GROWx teed- FeL 11 /o I
54
• FEE $35.00
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 !�U/.��i� iy71_1 es-e.4,Fc! PHONE
PROPERTY OWNER S w1le 6'.toeu PHONE
PROPERTY ADDRESS 6'a -lVo de • l q &Li
MAILING ADDRESS ay."l L 4,- c ezrie%6
TYPE OF RESIDENCE single, multiple, mobil home, etc.)
TYPE OF BUSINESS 79m_7_371c
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
NUMBER OF PERSONS INVOLVED IN BUSINESS %uso .2
LIST NAME OF PERSONS EMPLOYED -
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) , ✓'i✓
LOCATION AND SQUARE FOOTAGE OF.AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.") 1 %9
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USE IN THE
BUSINESS OPERATION C -04f 47e -I'S'
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATION C�L/� ( CONDITIONS ATTACHED) . � �/A/��
APPLICANT SIGNATURE DATE
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.
• Buildi Z nd Safety Department
APPROVED DENIED CONDITIONS ATTACHED
a :rf-3/V i,?°G
•4
Qu&rcv
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BUS. LIC. NO.
1995 BUSINESS LICENSE APPLICATION FORM
*************** *** ***
*APPROVED BY �*
* DATE ��{ —
****************************
1.
IS THIS BUSINESS LOCATED AT
YOUR HOME: YES
NO
2.
Business Name: Ty,(iLlc „(�%q/i0
AeSeXlFeW /91Y
/��tZg",v,/,y
3.
Business Address :3a -pyo 4-e
llewfe o, 7 4. Mailing Address: l,,6,;Ze ,fie
G e�%lrcJ6- Jam, p, /hex
5.
Business Phone:
6.
Owned By: CORPORATION
PAR �Jp
INDIVIDUA
7.
If Corporation or Partnership:
TAX I.D.#
8.
If Individual Owner: Social
Security # mai -
%� - 0/06
9. Name of Owner ,40X/;V s Title: QwxIeiC
Or Officers
�0. Type of Business: ZP,411e /QeseX,,Vc,� f rev/',ref
11. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNTY HEALTH PERMIT:
YES NO
12. SBEResale Number:
13.- BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To Building
Contractors):
A. E Stimated Gross Business Receipts for New Businesses Only:
B. Previous Year Gross Receipts for Established Businesses:
***********GOOD ONLY FOR JANUARY 1, 1995 THRU DECEMBER 31, 1995**********
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
t07 and are in full force and effect.
Signa ure
•
Title
Send Completed Form To:
CITY OF LA QUINTA.
BUSINESS LICENSE DIVISION
78-495 Calle Tampico
P. 0. Box 1504
La Quinta, CA 92253