ARDEN1 I IIIIII VIII IIII IIII
61
ceAitj/4ul�i'�trGv
- RECEIVEi
'JAN 211994 -
CITY
1994CITY OF LA QUINTA Ana ............
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
HOME OCCUPATION PERMIT
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 P1 G� �i��`' 81 PHONE(, 7 j -
PROPERTY OWNER l R C PHONE X 914 - -3 C/- l
PROPERTY ADDRESS
MAILING ADDRESS rI>
TYPE -OF RESIDENCE (single, m
TYPE OF BUSINESS / Pfj4)
BRIEF DESCRIPTION OF HOW THE
e,
, etc.)
INESS WILL OPERATE
IN HOUSE (EXCLUDE GARAGE) 1500
�PPR�x
LOCATION AND SQUARE FOOTAGE OF AREA 1000 - t-1 0" 2 DOM 0/nl114- d3/�J
OF BUSINESS ACTIVITY IN HOME 6eP J600N1.5
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION dX"flPOT 2� 1"`li�ti(c%/llj-�R;
I HAVE READ, UNDERSTAND,A THE CONDITIONS BY WHICH A
ME. OCCUPATI IS ALLOW S ATTACHED).
L//
AP064 PLICANT SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR -AGENT IS REOUIRED. i
SIGNATURE
11 M
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.
•
BuM=inq and Safety Department
APPROVED DENIED CONDITIONS ATTACHED
or
2.
4 4a
BUS. LIC. NO.
1994 BUSINESS LICENSE APPLICATION FORM
*APPROVED BY � J
* DATE 7
************* ************
......PROOF OF WORKERS COMPENSATION INSURANCE IS REQ/UIRED........
IS THIS BUSINESS LOCATED AT YOUR HOME: YES v NO
X 10 ay 0, &F0 t- �—
Business Name: ��,�/�� A-t- I—A
3.
Business Address: 53"3qv jI/ri/j 4.
Mailing Address: S��c
5.
Business Phone: (4L9_)
6.
Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7.
If Corporation or Partnership: Tax
8.
If Individual Owner: Social Security #
9.
Name of Owner �2L0,r/r%� �/�Q�,t/
Title:
Or Officers
•
10.
Type of.Business: l
11.
IF YOU ARE A FOOD VENDOR, DO YOU HAVE A
COUNTY HEALTH.PERMIT:
A114 YES / NO
12.
SBE Resale Number: 7-WIA
13. 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:
$ -,9— 0 7
********GOOD ONLY FOR JANUARY 1,1994 THRU DECEMBER 31,1994*******
I HEREBY CERTIFY that all the information supplied by me is correct and
any 1ses re uir the County, State or Federal Government have been
issu t me•a a n ull force and effect.
Si ure Title Date
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
78-495 Calle Tampico
La Quinta, CA 92253