BoeckmannCITY OF LA QUINTA
��`'►� „+°` 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 woe e - C,,e4 'NUJ PHONE
PROPERTY OWNER Sryrr, Com' PHONE
PROPERTY ADDRESS �/� �Zc> gi/�iyt o /h o e?7rvB? C�4 Qv� ti�.4 CA
TYPE OF RESIDENCE <X55j.Mp, multiple, mobile home, etc.) 9-11V6 4,�T'.
TYPE OF BUSINESS d-1,e—.e7k>Z./rL T)e.ac-ro^ -
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
Dff` P1 r �r�.>L� G__ �J�y , JUO /-kVCkS 6 ?%-&--
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) /250
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME. (EXAMPLE,
• "BEDROOM - 125 S.F.") 1/0 r.1c
DESCRIPTION OF MACHINERY,`` EQUIPMENT, AND
BUSINESS OPERATION • �Xre— Env/o/h�
I HAVE READ,
OCCUPATION I
VUM.00 STAMP
CITY OF LA QUINTA
MAR 0 81993
K
AND AGREE WITH THE CONDITIONS BY WHICH A HOME
(C -DITIONS - ATTACHED) .
AP LICANT SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY -OWNER, AUTHORIZATION. OF OWNER OR AGENT
REQUIRED.
o '
OWNER/AGENT SIGNATURE DATE
:MP%—D .%- '= : 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 Safety Department
• APPROVED BY' DATE 3`U ^ CONDITIONS ATTACHED'2f*,a.
DENIED BY DATE
T-eiut 4 4Q"
BUS. LIC. NO.
1993 BUSINESS LICENSE APPLICATION FORM II"IIIII'IIIIIIII'I
48
Send Completed Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION _
P.O. Box 1504 ' Z.e. C? C
La Quinta, CA 92253 �
to
I. Business Name: Sa��Gc�T �eE��re e�D
2. Business Address:
f z 2 s 3
3. Mailing Address:
4. Business Phone:
5. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
6. If Corporation or Partnership: Tax I.D.# Y3-0�
• 7. If Individual Owner: Social Security #
8. Name of Owner or Officers and Title:
9. SBEResale Number: QS
10. Number of Decals Needed:
11. CONTRACTORS ONLY: COPY OF STATE CONTRACTORS LICENSE IS.REQUIREED
A. Type of Contractor:
B. Classification: G C. State License Number:
CONTRACTORS - GENERAL. -$100.00 Per'Year or $50.00 Semi-annual
CONTRACTORS - SUB $ 50.00 Per Year or $25.00 Semi-annual
CONTRACTORS ARE ON A CALENDAR YEAR BASIS ONLY; ANNUAL FROM JANUARY 1ST
THROUGH DECEMBER 31ST. SEMI-ANNUAL FROM JANUARY 1ST THROUGH JUNE
30TH; OR JULY 1ST THROUGH DECEMBER 31ST.
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 me an"rei full force and effect.
�TitJl.�-
gnature Title
"16 -
Date