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1025 CASCADE LN_Redacted„w 1025 CIII &ADS Glu CITY OF EDMONDS APR '� BUSINESS LICENSE APPLICATION - HOME OCCUPATION ❑ Building ❑ Engineering FEE: $100.00 u Fire Planning �`T �jj� CIY CLERK'S OFFICE, BUSINESS LICENSE DIVISION LI Police ',r1' Cj `�j`�'”' AVENUE NORTH, EDMONDS. WA 98020 PHONE 425.775.2525 OFFICE USE ONLY BL# Customer# SIC I Year Class I SHD g y Dale Paid TR# as Mailed Deleted INSTRUCTIONS: Please complete the application In full and attach the required Questionnaire for Administrative Home Occupation Permit. Middle Initial or name required of all parties concerned. If no middle name, please indicate by writing NMN. Sign and return application with fee. Please advise of any change In status. New license required if business changes location or ownersh�. Notification to City of Edmonds required if business doses. License expires December 31" each year. Renewal must be submitted priortwo January 31 to avoid late fees. BUSINESS NAME Gx D A r: %j +r -�- 1 D Z 7 � GI Se � ,� ,^ e l � ` �. ( C� Q /� jn O n G S (�J� / G) 6 2'0 BUSINESS ADDRESS j2 Street Suite # : City, Mate, Zip Code �/] S t5a ` � � �y , / '"t_ V O MAILING ADDRESS Street or PO Box # Suite # City, State, Zip Code BUSINESS PHONE( (VI �0© — '�/��.^ WA STATE TAX ID#(UBI) Q Z D ©� �%, •''D BUSINESS E-MAIL `� Kr q S t�Y ✓I 15Z (,w/_ i /5, Q hp� BUSINESS WE851TE i esgC e 12&21%�G UILV � PROPERTY OWNER �` 'J K e /L Gt S j9(A- k g 1 I AG (e :30 O ame Phone Number EMERGENCY NOTIFICATION (For Premise Access In Eme ency): i A S i, - S CC.�t r � 1 --70 -- �v 0- Last Name eG FFrst ame "'S MI E Phone Number 7- 79 5- 2-- i,20bi— NATURE ,� OFF BUSINESS (Provide a�Detailed eDescription.�off Business Activities, Products & Services): P �Q t r,YYIR Irk! I r C ✓ \ [Lg L'"" ' L(/ti / h i Q �G. e C 11 �� C� 'h ke /lZ�rtc�G SPACE ALTERATIONS TO BE MADE: YES —_NO^ _ DESCRIPTION �— PREVIOUS BUSINESS AT THIS ADDRESS n'0 VJZ 7 NUMBER OF EMPLOYEES_ SQUARE FOOTAGE OF BUSINESS TYPE OF BUSINESS - PLEASE C E AP ROPRIATE CATEGORY: ❑ CONSTRUCTION ❑ FINANCE, INSURANCE, REAL ESTATE ❑ LANDSCAPE, HORTICULTURAL ❑ MANUFACTURING ❑ NON-PROFIT ❑ RETAIL ❑ SECONDHAND DEALER ❑ SERVICES ❑ WHOLESALE tl OTHER OPENING DATE: A SA P BUSINESS HOURS: r to DAYS OPEN: ❑ SUNDAY rrtkDNESDAY rdIAONDAY Oaf URSDAY ki'TUESDAY rRIDAY D ATURDAY (L4) �/o milt Ud AMUSEMENT DEVICES ON PREMISES? YES NO ✓ IF YES, TOTAL NUMBER LIQUOR SOLD ON PREMISES? YES NO '' GAMBLING? YES_ NO_ZZCIGAREtTES SOLD ON PREMISES? YES NO_pC FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED? YES NO -I' IF YES, PLEASE PROVIDE A LIST OF MATERIALS AND QUANTITIES: APPLICANT q NAME �� ' f TITLE 131Printed # .li (I APIj" DATE Signature k AIT '1 ZUlt - -- DuINv/vu� 111 X CURN NAYE {� n a s 1 ri SI Son L0.5T FIRST YIpOLE INRIgL PARTNERSHIP —PARTNER t NAME IaBT PYi6f MIOpLE INRNL AWRE66 STREET SMREVPTNNRR ft CRYSTATERPCOCE HOSE PHONE( 1 ORMER6'INENSEORIDBS I DAM0FBIRTIA CRY9TATEOFB OWNTRTOFIW