MILLERII'll'llll'llllll"I� 78-105 Calle Estado
PIN 13
P.O. Box 1504
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.
------------- _
//4APPLICANT'S NAME 1�G5 S3 `r VV f%
PROPERTY OWNER PAWsPA)IJ4-S Gmao RgN mcs PHONE 7/V 78ir' 34J 0
PROPERTY ADDRESS 52-5T AVE -NIDA MArZT1 At C Z, LQ 9 aas"3
TYPE OF RESIDENCE Ingle multiple, mobile home, etc.) S w ede,r
TYPE OF BUSINESS UAIC:T-- `L
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE &W7-
NUMBER
W
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYEDl���es-s"�,``'
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (.EXCLUDE GARAGE) 1.200
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE
"BEDROOM - 125 S . F . " )A/L�►4t_ �Q S�•
DESCRIPTION OF MACHI
BUSINESS OPERATION
1, EQUIPMENT AND
N004DM9,141%5
VPAII$MON - STAMP
CITY OF LA QUINTA -e
APR 2 41992 V.
BUILDING AND SAFETY DEPT.
FPPr8111t» S, BET_NG USED IN THE
e
co
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
ICANT SIGNATURE
11 5 2
DATE
IF AP-ItICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
kshwLen-
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.
Alding and Safety De ment
APPROVED BY DATE' !/U v CONDITIONS ATTACHED
DENIED BY DATE
1z
7F ll��
LavQuinta, CA 92253
CITY OF LA QUINTA (619) 564-2246
HOME OCCUPATION APPLICATION A I D APR 2 4 199?
ead each condition listed on the attachment to this
form to see if the
roposed activity
can comply with the City's Home Occupation Regulations.
-----------------------------
APPLICANT'S NAME
------------------------------
��i" %I%/�
--------------
PHONt
PROPERTY OWNER
P,4)K&SM)N4-S GA)00 (2,Q.nI7Y%(.S
PHONE 7Se' 3 %J 0
PROPERTY ADDRESS
5+-591 Ayt-wiQA MArt.7mei-,
LQ ri Q- 5 3
TYPE OF RESIDENCE
Ingle multiple, mobile home, etc.)
TYPE OF BUSINESS
1. AA -FT-" 460 L
BRIEF DESCRIPTION
OF HOW THE BUSINESS WILL OPERATE
&Zoa� 7 Sfyys
NUMBER OF PERSONS INVOLVED IN BUSINESS �'
LIST NAMES OF PERSONS EMPLOYED Z r>r wvS C -
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (.EXCLUDE GARAGE) Loco
.LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE{
"BEDROOM - 125 S.F.") L�VaS�•
VMUI; MON STAMP
CRY OF LA OUINTA C
APR 2 41992
BUILDING AND SAFETY DEPT.
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPIWLSBgINQ USED IN THE
BUSINESS OPERATION W00OIit Zl4t45 PCWttc � HAW0 7-0,6&5--
I
UI HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
1. t;
3.J -
A*Q
2
PLICANT SIGNATURE DATE
IF APirLICANT IS OTHER THAN PRQPERTY 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.
Building and Safety Department
APPROVED BY 6P DATE yo7%9 pprl�jssy CONDITIONS ATTACHED
DENIED BY DATE
1992. BUSINESS LICENSE APPLICATION FORM
BUS. LIC. NO.
......PROOF OF WORKERS COMPENSATION INSURANCE IS REQUIRED........
*APPROVEDINITIALS TgAS'L
*DENIED INITIALS DATE
******************************************************************
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES NO
2. Business Name: 1410 D,�tI QQL�S
3. Business Address: 5Z-.59 i Vew,0A 4 . Mailing Address • PO box 1778
fMAi2i 7n/bre, GA- Qy1;vM 5 z z�r3 LA Qy, mm CA �► L L5�3
5. Business Phone:(_ (915 ) Sb y` yy4?4
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership: Tax'I.D.#
8. If Individual Owner: Social Security # 555 "7`/"7051
Name of Owner ipvntS In flu Title: OWW4
Or Officers A//jor 414
10. Type of Business: (29*pl Zoees 'lc-
11. SBE Resale Number: sIR 6—HC, a3- 896-785-
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ 600,
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
is d to me and are in ull force and effect.
��z5z
ianature Title Date
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253