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APPLICATION USINESS LICENSE <br /> -pG SAN JOAQUIN COUNTY COMMUNITY ELOPMENT DEPARTMENT <br /> :< �v 2008 <br /> '• BUSINESS LICENSE NO. <br /> <<FOR <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> FBRusiness Name: AMEIZ_) CAIt PIL� DrZi�/1N QUI M1✓�T <br /> Business Address: 2`1 0!5 Lb©MIS V—D Cross St <br /> DBA Mailing Address: City: S j©LKTUrA State: o01 ZIP: �j Zp <br /> Phone#: Assessor Parcel Number(s): I-71— t) -'23 <br /> Email: <br /> Other Businesses at this Address: <br /> Previous Business at Address: VI STA CA qq <br /> Type of Business: <br /> �ENTAt PrNb SALE o�: 'FIL-ED�,IVINfi RJ17MENE <br /> Type of Organization: ❑ Single Owner ❑ Partnership P Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: 0 <br /> Applicant Last Name: h u h If S Applicant First Name: LAW E N LE <br /> Applicant Mailing Address: I Cl V" SIT <br /> City KENT State Vj A- ZIP �D1j1_ Applicant Phone No: <br /> Water Supply:�ublic ❑ On-site Well Sewage Disposal: Public E] Septic System <br /> 9 <br /> Will there be any sale of firearms? ❑ Yes U No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I,affirm,all the above i ation is tru r t Date: <br /> Applicant's Signature; <br /> STAFF USE ONLY <br /> G <br /> IPignation: ( j_ Zoning: (—G /—L Use Type: S r �� �c 0 ix t <br /> DEPARTMENT APPROVED DENIED J M� !� DATE <br /> ment Services Planner Name: (� Z <br /> Inspection <br /> mental Health Div <br /> rden <br /> orks <br /> .D. <br /> (Junk Dealers Only) <br /> Approved For: ew 6k S,e !S l4 lff-e (GZ r T 10r <br /> Remarks: C T�0 7 f <br /> Occ.Grp. l� <br /> Accepted as Complete: Date: <br /> F:1DevSvc\P1anning Application Forms\Business License(Revised 05-01-08) Page 2 of 7 <br />