Potter & Heimark_:• ' ; ��t-�� �, Z r I IIIIII VIII IIII IIII P.O. Box 1504
La Quinta, CA 92253
46
CITY OF LAUINTA (619) 564-2246 y�
Q yi O v - _(
'f r,� �'` 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.g TFE:7f PHONE S k2q-I66S
PROPERTY OWNER 32A -#`i 6 -1 -TU -(I-,4- -FbV'GfR- 4Velw0- K- PHONE
n
PROPERTY ADDRESS Pj
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)I,�,Q
TYPE OF BUSINESS Pn SAJ.ps
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED <so-I�
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE ( EXCLUDE GARAGE) t 600 S C, .meq' CITYOF ALICAM
QUINTA TAMP
LOCATION AND SQUARE FOOTAGE OF .AREA OF �� .22.
• BUSINESS ACTIVITY IN HOME. (EXAMPLE, DEC 11.1992
"BEDROOM - 125 . S.F.") 12MK �4
BUILDING .
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIft ATi ING 1SED TU HE
BUSINESS OPERATION P4tAM#j" -j N6 L &c o U
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION ISLOWED (CONDITIONS ATTACHED).
L
APPLICANT S GNATURE 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 in and Safety De art lit--
.
APPROVED BY DATE h CONDITIONS ATTACHED
DENIED BY DATE
LL STATE ,QF • ' '' 3 q 1 BOARD OF EQUALIZATION
A N � CALIFORNIA �. _ : •.. :.80ARD USE ONLY
::_WANCMO.. MIRAGE92270-4473
CLADISTRCALES,$�SIEAX-RETURN -"�
DUE ON OR BEFORE JULY 319. 1990 FOR APR THROUGH -JtJ% . 1990 2-1990
''� • s R JE Z' 0
I - -
942861
94261-0001
01326 11189 33658/40 0000
R ENC 241-435811
AEG
ACC
REF
TERESA D.POTTER n
5 ;
P_AL*. ZE_3-Elis -- r A---92'2 60 I )`.. j� v �C-f-11 2
If the above information is incorrect or your business has closed, please phone us at:
1. TOTAL GROSS SALES .......................................... $
2. PURCHASES SUBJECT TO USE TAX ........... 2. �=
34YOTi' he 'plus Vne ....:..............`......:............:-:::::..'.�......:. ���..:..... 3" I'D
4. SALES TO OTHER RETAILERS FOR PURPOSES OF RESALE ........ I $
5. NONTAXABLE SALES OF FOOD PRODUCTS ...........................
6. NONTAXABLE LABOR (Repair and Installation) ...........................
7. SALES TO THE UNITED STATES GOVERNMENT .......................
8. SALES IN INTERSTATE OR FOREIGN COMMERCE
TO
OUT -OF -STATE 'CONSUMERS ..:....::.`.:..:,:.:..:..:.::.
9. SALES TAX (IF ANY) INCLUDED ON LINE�.1, ...:; .'.............:..,:....
10. (a) BAD DEBT LOSSES ON TAXABLE SALES "....... _. ..... F
..(b)COST OF TAX PAID PURCHASES RESOLD PRIOR TO USE ..........
(c) RETURNED MERCHANDISE .:...:..... ..........::..:......:....:.....
(d) CASH DISCOUNTS ........................ `........................
READ INSTRUCTION
BEFORE PREPARINI
PLEASE ROUND
CENTS TO THE
NEAREST WHOLE
DOLLAR
(e) OTHER (Cleary explain) :.....................' )"...... ..............
19. TOTAL STATE, COUNTY, LOCAL AND DISTRICT TAX (Total of Lines 13, 17, & 18) ....................... 19. lUU
I
I,
20. DEDUCT sales or use tax imposed by other states and paid on the.purchase j
tangible ,00
)
!00
11. TOTAL OF EXEMPT TRANSACTIONS REPORTED ON LINES 4 thru 10e (Add Lines 4 thru 10e) ....
11.
22. Less PREPAYMENTS. 1ST PREPAYMENT 2ND PREPAYMENT Total �� .00
$ $ atapayn e t 22. $
,
0
OO
' f
12. TAXABLE TRANSACTIONS (Line 3 minus Line 11) ................................. :.....................
12.
25. INTEREST is due on tax for each month 1.1157 PERCENT 1.011661')
' I
1
or fraction of a month that payment is -INTEREST 25.
delayed after the due date. The adjusted (142 DIVIDED 8Y 123 � 00
1100
monthly interest rate is ................. ,
110O
13. STATE & COUNTY TAX 5 1/4% (Multiply Amount on Line 12 by .0525) ...............................:.
13.
26. TOTAL AMOUNT DUE AND PAPA LE (Line 23 plus 24 & 25) :...................::...................... 26.1$
Ig
I he a/ cerdty that this velum, uq trying schedules statements, has goon examined by me '
SIGNATURE an ma oas+ rn mr kno ed a oe et end sono tycv: t iG iy I� 1
- _ _
i AND TITLE _ _ _ _ } _ L [ jli 1p u
MAKE CHECK OR O ODE L TO TE BOARD OF EQUALIZATION PHONE NUMBER
Always ite Your Account Number on Your Check or Money Order
fy .
.:00
-
14. ENTER AMOUNT FROM LINE 12..........................................................................
14.
15. ADJUSTMENTS (See Instructions 15).....................................................................
15.
00
16. TAXABLE TRANSACTIONS (Line 14 plus or minus Line 15) .............................................
16.
17. LOCAL TAX 1 % (Multiply amount on Line 16 b 01) ................ .......
"00,
_
18:1DISTRICT TAX (From Schedule A Line At 1). YOU MUST COMPLETE SCHEDULE A_ . •,.,--,�
iOO
IF YOU ARE ENGAGED IN BUSINESS IN A TRANSACTIONS TAX DISTRICT ...: •........ .t" r0.
418.
('!
19. TOTAL STATE, COUNTY, LOCAL AND DISTRICT TAX (Total of Lines 13, 17, & 18) ....................... 19. lUU
I
I,
20. DEDUCT sales or use tax imposed by other states and paid on the.purchase j
tangible ,00
?t
price of personal property. Purchase price must be included in Line 2 ......................... 20.
21. NET TAX (LineA minus Line 20). r .... 21. i0O
.
22. Less PREPAYMENTS. 1ST PREPAYMENT 2ND PREPAYMENT Total �� .00
$ $ atapayn e t 22. $
,
23..REMAINING TAX (Line'21 minus Line 22) 23. sOO
' f
24. PENALTY- OF 10% (.10) if paymeht is made `after due date shown above .....:.......... PENALTY 24. 1100
25. INTEREST is due on tax for each month 1.1157 PERCENT 1.011661')
' I
1
or fraction of a month that payment is -INTEREST 25.
delayed after the due date. The adjusted (142 DIVIDED 8Y 123 � 00
monthly interest rate is ................. ,
110O
RE
26. TOTAL AMOUNT DUE AND PAPA LE (Line 23 plus 24 & 25) :...................::...................... 26.1$
Ig
I he a/ cerdty that this velum, uq trying schedules statements, has goon examined by me '
SIGNATURE an ma oas+ rn mr kno ed a oe et end sono tycv: t iG iy I� 1
- _ _
i AND TITLE _ _ _ _ } _ L [ jli 1p u
MAKE CHECK OR O ODE L TO TE BOARD OF EQUALIZATION PHONE NUMBER
Always ite Your Account Number on Your Check or Money Order