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BUS .-LIC. NO.
4-3
P A I n gfill q q +!?nt
1991 BUSINESS LICENSE APPLICATION FORM
*************** ******************** ****************************
*APPROVED INITIALS- DATE -
*DENIED INITIALS DAT
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YESy" 'NO
2. Business Name:
3.Business Address: �� �JoX %S/ 4. Mailing Address :!/ �,�%p� 7s'��
-CJGin !n AQk ek_ J
• 5. Business Phone: (l4 i
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7.
If Corporation or Partnership: Tax I.D.#,
8. If Individual Owner: Social Security #
9. Name of Owner Title:
Or Officers
10. Type of Business: /PBo1CI.vaa,A-V �Prd�,ee
11. SBE Resale Number:
•12.-
BUSINESS
LOCATED WITHIN THE
CITY OF LA QUINTA itDo S OdtT 1� To i -06-9i18. 00 14
Building
Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ /8 r� 9.�
B. Previous Year Gross Receipts For Established Businesses:
********GOOD ONLY FOR JANUARY 1,1991 THRU DECEMBER 31,1991*******
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.
Signature Title Date
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
C171f Of LA QUINTA
HOME OCCUPATION PERMIT
7e-106 Celle Eel
P.O. •oa 1604
Le Oulnte, CA
(619)6.64-2246
APPLICATION
!ach condition listed on tte attachment to this form to see if the
sed activity can comply with the City's Home Occupation Regulations.
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OR PRINT IN INK)
APPLICANT'S NAMEu" �/ �/��r e /i -- PHONE
PROPERTY OWNER Xt�� I %�r .� /[ PHONE
PROPERTY ADDRESS y -/ `�l�r k � '' foAly SVI
TYPE OF RESIDENCE (single, multiple, mobile home, erste.) S r
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSINESS MILL OPERATE��
NUMFER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN PAID $35
HOUSE ( EXCLUDE GARAGE) CI19t�F��Nt�P
LOCATION AND SQUARE FOOTAGE. OF AREA OF NOV 0 41991
BUSINESS ACTIVITY IN HOME (EXAM
"BEDROOM - 125 SQUARE FEET") ___77_'
• DESCRIFTI OZN�MJACHINERY EQUIPMEr?, AND SUiffIES MING US D IN SINESS
OPERATION "vim t 19= Q� �"` "711-2
p t
-� 4 r�
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT'
REQU I RED .
OWNER/AGENT SIGNATURE DATE
IMPORTA.WT: False or misleading information shall be grounds for denying your
Nome Occupation; failure to comply with conditions listed on the attached page
shall be grounds for revocation of permit.
BUILDING ATETT DEPARTNEWIr
APPROVED BY g&Cr DATE // 6 -C%� CONDITIONS ATTACHED .
DEN*, ED BY DATE �
I]
•
BUS—LIC. NO.
1991 BUSINESS LICENSE APPLICATION FORM
*APPROVED
INITIALS,-DATE
*DENIED INITIALS DAT
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES v' 'NO
2.. Business Name:
3 . Business Address: If0 o6ay %S/ 4. Mailing Address : /,'P'0,r 7s��_
0 7 Gam. CX G , vt �G� A "r�[ , r� G T C�G� /rf� /
5. Business Phone:(
6. Owned By:CORPORATION PARTNERSHIP INDIVIDUAL=)
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security #
9. Name of Owner Title:
Or Officers
10. Type of Business: 19001 C 4arc,A e
11. SBE Resale Number:005jQQ
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTAiQDo S ttTW 1� To 118.00 1
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$
B. Previous Year Gross Receipts For Established Businesses:
GOOD ONLY FOR JANUARY 111991 THRU DECEMBER 31,1991*******
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.
Signature Title Oate
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quintal CA 92253