HomeMy WebLinkAboutPeddler Permit Application_________________________________________________________________________________________________________________
City of Renton Tax & Licensing • 1055 S Grady Way, Renton, WA 98057 • 425-430-6851 • taxandlicensing@rentonwa.gov • rentonwa.gov
City of Renton Tax & Licensing Peddler Permit Application
Non-Refundable Fee
$75.00
All persons, both principals and agents, as well as employers and
employees, who sell, offer for, or expose for sale, or who shall trade, deal,
or traffic in any personal property or services in the city by going from
house to house or from place to place or by indiscriminately approaching
individuals must apply individually for a peddler's permit.
Applying as: ☐ Employee ☐Employer* ☐ Principal*
*Each employer/principal(s) must also complete the supplemental form
Items required with application: 1) two passport photos (2” x 2) taken within 60 days of application.
2) a copy of applicant’s current State ID with picture.
This is an APPLICATION ONLY – it is NOT a permit to conduct business.
Business Name: Home address:
Applicant legal
name:
Date of birth: Business address:
☐same as homeSocial Security #: All correspondence will be mailed to this address
Driver’s License #: Email address:
Business phone: Renton Business
License #:
Cell phone: WA State Dept of
Revenue #: (UBI#)
Height: Weight: Age: Nature of business
description:
Hair color: Eye color:
Ownership status:
☐Corporation ☐ Non-profit
(exempt) Goods or services
to be sold:
☐Sole Proprietor ☐ Partnership
Business will be
conducted:
☐Door to Door ☐Other All sales to occur on a parcel of land must be upon property
zoned CB or RB and a peddler’s site plan/authorization must
accompany the application. ☐Set location/
address:
If employed or acting as an agent, list the name, address, and phone number of the employer(s) or principal(s) and their relationship:
*Each employer and/or principal must also apply separately and complete the supplemental form
Name: Phone: Address: Relationship to applicant:
Will a vehicle be used? ☐ Yes If yes: Plate #: Make: Model: Color:
☐ No
Has applicant (includes application by employer and/or principal) been convicted of any crime within the last 10 years, including misdemeanors, gross misdemeanors, or violations of any municipal ordinance? ☐ No ☐ Yes
If yes, list the nature of the offense and the punishment or penalty assessed:
_________________________________________________________________________________________________________________
City of Renton Tax & Licensing • 1055 S Grady Way, Renton, WA 98057 • 425-430-6851 • taxandlicensing@rentonwa.gov • rentonwa.gov
City of Renton Tax & Licensing Peddler Permit Application
I hereby certify and declare under penalty of perjury under Washington law that the statements furnished by me on this application are true
and complete to the best of my knowledge and that I will comply with the provisions of the Renton Municipal Code in doing business in
Renton. I understand that any untrue statement is cause for revocation of my permit.
Date: __________ Signature: Printed Name: ___
STATE OF WASHINGTON )
COUNTY OF KING )
I certify that I know or have satisfactory evidence that ____ signed this instrument and acknowledged
it to be his/her/their free and voluntary act for the uses and purposes mentioned in this instrument.
Notary Public in and for the State of Washington
Notary (Print):
My appointment expires: Dated:
_________________________________________________________________________________________________________________
City of Renton Tax & Licensing • 1055 S Grady Way, Renton, WA 98057 • 425-430-6851 • taxandlicensing@rentonwa.gov • rentonwa.gov
City of Renton Tax & Licensing Peddler Permit Application
Supplemental Form for Employers and Principals
Applying as: ☐
☐
Employer
Principal
Business Name: Business Address:
Business Phone:
City of Renton Business License #
for Employer: Cell Phone:
Email:
ALL EMPLOYEES AND AGENTS APPLYING FOR PEDDLER PERMIT
Employee Name: Employee Address: Employee Cell Phone:
MANAGER(S) FOR APPLICANT(S) CONDUCTING BUSINESS IN RENTON
Name: Address: Business Phone:
Home Phone:
Email:
Ownership of Business: ☐Sole Proprietor ☐Partnership ☐Corporation ☐Non-profit (exempt)
If a corporation or Partnership, provide name, address, and phone number of Board of Directors, principal officers, registered agents,
and/or partners: (attach additional sheet if needed)
Name: Address: Phone:
Title:
Name: Address: Phone:
Title:
Name: Address: Phone:
Title:
Name: Address: Phone:
Title:
_________________________________________________________________________________________________________________
City of Renton Tax & Licensing • 1055 S Grady Way, Renton, WA 98057 • 425-430-6851 • taxandlicensing@rentonwa.gov • rentonwa.gov
City of Renton Tax & Licensing Peddler Permit Application
Has any of the above been convicted of any crime within the last ten years, including misdemeanors, gross misdemeanors, or
violations of any municipal ordinance? ☐ No ☐ Yes
If yes, list name/title, nature of the offense, and the punishment or penalty assessed:
Please list other cities, towns, and counties where the applicant has obtained a peddler's permit or similar permit within the
past five years:
I hereby certify and declare under penalty of perjury under Washington law that the statements furnished by me on this application are true
and complete to the best of my knowledge and that I will comply with the provisions of the Renton Municipal Code in doing business in
Renton. I understand that any untrue statement is cause for revocation of my permit.
Date: __________ Signature: Printed Name: ___
STATE OF WASHINGTON )
COUNTY OF KING )
Signed and sworn to (or affirmed) before me on by __.
Notary Public in and for the State of Washington
Notary (Print):
My appointment expires: Dated: