Laserfiche WebLink
<br />TAX ACCT # <br />CONTROL # <br />TAG # <br />CLASS <br />SINC <br /> <br />BOE <br /> <br />EXP: <br />FOR OFFICE USE ONLY: <br />CITY C_,Ar: STOCKTON <br />ADMINISTRATIVE SERVICES DEPARTMENT <br />REVENUE SERVICES DIVISION—BUSINESS LICENSE TAX <br />425 North El Dorado Street • PO Box 1570 • Stockton, CA • 95201 <br />Phone (209) 937-8313 Fax (209) 937-7184 <br />Email: bl(stocktonca.qov <br />www.stocktonca.goy <br />BUSINESS LICENSE TAX APPLICATION <br />NEW V City of Stockton Number of Employees: Full Time Part Time Temporary <br />CHANGE From: Date of Change Bus Lic # <br />NOTE: Any change in ownership, address, or business activity, requires a new application. The City of Stockton does not <br />guarantee that information on this form will be exempt from disclosure under the Public Records Act. <br />**ALTERED OR INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED** <br />BUSINESS INFORMATION: <br />Business Name (DBA) 1. E eriSe (Rctsiei Toe) Phone ( 2)e1 ) 2O1 <br />Business Address (No PO Box) I 7:5-M S- WASOrl i.Aktj Ste/Apt # City Silk-14+er State G; ZipCi 20S <br />Business Mailing Address Ste/Apt # City State Zip <br />Business involved in renting residential or commercial real estate (Stockton only): <br />Property Address /VI+ <br />Property Owner Parcel # <br />-7-r147 Business Activity Description k..,L:Prx-Ifx e3 <br />Are you Chamber of Commerce Green Certified? Yes No X (For information contact Chamber of Commerce (209) 547-2770) <br />Is this a "Green Industry" business? Yes No Square Footage of Business Facility <br />Start date in Stockton /01/414 /244 Estimated Monthly Gross Receipts in Stockton $ <br />Contractor's only: Project Amount CA Contractor's License # <br />Classification Expiration Date <br />Seller's Permit # 10 2 Li 1) lc( 5 Federal Tax ID # 109 19'9 <br />Check One: Single Owner 0 Partnership 3:SI Corporation LI LP III LLC 0 Trust <br />Owner(s) Information: (Attach a separate piece of paper if additional space is needed.) <br />Name Plaxn0 in Etc) eArre ti.) e.nSt (, 6 tivOome Address (NO PO Box) Vb N S • Vv .1 %Wis./ Wctl <br />City StDr-A6--i—ov• State Ca. Zip Ci S2-0 S Home Phone ( ) <br />Soc. Sec. #573 -1C —qkCI Date of Birth NOV 17 1 1052 Driver's Lic./I.D.#XL1311034State CC1 , <br />Name Home Address (NO PO Box) <br />City State Zip Home Phone ( ) <br />Soc. Sec. # Date of Birth Driver's Lic./I.D.# State <br />COMPLETE PAGE 2 OF THE APPLICATION