Form Bls 700-060 - City Business License Addendum Page 2
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1
2
3State of Washington
UBI
Business Licensing Service
po Box 9034
owner name
olympia Wa 98507-9034
1-800-451-7985
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 at
business.wa.gov/BLS
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. first date of business in the city indicated: _______________________________________________________
3. Have you ever held a business license in the city you indicated above? .............................
Yes
No
If yes, note the city license number of your previous business (if known): _______________________________
4. Will you use or store any hazardous or flammable materials at this location? .....................
Yes
No
5. are you conducting the business from a residence? ............................................................
Yes
No
If yes, will business customers be visiting the residence? ....................................................
Yes
No
Some cities have special home occupation regulations, please contact the city for more information.
6. Square feet of floor space utilized by your business at this location: ____________________________________
7. give the name and phone number of two after-hours emergency Contact persons for this business location:
Name
phone number
(
)
Name
phone number
(
)
8. 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.
9. are you a general or specialty construction contractor? .......................................................
Yes
No
If yes, provide the Dept. of Labor & Industries registration number (if known): ____________________________
10. 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
Utility (telephone/cellular/ISp, cable, gas, electric, garbage)
Note: In Section 2 of the Business License Application, write the city name and fee indicated above.
for assistance or to request this document in an alternate format, visit or call 1-800-451-7985. Teletype (TTY) users may call 360-705-6718.
BLS 700-060 (06/25/12) page 2 of 3
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