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BELL• CITY OF LA OUINTA NOME OCCUPATION PERMIT APPLICATION 78-106 Cello Est• P.O. Box 1601 Le Oulnte. CA 92 (610)661-2246 Pead 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. (TYPE OR PRINT IN INK) NUMBER OF PERSONS INVOLVED IN BUSINESS /�/(J� - L"_! /""/tA-�.x -1"1' LIST NAY,ES OF PERSONS EMPLOYED 4 �� �/ )L) z"L— SQUARE FOOTAGE OF USABLE FLOQR AREA IN HOUSE (EXCLUDE GARAGE) / L"0 n LOCATION AND SQUARE FOOTAGE. OF AREA OF BUSINESS ACTIVITY IN HOME (EXAMPLE, BEDROOM - 125 SQUARE.FEET")_ A DESCRIPTION F MACHINERY, OPERATION VALIDATION STAMP 005182 N 4131 08-9-9i i0 10 CASH i TOTAL i' 1.00 , AND SUPPLIF*S DEM97USED IN.THE BUSIWESS -7'9�--' n I HAVE READ, ERSTAN' , AND AGREE WITH THE CONDITIONS BY WHICH A HOME OCCUPATIO S ED (CON ITIONS ATTACHED). �/�.y �I APP C T SIGNATURE DATE IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT REQUIRED. OWNER/AGENT SIGNATURE DATE IMPORTANT: False or misleading information shall be grounds for denying 'your HoleOccupation; failure to comply with conditions listed on the attached page shall be grounds for revocation of permit. ------------ SUILD11k i SAFETY DEPAR C APPROVED BY / YDATE �� CONDITIONS kTTACHED DEN: ED BY DATE , ------------- I IIIIII VIII IIII IIII 74 !/ 4 ����` �� LL- PHONE 6�� APPLICANT'S NAME PROPERTY OWNER��_ / �� f 7/E� cT) 142— PHONE PROPERTY ADDRESS /f c�I / ��) 7-4 24— TYPE OF RESIDENCE (single, multiple, mobil home, etc.) �C-ycG /�� r C,/ TYPE OF BUSINESS BRIEF DESCRIPTION OF HPW THE BUSINESS WL 9PERI�TE NUMBER OF PERSONS INVOLVED IN BUSINESS /�/(J� - L"_! /""/tA-�.x -1"1' LIST NAY,ES OF PERSONS EMPLOYED 4 �� �/ )L) z"L— SQUARE FOOTAGE OF USABLE FLOQR AREA IN HOUSE (EXCLUDE GARAGE) / L"0 n LOCATION AND SQUARE FOOTAGE. OF AREA OF BUSINESS ACTIVITY IN HOME (EXAMPLE, BEDROOM - 125 SQUARE.FEET")_ A DESCRIPTION F MACHINERY, OPERATION VALIDATION STAMP 005182 N 4131 08-9-9i i0 10 CASH i TOTAL i' 1.00 , AND SUPPLIF*S DEM97USED IN.THE BUSIWESS -7'9�--' n I HAVE READ, ERSTAN' , AND AGREE WITH THE CONDITIONS BY WHICH A HOME OCCUPATIO S ED (CON ITIONS ATTACHED). �/�.y �I APP C T SIGNATURE DATE IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT REQUIRED. OWNER/AGENT SIGNATURE DATE IMPORTANT: False or misleading information shall be grounds for denying 'your HoleOccupation; failure to comply with conditions listed on the attached page shall be grounds for revocation of permit. ------------ SUILD11k i SAFETY DEPAR C APPROVED BY / YDATE �� CONDITIONS kTTACHED DEN: ED BY DATE , ------------- I IIIIII VIII IIII IIII 74 • • 5. G, . BUS. tIC . NO. 73 1991 BUSINESS LICENSE APP IC TI N FORM '�I� SEP 1010 u *APPROVED • INITIALS DATE' *DENIED INITIALS ;,; DATE IS THIS BUSINESS LOCATED AT`'YOUR HOME: j YES NO Business Name': 4,4A) of % ,('�L�' - Business Address: 5`/ !?P, '' � 4. Mauling Address.: ` A o 7 4 , 9zzs`3 `Business Phone':-( ) lCr9 Owned By:CORPORATION ' 'PARTNERSHIP"'!INDIVIDUAL _) If Corporation or Partnership:`Tax I.D.# 8. If Individual 9. 10. 11. 12. Name: of -Owner ZI all, -, I Or Officers Owner: Social Security #_ `T` 6 AJ ; f ,lam G L L Title': ©LQ) /j Type, -o­f--Business :-i SBE -,Resale •Numbe=:••t~ BUSINESS -,' LOCATED WITHIN THE `CITYOF_•LA, `QUINTA i ( Does Building. Contractors).:... Not Apply To A. Estimated Gross Business Receipts for New Bu58A (9 09 -i0 -9i iC i L i 58.00 .B. Previous Year Gross Reoei ts-for;E§tablished Businesses: A 4m, , Low, F.1 i/I' 1 I HEREBY Cre all the information,supplied by me is correct and any lice sed by the County, State or Federal Government.have been issued e in`full force and effect. re Title Da Submit Form To: CITY OF LA QUINTA BUSINESS LICENSE DIVISION ,P.O. Box 1504 La Quinta, CA 92253