JUAREZI
Of
BUS. LIC. NO.
1993 BUSINESS LICENSE APPLICATION FORM
71
I� �
......PROOF OF WORKERS COMPENSATION INSi.MANCE IS REQUIRED........
APPROVED BY BUILDING & SAFETY DEPARTMENT�-
1. IS THIS BUSINESS LOCATED AT YOUR HOME:1 YES. NO
2. Business Name: C�li'f(Jrni� ���U�GJ
3. Business Address: to AR5 4. Mailing Address: TO, pwy 0
(loV-U10 L, -Q. (,A1 qa,5
5. Business Phone: (�Q�_)
6. Owned By: CORPORATION PARTNERSHIP I IVID
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security #
9. Name of Owner �21A t �K'��1�� c�l�(��i� Title:
• Or Officers '
10 Tyr%o ^f nve_"eaq.
11. SBE Resale Number: lil(`1r1�
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. (Estimated Gross Business Receipts for New Businesses Only:
B. Previous Year Gross Receipts For Established Businesses:
$
********GOOD ONLY FOR JANUARY 1,1993 THRU DECEMBER 31,1993*******
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
I IIIIII VIII I'll I'll
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 and are in full force and effect.
50
•
CITY OF LA QUINTA
ern+ 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 PHONE -A S -7
PROPERTY OWNER SL�j& PHONE wo
PROPERTY ADDRESS
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
BRZ F DESCRIPTION OF HOW THE BUSINESS WILL OPERATE --i-A m n nrrF A;e
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYEDd-
SQUARE FOOTAGE OF USABLE FLOOR ARE IN / ��-
HOUSE (EXCLUDE GARAGE) , � Z'., � Ai,i Q }�
LOCATION AND SQUARE FOOTAGE OF .ARE OF
BUSINESS ACTIVITY IN HOME. (EXAMPLE,
"BEDROOM.- 125 S.F.")�js,
DESCRIPTION Of. MACHINERY, EQUIPMENT, AND SUPPLIES MILT
,—^�—
BUSZN SS OPERi
AL1 i�iQ ■�e""�' f�ll 11 WI(i i
— / .
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHI HOME`
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
----
IF APPLICANT IS OTHER THAN PROPERTY -OWNER, AUTHORIZATION OF OWNER OR AGENT.
REQUIRED.
:MPO 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.
Buildi' and Safety Department
APPROVED BY Z�L DATE
DENIED BY DATE
'IONS ATT,
CfT OFLA QUINTAL
_^-QR30
1993 _�
BUILDI(yG D MFEnYI)T,
I!