HOUSTON8-10
I'llll "III IIII I"I P.O. Boxa1504Estado
04 La Quinta, CA 92253
CITY OF LA QUINTA (619) 564-2246
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'RONIC)L.A E W161 d(ItAgah( PHONE 5te4- P_$Q0
PROPERTY OWNER - i"��n ►� l �i -row
S i o Ail PHONE 56-1 - g Q,�}
PROPERTY ADDRESS 0F_ -Z R 0R-Pj
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) SINCgLL
TYPE OF BUSINESS 12GA L SERW C E
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE ATitomt:4
INA 't 'RaeRA �a0 OT i GaSE
NUMBER OF PERSONS INVOLVED IN BUSINESS Cj� O N L
LIST NAMES OF PERSONS EMPLOYED - 4ROWi1LJ t-[O(,4�1m
SQUARE FOOTAGE OF USABLE FLOOR AREA IN CnVinPAID,pp
HOUSE (EXCLUDE GARAGE) 9,66, VALID P UA, KI
• LOCATION AND SQUARE FOOTAGE OF AREA OF FEB 0 41992
BUSINESS ACTIVITY IN HOME ( EXAMPLE, BUILDING "BEDROOM - 125 S.F.") a � s -T-- SAFETY D ,
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED .IN THE
BUSINESS OPERATION -4N0(u C, l'Drh,PU 1 ER . LETTr--R3 . 3MfCS
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
� i�/f 02693FZ
APPLICANT 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 Home Occupation; failure to comply with conditions listed on the
attached page shall be grounds for revocation of permit.
--------------------------------------------------
• Bui�ldin and Safety Department
ROVED',`
BY � DATE � Y �Z. CONDITIONS ATTACHED "�_
DENIED BY DATE
(j(/ BUS. LIC. NO.
'Eitit 4 4Q,
c
1992 BUSINESS LICENSE APPLICATION FORM e% O 9 p
� z
*APPROVED INITIALS DATE ,2.-V— 2:
*DENIED INITIALS DATE
******************************************************************
1. IS THIS BUSINESS LOCATED AT YOUR HOME::
2. Business Name: I�r1��F.n. (WE-87te w , 4
3. Business Address: .53-2Z A0i�- 14EgpEgA 4
YES ✓ NO
Mailing Address: SAm c
5. Business Phone:( (e i
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8.
• 9.
If Individual
Owner:
Social
Security #
J`�'Z-�0 CGUgq
Name of Owner
0N13�-1�
7-&&uS;blj
Title:
Or Officers
10. Type of Business: LF -GAL SERVW-
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:
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. -'and' arm in ul'l-)force and effect.
>
S' ature Title
• Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box .1504
La Quinta, CA 92253
e5: 1Q C -)a5' Z
Date