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WORLDWIDE GROSS INCOME
What do you anticipate your businesses annual worldwide gross income to be?(Worldwide gross is total income regardless of
location) The business license fee is based on anticipated total worldwide gross income. See page 3 to determine the license fee. ( Check
One)
☐ Over $250,000 ☐ Between $12,000 and $250,000 ☐ Less than $12,000 - Refer to non-reporting status details on page 4
COMMERCIAL AND INDUSTRIAL SURVEY
The City of Tacoma must inventory all commercial or industrial users of the City's storm and sanitary sewer systems in order to help our
businesses protect the quality of our waterways and the wastewater treatment system. If your business is in the City of Tacoma, Fife
Ruston or Fircrest, please answer the following question. For questions regarding this survey, please contact City of Tacoma's
Environmental Service Science and Engineering Division at 253-591-5588. Do you or will you discharge wastewater, other than
domestic waste*, into the public wastewater system? Yes ❐ No ❐ *“Domestic wastewater” is defined as water carrying human wastes
including kitchen, bathroom, and laundry wastes that are typical of residential discharges
CERTIFICATE OF COMPLIANCE - PAID LEAVE
Per Title 18 of the Tacoma Municipal Code (TMC), the City requires all employers to provide Paid Sick Leave to all employees that work at
least 80 hours in any benefit year within the city limits. Visit cityoftacoma.org/employmentstandards for more information. Please review
and check the appropriate box below.
☐I certify that I comply with the requirements of TMC Title 18. I have employees that work in the City of Tacoma at least 80 hours in a
benefit year and I give them at least 1 hour of Paid Sick Leave for every 40 hours they work as set forth in Title 18.
☐ I am not familiar with the requirements of Title 18. I will visit the City website or call 253-591-5306 to learn more about Tacoma's Paid
Sick Leave requirements to ensure my business is in compliance.
☐ I do not have employees or I do not have employees that work 80+ hours in a benefit year in Tacoma.
RENTAL PROPERTY - WITHIN CITY LIMITS
Do you own real estate that you rent or lease inside Tacoma? Yes ☐ No ☐ If yes, complete the rental address information:
Rental Address_____________________________________________________________________________# of units________________
Dwelling Type: ☐ Commercial ☐ Single Family ☐ Multi Family
Monthly Rental Income $ _____________Local Agent Name_________________________________________________Phone___________________
If you have more rental properties in the City of Tacoma, please attach additional rental address information to application.
DEMOGRAPHIC INFORMATION - You are not required to answer these questions, however your participation is encouraged to help the City of
Tacoma better understand the community we serve.
1. What is the racial/ethnicity identity of the business owner(s) with majority-stake (at least 51% of ownership)? Check all that apply.
☐American Indian or Alaska Native ☐Asian ☐Black or African American ☐Hispanic/ Latino/ Spanish Origin
☐Native Hawaiian or other Pacific Islander ☐White Other
2. Is the business woman-owned? To be considered a women-owned business, the business must be held with majority-stake (at least 51%) of
ownership by a woman or collectively by women. ☐ Yes ☐ No
SIGNATURE - Must be signed by sole proprietor or spouse, member, partner or corporate officer
The undersigned acknowledges that this business will operate consistent with zoning standards, meet fire and building code requirements,is governed by the Tacoma
Municipal Code, and is responsible for becoming familiar with the code and abiding by its requirements. See page 3 and 4 for details and filing instructions. The
undersigned hereby certifies under penalties of perjury that the information included here is correct to the best of his/her knowledge and belief.
Signed by_______________________________________________ ______________________________________________________
(Sole proprietor, partner, officer or member) Signature of preparer if other than owner, partner, officer or member
Title___________________________________________________________________________________Date____________________________________________________________________________
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