WILLIAMSN
1.
T-i I IIQu4A
II
32
1992 BUSINESS LICENSE APPLICATION FORM
ou �
*APPROVED t�jL, INITIALS - DATE -'o
*DENIED INITIALS DATE
IS THIS BUSINESS LOCATED AT YOUR HOME: YES L/' NO
BUS. LIC. NO.
2. Business Name: ,
3. Business Address: !`q- i7 0 4. Mailing Address:
5. Business Phone:(
6. Owned By: CORPORATION PARTNERSHIP jI IDZV-1DUAL
7. If Corporation or Partnership: Tax I.D.#-
8 . If Individual Owner: Social Security #
. 9. Name of Owner Title:
Or Officers
s
10. Type of Business:
11. SBE Resale Number:
•
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$
B.. Previous Year Gross Receipts For Established Businesses:
$
********GOOD ONLY FOR JANUARY 1,1992 THRU DECEMBER 31,1992*******
I HEREBY CERTIFY that all the information supplied by me is correct and
any licenses required by the County, State or Federal Government have been
issued to me and are in force and effect.
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
Date
•
78-105 Calle Estado
P.O. Box 1504
S La Quinta, CA 92253
CITY OF LA QUINTA (619) 564-2246
HOME OCCUPATION APPLICATION
Read each condition listed on the attachment to this form to see if the
proposed -activity -can -comply -with -the -City's Home Occupation Regulations
APPLICANT'S NAME Rnnnie Gillman PHONE 564-4105
PROPERTY OWNER Rnnn;c- Irl;11man PHONE 564-4105
PROPERTY ADDRESS 54-860 Ave. Alvarado
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSINESS WIL; OPERATE
_--- --11- ,
NUMBER. OF PERSONS INVOLVED IN BUSINESS two myself and wife
LIST NAMES OF PERSONS EMPLOYED none
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (.EXCLUDE GARAGE) 110SF bedroom
• LOCATION AND SQUARE FOOTAGE OF
BUSINESS ACTIVITY IN HOME AREA OF
PLE
"BEDROOM - 125 S.F.")('
STAMP
OCT 01992
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPL r.a �a�,lr�,- �--E
BUSINESS OPERATION 1 car 1 van
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATrnrurni
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
uwNLR/AGENT SIGNATURE
DATE
IMPORTANT: False or misleading information shall be
grounds
your Home Occupation; failure to comply with conditions listedoondtheing
attached page shall be grounds for revocation of permit.
Building and Safety PI.P—ar4ont
APPROVED BY DATE_
DENIED BY DATE
CONDITIONS ATTACHED