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LICENSE NO._ <br /> CITVO REmVOODCITY &R}q <br /> BUSINESS LICENSE <br /> P.O. BOX 3355 <br /> 1017 MIDDLEFIELD RO,~ <br /> ~DWOOD CITY, CA 94063 <br /> TELEPHONE (650) 780-7214 / FAX (650) 368-6974 <br /> f ~r <br /> ~USINESS ADD.SS &~5~ <br />MAILING ADDRESS &lGffl Prm'ci~ ~. G~too¢~k ~ <br />SELLERS ~ERMiT NO. ~ ~Y~C ~ -Z~ & ~ 3 STATE CONTraCTOR LiC. NO. <br /> <br /> BUSINESS TYPE: <br /> ~ SOLE PRO?Ki-'-TOR SOCLKL SECbKITY NO. DRIVER'S LICENSE NO. <br /> <br />El PARTNERSHIP FEDERAL TAX ID NO. <br />~;~/'CORPOIL&TION FEDERAL TAX ID NO. 6~'-~5 I} q ~ <br /> <br />If Real Estate Rental: <br />RESDENq-IAL: No. &units I NO. OF COIN ,MACHINES, if any <br />COMMERCIAL: No. of square feet [ NO. OF DELWERY TRUCKS. if any <br /> [ <br />IN CASE OF EMERGENCY, LIST A CONTACT PERSON FOR POLICE AND FIRE DEPARTMENT: <br /> 0fL Hadd%e~os- ¢,e~, ¢q~c. q~5- 6-oq-~3qqq <br />I declare, under penaky ofpeo~ry, that this application has been prepared by me or under my direction, and to the best of my <br />knowledge and_C_.h~f, is true and correct. <br />SIGNATL',~E~,.,~j~Lr.~ ~ ~.~ Cff2.c,2.OL~/' TITLE ~,,~ ~;". DATE <br /> <br /> Make check payable to CITY OF REDIVOOD CITY <br /> <br /> FOR OFFICE USE ONLY <br /> <br /> FEE CALCULATION Pl.. ~NNF REVIEW <br /> <br />BASE FEE = $. ,~ ~ ~2_ Al OVED <br />No. of persons x $ = $ APPROVED SUBJECT TO <br />No of un!ts ¥ c = 5. CONDITIONS OF SECTION 2.50 <br />No. of square feet (HOME OCCUPATION) <br />Commercial x $ = $. FIRE DEPT APPROVAL'PER.MIT <br />PENALTY = $ DENIED <br /> <br /> CONDITIONS COMMENTS <br /> TOTAL FEES DUE = $~ <br /> <br /> APPLICANTS SIGNATURE <br /> <br /> <br />