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FEE $35.00
4 4v
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
HOME OCCUPATION PERMIT
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.
BUSINESS NAME
PROPERTY OWNER _
PROPERTY ADDRESS
MAILING ADDRESS
TYPE OF RESIDENCE
TYPE OF BUSINESS
BRIEF DESCRIPTION
NUMBER OF PERSONS INVOLVED IN BUSINESS a
LIST NAME OF PERSONS EMPLOYED A/o n C Z o wKc�S
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) �1 S00
LOCATION AND SQUARE FOOTAGE OF
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUI,,
BUSINESS OPERATION PU.ce. cog -
AREA
CG h -1qj c ( 6 e v s e -Q fo •^ 5 `f �9 4�k� e.
?MENT, AND SUPPLIES BEING USED IN THE
foie. cs 6e- e
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATIQN IP ALLOWED (CONDITIONS ATTACHED).
OZA/4- /11AL(
APPLICANT SIGNATURE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS REQUIRED.
OWNER/AGENT SIGNATURE DATE
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.
Bu&lding_and Safety Department
i APPROVED DENIED CONDITIONS ATTACHED
1. .N0 fRF]97/UCAIT
- .S 13E --
A J
3E--,N L-�?�&77
04,
THIS PERMIT DOES NOT
AUTHORIZE THE HOLDER
TO EW GAGE IN ANY
BUSINESS COMRARY TO
LAWS REGULATING THAT
BUSINESS OR TO
POSSESS OR OPERATE
ANY ILLEGAL DEVICE.
Not valid at any other address
BT -442 -R -LZ REV. 10 (6-90)
CALIFORNIA STATE BOARD OF EQUALIZATION
SELLER'S PERMIT
ACCOUNT NUMBER
x10/1/1994 SR ERC 99581343
DESERT TENNIS COURT SUPPLIES
51255 AVE. DIAZ
LLA QUINTA, CA 92253 J
IS HEREBY AUTHORIZED PURSUANT TO SALES AND USE TAX LAW
TO ENGAGE IN THE BUSINESS OF SELLING TANGIBLE PERSONAL
PROPERTY AT THE ABOVE LOCATION
THIS PERMIT IS VALID UNTIL REVOKED OR CANCELLED BUT IS NOT TRANSFERABLE. IF YOU SELL YOUR BUSINESS,
OR DROP OUT OF A PARTNERSHIP, NOTIFY US OR YOU COULD BE RESPONSIBLE FOR SALES AND USE TAXES
OWED BY THE NEW OPERATOR OF THE BUSINESS.
DISPLAY CONSPICUOUSLY AT PLACE OF BUSINESS FOR WHICH ISSUED
NOTICE TO TAXPAYERS
INFORMATION FURNISHED TO THE BOARD OF EQUALIZATION
The Information Practices Act of 1977 requires this agency to provide the following notice to individual taxpayers who are asked by the State
Board of Equalization to supply -information:
The principal purpose for which the requested information will be used is to administer the California Sales and Use Tax taws, Special (Excise)
Tax Laws, or Timber Yield Tax Law. This includes the determination and collection of the correct amount of tax
As an individual taxpayer, you have the right of access to personal information about you In records maintained by the State Board of
Equalization. Please contact your local Board office listed in the white pages for assistance. The Board officials responsible for maintaining this
information are: Sales and Use Tax, Deputy Director, Sales and Use Tax Department, 450 N Street, MIC:43, Sacramento, CA 95814, telephone
(916) 445-6464; Excise Tax and Environmental Fee Tax, Deputy Director, Special Taxes and Operations Department, 450 N Street, MIC:31,
Sacramento, CA 95814, telephone (916) 327-4208; Timber Yield Tax, Deputy Director, Property Taxes Department, 450 N Street, MIC:63,
Sacramento, CA 95814, telephone (916) 445-1516.
If the local Board office or Deputy Director Is unable to provide the information sought, you may also contact the Information Security Office in
Sacramento, telephone (916) 324-1627.
The California Revenue and Taxation Code, Parts 1, 1.5 and 1.6 (State Sales and Use Tax), 2 (Motor Vehicle Fuel Tax), 3 (Use Fuel Tax), 7 (rax
on Insurers), 13 (Cigarette and Tobacco Products Tax), 14 (Alcoholic Beverage Tax), 18.5 (Timber Yield Tax), 19 (Energy Resources Surcharge),
20 (Emergency Telephone Users Surcharge),. 22 (Hazardous Substances Tax Law), 23 (Solid Waste Disposal Site Cleanup and Maintenance Fee
Law), 24 (Oil Spill Response, Prevention and Administration Fees), and 26 (Underground Storage Tanks Maintenance Fee Law); Government
Code, Title 7.3, Chapter 6 (Tire Recycling Fee); Public Resources Code, Div. 30, Part 7, Chapter 4 (Oil Recycling Fee); Health and Safety Code,
Div. 1, Part 1, Chapter 2, Article 4.6 (Childhood Lead Poisoning Prevention Fee); and Chapter 1 of the Public Utilities Code (Hazardous Spill
Prevention Fee) require persons meeting certain requirements to file applications for registration, applications for permits or licenses, and tax
returns or reports in such form as prescribed by the State Board of Equalization.
It is mandatory that you furnish all of the required information requested by applications for registration, applications for permits or licenses, tax
returns and other related data. Failure to provide all of the required information requested by an application for a permit or license could result
in your not being issued a permit or license. In addition, the law provides penalties for failure to file a return, failure to furnish specific
information required, failure to supply information required by law or regulations, or for furnishing fraudulent information.
Pursuant to California law, the information appearing on the face of any permit or license issued by the Board is a public record. Information you
furnish to this agency may be used for the purpose of collecting any outstanding tax liability and may be given to federal, state and local
government agencies as authorized by law.
GA -324-A REV. 5 (6.93)
BUS. LIC. NO.
1994 BUSINESS LICENSE APPLICATION FORM
***************** *
*APPROVED BY
* DATE AO^
**************************
......PROOF OF WORKERS COMPENSATION INSURANCE -IS REQUIRED........
1.
IS THIS BUSINESS LOCATED AT
YOUR HOME: YES— NO
2.
Business
Name: [�PSP�f TCK�I�S
Co���. SVDOII�S
3.
Business
Address:
4. Mailing Address: R .S°'JL 15 2
S I -�,55
Aue Adn Ut5i , L -L
Q�tw+ti l.y l?,;t.4 C
5.
Business
Phone:(
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership Tax I . D . # 33 - 09 6 d311
8. If Individual Owner: Social Security #
9. Name of Owner Fos�i1e..^ Title • poesla e4
toOr Officers
10. Type of Business: Te -1-11'f Cov�TS�pp�[e3
w 11. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNTY HEALTH PERMIT:
YES NO
ol 12 SBE Resale Number: 0�� �G�HC-
12.
13. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
WN
B.
Estimated Gross Business ceipts
s -
for New Bus
Previous Year Gross Receipts For Established
$ 3 .5 4 o o
********GOOD ONLY FOR JANUARY 1,1994 THRU DECEMBER 31,1994*******
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.
o,G�tc,Y��
Signat
Title
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
78-495 Calle Tampico'
La Ouint-.a. rA g22c;l
Da