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CITY OF LA QUINTA
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58
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 j /VLr-S �'�%ld 190b%OAONE
PROPERTY OWNER ,PHONE
PROPERTY ADDRESS 653 5-00 e,�.P
MAILING ADDRESS 'y .nom
TYPE OF RESIDENCE (single, multiple, mobil home, etc.) SINGL Ll
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
NUMBER OF PERSONS INVOLVED IN ;
LIST NAME OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR
IN HOUSE (EXCLUDE GARAGE)"
INESS
19,
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LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME 5/71/9LQ&$7-
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING ED ,INE
BUSINESS OPERATION LrCeot&AAC7-S ,,,pgS/CS -- %A.4� 1�1 GS�i
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATION IS ALLOWND (CONDITIONS ATTACHED). ,
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AG,FNT IS REQUIRED. i
V-�AP- 151,tv z6 -
l.GE )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 DENIED CONDITIONS ATTACHED
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