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DOMINGUEZ11111111111111111111 oa /CITY Of LA WNW HOME OCCUPATION PERMIT APPLICATION 78-105 Celle Eefede P.O. Box 1504 Le QulnN,CA. 9221131 ,1619) So* -1246 664-2246 PLANNING DIVISION 'jam 6/87 ead each Condition listed on the severs e s e o i s form to see f the proposed activity can comply with the City's Home Occupation - Regulations. $35.00 fee TYPE OR PRINT IN INK APPLICANT'S N ' -V PHONE . b'1 BROPERTY OWNER4* Z PHONE PROPERTY ADDRESS Z (Street) 1,-a �-z� � (City) (State) (Zip) Type of residence (Singlet, Multiple, 1mobile home, etc.) 6(✓A& Type of businessT�_)'in��atreco C.tG�1tY1Ga. Srie�f description , f how the business will o,ppe�rate P✓`.� _ in 0117.3 D�'1'.PS C - ©Mona. 03-kq' Q nm2.� . Number of persons involved in business List names of persons employed D - Square footage of usable floor area in house (exclude garage) JaQQ Validation Stamp 005182 10 4571 02-08-89 i0 Location and square footage of area of 0 CASH i TOTAL I 35.00 business activity in home (example: bedrooms; 125 square ee ) 1Wj S(a. rre Description of machinery, equipmerkt, and supplies being used in the business operation+�� InawiDt�� • iXlGk [��c:K . I have read and understand and agree with the conditions by which a home occupation is allowed (Conditions on reverse side). APPLI SIGMA DATE If Applicant is other than property owner, authorization of owner or agent required. OWNER OR AGENT SIGNATURE DATE IMPORTANT: False or misleading information shall be grounds for denying your Home Occupation, or failure to comply with conditions listed on reverse shall be grounds for revocation of permit. (� • • f • • f f • Q f R R R y I►PPROVED 90114- Initials a 8 ^ U Date CONDITIONS ATT HED DENIED .;'Initials Date LQHOMOCC.PRT I