PARTNERSHIP —PARTNER 2 xaME IAST FRET MIDDLE MITML AooRE3s STflEET 6OREIAPTNXffR NrvSTATE2IP CODE HOME PNOH ONVER'SLICENSEORIDN&6TATE MTE OF OWN ORY/BTATE OF WITH CWNTRYOFBMN RAW MORPORATIDM OORP.AOd1E8.9 CORPORATIONI LLC W PLLC TN(OE CORPORATE OFFCFAS: LM Nmne aNM RM Mm sMm,API.Iwv clr.swvARe�um PIMro Hu�AM ri MI Twe OMeoIBT OIWeM[slromOlMr OR/SINe LOGLOTXRACf (ffiN RR HBme MI T" OpNNp Dew�a p01Fe UP 18aM PMreNumM GRT MBE ONLY: SMIM"DE".. Q NWRME Q DS ROW DATE SN TME OCCUPANT LOAD BRAIDING PEAMR OCWPANGV GRdIP COMMENTS ENGINUM I Q gPfltpVE Q pA$ppgypyE PATE fiNiIANRE IRREOEPT. Q APpipyE Q DISAFPROTE DATE SIGAIMRE U.F.IR C MENT3 PLANNMM OFPT. Q APPRpyE Q DMAFPROAE DATE SIGNANRE 2 WO CODE GONORACNAL USE PERW COMMENTS POUCEYEPT. Q MPROME Q OISAPPROSE MTE SIGNATURE COMMEMS '`EQJVED CITY OF EDMONDS 'Pr' 7 nil QUESTIONNAIRE FOR ADMINISTRATIVE HOME OCCUPATIOMOVI h'I IT CjTyC - Y;�E] No 1. Will the home occupation be carried on exclusively by a family member(s) residing in the dwelling unit? 2. ❑ Cd Will there be employees working at or visiting the subject property, who are not family members residing at the residence? 3.� ❑ Will there be customers or clients visiting the property? 4. ® ❑ Will the home occupation be conducted entirely within the structures on the site, without any significant outside activity? If no, please explain: 5. ❑ Gd Will there be heavy equipment, power tools, or power sources associated with the home occupation? / If yes, please list types: 6. ❑ lid Will vehicles be used in conjunction with the hame occupation? If yes, please list all types, including gross vehicle weight of trucks: 7. ❑ IY'Will there be deliveries made to the property by commercial vehicles in excess of 20,000 gross vehicle weight, (example: standard UPS truck)? If yes, please explain: 8. ❑ 2 Will the home occupation create noise or vibration? If yes, please explain: 9. ❑ 0 Will the home occupation produce dust, odors, or smoke? ff yes, please explain: 10. ❑ I2Will the home occupation create any glare on public streets and neighboring properties, such as from lighting, welding, etc.? If yes, please explain: 11. ❑ a Will flammable and hazardous materials be handled or stored on the property? If yes, please explain: 12. ❑ Will materials in conjunction with the home occupation be stored outside of the dwelling? /If yes, please explain how and where: 13. ❑ Cd' Will there be a sign on the property in conjunction with the home occupation? If yes, please describe: The undersigned applicant for a business license certifies that the information provided within this application is correct and accurate. The applicant acknowledges that his/her business license is subject to suspension or revocation if false or misleading information is provided. Violation of any of the conditions and requirements of ECDC Chapter 20.20 will result in the loss of his/her business license and the forfeiture of any fee paid. APPLICANT: o-n J Name (Printed) Signature Date