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FEE $35.00
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CITY OF LA QUINTA Q a
78-495 Calle Tampico, P. O.Box 1504, La Quin�2295
HOME OCCUPATION PERMIT BY
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)rfa L ed zb A ���'��1; PHONE S(o �l - y fS- 6 .
PROPERTY OWNER i I h c ��G R� f a t PHONE e; 1, Si- V 556
PROPERTY ADDRESS 6-3 - 3 3 a ►^
MAILING ADDRESS /V ecua V N a
TYPE OF RESIDENCE (single, multiple, mobil home, etc.)
TYPE OF BUSINESS 14 t m r- C I e aV%J 4 ►v I
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL QPERAfTE
'%0r�;Nq SGL to lgk-e fa Job S
NUMBER OFIPERS014S/INVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED AJ 0 !V r
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.") C,"i :S_�
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION
I HAVE READ, UNDERSTAND, AND AGREE WITH --THE CONDITIONS BY WHICH A
HOME OCCUPATION IS ALhOWXD�(CONPITIONS ATTACHED).
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.
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Buildin(� and Safety Department
APPROVED DENIED- CONDITIONS ATTACHED
95
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