OlivaT,,iht 4
BUS. LIC. NO.
1992 BUSINESS LICENSE APPLICATION FORM
I I'll'I IIT IIII IIII
16
......PROOF OF WORKERS COMPENSATION INSURANCE IS REQUIRED........
*APPROVED Y INITIALS DATE
*DENIED INITIALS DATE
****************************************************** ***********
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES NO
2. Business Name: /)ESE.T k-;iyENL.402. rk0 DUCTS
3. Business Address: 541-L/ G- jlR4ttCT6 4. Mailing Address:�S
„
fq- Q Ul N -re eI22s 3
5. Business Phone:( (01 Cj
6. Owned By: CORPORATIONPART IP (�IV�IDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # 5'6, y- 3 S — 7--71-7
•
9. Name of Owner i� �, 1 S ECU e OL I UA Tit Title: Oc.✓n,) _
Or Officers _ O a l -ETI TI A- OL I V !4 O w /V 6-r2-
10.
-72_10. Type of Business: �iLS d�i»i 5 �D G�ONd'PATE�/6�U//,
11. SBE Resale Number:
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ CP00' 00
B. Previous Year Gross Receipts For Established Businesses:
$ 1161 --
********GOOD ONLY FOR JANUARY 1,1992 THRU DECEMBER 31,1992*******
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
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
Date
s
� �.�� 78-105 Calle Estado
P.O. Box 1504
��
La Quinta, CA 92253
- CITY OF LA QUINTA (619) 564-2246
F TO 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.
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-------------------------------
61A 01-1-V6
APPLI CANT'S NAME e!�-A lSfO C' , Q L1 V 4 Tie. PHONE
PROPERTY OWNER CSAmE) PHONE ff4HE)
PROPERTY ADDRESS SZI- 11dS AvLu_B1jD4 VAL-LEfiQ
TYPE OF RESIDENCE single multiple, mobile home, etc.)
TYPE OF BUSINESS .�ZLIAJ 6- A- ?90 1:)dCT %a k --LST R.A -TS
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE /AeE/N d" OeDS 8
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED E 41 S frD -k DST Ti D 1-1 ✓ 79 -
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.")
VALI AMROOSTAMP
CITYOF LA QUINTA C1
JUN 12 1992 J�o28,
BUILDING AND SAFETY DEPT
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIEYhE ua ttcFn TN THR � p
BUSINESS OPERATION P/) E7 , (Am PU jBYE--
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATIqN IS ALLOWED (CONDITIONS ATTACHED).
— / Z� . L lvw�� � - /2, —9 2
APPLICANT SIGNATURE 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.
---- - ------------------------------------------------------------------
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Building and Safety Department
C,— APPROVED BY DATE bl-IZ CONDITIONS ATTACHED
DENIED BY DATE
•
Ce
4
�,Z -yam
BUS. LIC. NO.
1992 BUSINESS LICENSE APPLICATION FORM
......PROOF.OF WORKERS COMPENSATION INSURANCE IS REQUIRED........
*APPROVED INITIALS DATE
*DENIED INITIALS DATE
****************************************************** ***********
I. IS THIS BUSINESS LOCATED AT YOUR HOME:
YES NO
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
2.
Business Name: %��?��r ��y�7�✓-��2 4 -020C, -Ts
3.
Business Address:b14UC Tn 4. Mailing Address: s
12Zs 3
5.
Business Phone: ( (o�) $7z [/
6.
Owned By: CORPORATION PART IP INDIVIDUAL
7.
If Corporation or Partnership: Tax I.D.#
8.
If Individual Owner: Social Security Y-71%
•9.
Name
of Owner 1,C-, ECU (' . OL I vA Tie Title: 0wA)
Or Officers 0anETITI A- D. 01 IV 6 p w„V&—z-
10.
Type of Business: �f=)L�S DS X012 CON1S'EarT,P , TES �/6{�///,
11.
SBE Resale Number:
12.
BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ &00- 00
B. Previous Year Gross Receipts For Established Businesses:
$
********GOOD ONLY FOR JANUARY 1,1992 THRU DECEMBER 31,1992*******
I HEREBY CERTIFY that all the information supplied by me is correct and
any
issued
licenses required by the County, State or Federal Government have been
to me and are in full force and effect.
�Date
•
Signature Title
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
� '�� s 1 � gSS t-- t S o• asp V � �
City of La Quini�
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