EBY (2)30
CITY OF LA QUINTA
78-105 Calle Estado
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
•"yo TM HOME OCCUPATION APPLICATION
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
16AV , D lS
PHONE
S G y V 7 V?
PROPERTY OWNER
S/0 -6 .D,oc f o
PHONE
PROPERTY ADDRESS X775 �O/A Z
TYPE OF RESIDENC (single rultiple, mobile home, etc.)
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE /�ft/C, %✓l�fl�(P�
Z-1-5- — 2W 004,0ZQ UJOR t /1k/ VO4 UC.0 -- (fc)titpU-rr,2 Ltuo�2 C
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED 0,QU1,0 ,(j i �v�I/`,� R,!FCVE4
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) /1200
• LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE
"BEDROOM - 125 S.F.") /2 ® S,
PAID $35.00
VALI
.JAN 2 3 1992_ 3
4��
BUILDING AND
DESCRIPTION OF MACHINERY, EQUIPMENT, ANDUPPLIES BEING USED.IN
BUSINESS OPERATION SET TIF<S 7 6o 1-,5
VOLS C4/4rw HfL/�7 %/LF2 SACC
I HAV4 READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPA�ON IS ALLOWED (CONDITIONS ATTACHED).
M
APPLICANT SIG TURE
TE
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 Home Occupation; failure to comply with conditions listed on the
attached page shall be grounds for revocation of permit.
Building and Safety Department
' APPROVED BY DATE '3 CONDITIONS ATTACHED
DENIED BY DATE
•
T., .4
��j BUS. LIC. NO. 4Q
1992 BUSINESS LICENSE APPLICATION FORM
l X 3- 9/
*APPROVED INITIALS DATE3—
*DENIED INITIALS DATE
******************************************************************
1. IS THIS 'BUSINESS LOCATED AT YOUR HOME: YES. NO
2. Business Name: GAOZ A MARBLE AfJO STOO(
3. Business Address: Sa'j'7r PJAZ 4. Mailing Address: 5/11'' r
S3
5. Business Phone:( GI�1 ) S�`/ 401-3 _
6. Owned By: CORPORATION PARTNERSHIP �INDI UAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security •# Si3 /> '736V
9. Name of Owner �� a o �i Title: - SF - r—1 k R
Or Officers
10. Type of Business: )CA,)QBLjZ ./A-tS Ta L L iA-/('"
11. SBE Resale Number:
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ 91!S. 000
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
issue& to me and are in full force and effect.
gnature Title
• Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
<7 -
Date