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,\ CITY OF LA QUINTA
�( HOME OCCUPATION APPLICATION
78-105 Calle Estado
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
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 6'f05e�2 %� Ko44Aq iL PHONE
PROPERTY OWNER 452 /G PHONE 4;/9-,5-6 'r1' -1 -?,9Z
PROPERTY ADDRESS 53.795 14t1tW106 ;:Fk7ea, 44 4y11V7# . CA 922E3
TYPE OF RESIDENCE (single, multiple, mobile home, etc.). S1/y1/L16
TYPE OF BUSINESS lly/ /Lo/- 344PMA
BRIEF .DESCRIPTION OF HOW THE BUSINESS WILL OPERATE Awl//OE CG✓�/YT-SiTE
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
PAID $35.00
SQUARE FOOTAGE OF USABLE .FLOOR AREA IN CITY OF LA QUINTA
HOUSE (EXCLUDE GARAGE) / V3U SD 14,4- VALIDATION -STAMP.
AUG 3 1992
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME ( EXAMPLE, . BUILDING AND SAFE DEPT.
"BEDROOM - 12 5 S.F.") �DR4a* 1 / 125 s f BY
1e6 ToTRL s.F, % F,0k-0&M 4 &0 5,.,
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN.THE
BUSINESS OPERATION CO/Y�AvT6.e Oft�G�/�.E�/V/TU.P�' ji✓B S'flM,dtE /d0%S
_lqt✓�b 13h- G C`,C/GE Sv��uEs
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
CANT SIGNATURE
TE
IF APPLICANT IS
OTHER THAN
PROPERTY OWNER,
AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
,
J".-,
SIGNATURE
v.
IMPORTANT: False or misleading information shall be grounds for denying
your Home Occupation; failure to comply with conditions listed on the
attached page shall be grounds for revocation of permit.
B uilzing and Safety De a tment
APPROVED. BY 1/DATE CONDITIONS ATTACHED
DENIED BY DATE
9F
�W BUS. LIC. NO.
1992 BUSINESS LICENSE APPLICATION FORM
0-'92'* 14
18.00
*APPROVED INITIALS DATE
*DENIED INITIALS DATE
******************************************************************
1. IS THIS BUSINESS LOCATED AT -YOUR HOME: YESy NO
2. Business Name: 11711E"2/Q,e Aec /y%s z11z1r'eS6-
3. Business Address: 4. Mailing Address: 4���
53.7,95-
.9 v�.v�r q FEZ
A'9- i2 �A. �.� 922s-3
5. Business Phone:(
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
B. If Individual Owner: Socials Security # 382 -62D- 63-39
Name of Owner �dSE/j?fi/Z� UOLL�'!t2 Title: .040IV62
Or Officers
10. Type of Business:
11. SBE Resale Number: S/9f4C /.3.- 606 S7f8
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ z��®o
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 full force and effect.
Signature Title
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box.1504
La Quinta, CA 92253
Date