CEJA•
CITY OF. LA OUINTA
HOME OCCUPATION PERMIT
APPLICATION
76-106 Calla Eels
P.O. sox 1601
Le oulnla. CA $2
(610)664-2216
Read each condition listed on tt.e attachment to this form to see if the
proposed activity can comply with the City's Home Occupation Regulations.
ITYPE OR PRINT 1N 1NK)
APPLICANT'S NAME
PROPERTY OWNER
PROPERTY ADDRESS
PHONE ` -,Vf Z
PHONE 418 Z
TYPE OF RESIDENCE (single, multipl , mobile home, etc.) 15JQ V 1.•+e
TYPE OF BUSINESS L 1
B ,�,SCWIP�IJ }IOV& A*A0NeNM'5/�E E ,� T3%��,_ �.
NUMFER OF PERSONS INVOLVED IN BUSINESS !�
LIST NAMES OF PERSONS EMPLOYED PIKWei �• LG�'� ! &�l�� F•
In g -r M
SQUARE FOOTAGE OF USABLE FLOOR AREA IN -` — """4119^
HOUSE ( EXCLUDE GARAGE) VALIDATION
STAMP
LOCATION AND SQUARE FOOTAGE.OF AREA OF O C T 1 8 1991
BUSINESS ACTIVITY IN HOME 1EXAMPLE,
"BEDROOM�D_UARX-MET") BUILDWG AND SAFETY
DESCRIPTION 3�F SMC ERRY QUI rr AN aSUP� ES BEING USED IN TH . BUSINESS
OPERAI
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION�JZALLOWED (CONDIT S ATTACHED).
APPLICANT SIGMA
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
IMPORTANT: False or misleading information shall be grounds for denying your
Hole Occupation; failure to comply with conditions listed on the attached page
shall be grounds for revocation of permit.
SUILD i SAFETY DEPAR �q�
APPROVED B /Y DATE CONDITIONS ATTACHED
DENTED BY DATE
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FRANK R CEJA
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52145 AVENIDA BERMUDAS
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LA QUINTA, CA 9225
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Pahg Oasert Branch 0585
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P.O. Box 1198
Palen Qgsert. CA 92280
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BUS—LIC. NO.
4
.1991 BUSINESS LICENSE APPLICATION FORM
*APPROVED l/INITIALS!7 DATE -
*DENIED INITIALS DATE
******************************************************************
IS THIS BUSINESS LOCATED„AT YOUR HOMEij YES. NO
2. Business Name:
3 .
5.
Business Address: JrZ� ¢ 4
Business Phone: ( c1401!j ) ¢%
Mailing Address:
smf.
Z
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership: Tax I.D.# �2
8. If Individual Owner: Social Security #
•
9. Name of Owner �, 4AI4 ,4 4�&1,' Title: GAuI✓��- DY✓SUi-'mow%'
Or Officers
10. Type of Business:
11. SBE Resale Number:
t
V
5
12.- BUSINESS LOCATED WITHIN THE CITY OF LA,QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$
S� 1
B. Previous Year Gross Receipts For Establishf@0ll#k"4li05-9S,,t.00 t4
IL
********GOOD ONLY FOR JANUARY 1,1991 THRU DECEMBER 31,1991*******
I HEREBY CERTIFY that all the information supplied by me is correct and
any licenses requiredthe County, State or Federal Government have been
issued " me and.are!b full force and effect..
• Signature
Title
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
uaLe
1
•
BUS—LIC. NO.
PAin NOV 051991
1991 BUSINESS LICENSE APPLICATION FORM
*APPROVED l/INITIALS 7�7DATE
*DENIED INITIALS DATE
1. IS THIS BUSINESS LOCATEDAAT YOUR HOME YES_ NO
2. Business Name:
3.
5.
Business Address : SZ/ 4!�' 4.
Business •Phone: ( cam) 4-- ¢l�'
Mailing Address:
sA46.
Z
6. Owned By: CORPORATION PARTNERSHIP <INDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security #
Is 9. Name of Owner �, A&,R 4::�aT,4 Title: I✓�ii� SSU )Ni
Or Officers
10. Type of Business:
11. SBE Resale Number:
R
• 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 Establishp#0!Ij#L1i105-91n,.00 14
********GOOD ONLY FOR JANUARY 111991 THRU DECEMBER 31,1991*******
I HEREBY CERTIFY that all the information supplied by me is correct and
any licenses required b the County, State or Federal Government have been
issue me and.are full force and effect.
J. I " k �. �-- -'/� dlAIA1��
Signature Title Date
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504'
La Quinta, CA 92253