depending on the business activity.
(2) Tax forms must be filed by every business according to assigned filing frequency, even if no tax is due.
(3) Attach list for additional partners.
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BUSINESS LICENSE APPLICATION 06 2019 (City of Everett)

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Completed 14 July 2020

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