STASHITutj/ 4 XP Quin&
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 4, STAS/-!/ PHONE
PROPERTY OWNER 14A/. S7 -<7S/// PHONE /,/,? - S-& 5/-
PROPERTY ADDRESS 54-1.4SAvFnido_ 197adpro, 1.Qnuinta 04- 9aa6-3
MAILING ADDRESS ero i -a_ Quznea 1,q 9 y,<f
TYPE OF RESIDENCE (single, multiple, mobil home, etc.) �S1Af&i_g-
TYPE OF BUSINESS AngjnPPri/1 Q eontractor-
BRIEF DESCRIPTION OF 'ROW THE' BUSINESS WILL OPERATE q f6
TFi gAq,Q - RE!` P. - rnR- C.00RA)J VAT1aV FOR F/ALO COit1St
NUMBER OF PERSONS INVOLVED IN BUSINESS o2
LIST NAME OF PERSONS EMPLOYED' Al14
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE ( EXCLUDE GARAGE) / /,o 5,e..
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
( EXAMPLE, "BEDROOM -125 S.F.") /j,E/JROOi✓)
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION oFFic,F eou101n�EWT.
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCC A O MLOWED (CONDITIONS ATTACHED).
oa- 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.
•
Building and Safety Department
0(4 APPROVED DENIED CONDITIONS ATTACHED
3 -i -17y awl