RETAIL FIREWORKS STAND ASSISTANT
CONSENT FORM - FY2014
The Tulalip Tribes of Washington
TAX &
LICENSING DIVISI
ON
6406 Marine DR NW
Tulalip, WA 98271
Telephone: (360) 716-4204
Home Telephone Number
(_____ ) ______ - _______
Alt Telephone Number
(_____ ) ______ - _________
Stand #
I, __________________________________, have read and understand Tulalip Fireworks
Code, Title 10, chapter 10.25, adopted May 4, 2012 as amended, specifically, Section
10.25.200 Authority to enter and search, which states:
“The Tax and Licensing Division, and Tribal officials or Tribal law enforcement officers to whom it
has delegated authority, may enter and search any fireworks stand, home, other building,
property, or vehicle owned or utilized by any licensee, or any person operating or assisting in the
operation of any fireworks stand, for purposes of determining whether violations of this code
have occurred or are occurring. By acceptance of a license, the licensee consents to such entries
and searches. Notwithstanding any other provision of this code, no person other than the
licensee may operate, or assist in the operation of, a fireworks stand without first having signed
and delivered to the Tax and Licensing Division a consent to the Tax and Licensing Division, and
Tribal officials or Tribal law enforcement officers to whom it has delegated authority, entering
and searching any fireworks stand, home, other building, property, or vehicle owned or utilized
by such person, for purposes of determining whether violations of this code have occurred or are
occurring.” (Emphasis added)
Having read this section of this code, I hereby grant my unconditional consent to the Tax
and Licensing Division, Tulalip Law Enforcement Officials, or its designee to enter and
search any fireworks stand, home, vehicle, and other buildings and property owned or
utilized by me.
_________________________________ _____________________
Signature Date
Assistant Name:
Tribal Enrollment or WA DL #
D.O.B
Home Address (Street):
City
Zip
Stand Owner Name(s)
Stand Owner Name(s)
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