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15 4
CITY OF LA QUINTA
HOME OCCUPATION APPLICATION
78-105 Calle Estado
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
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 S� y 2 Or.; a
PROPERTY
OWNER
`SGS-rh e
PHONE
PROPERTY
ADDRESS
Sy
4V�� ,JI
/
V
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) b17
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSIPESS WILL OPERATE
cJ ad�►d� �e+son a-(- f�,ei- ejti k tS- C* k 0-1�r-ac-
feJ1 sos.4- ehaaI i.I4-C riit-FA It' xc� r - u- -, hiati
NUMBER OF PERSONS INVOLVED IN BUSINESS '
r
LIST NAMES OF PERSONS EMPLOYED /�� "�r `�' 14 n n L0vhe-T
SQUARE FOOTAGE OF USABLE FLOOR AREA IN PAID $35.00
•HOUSE ( EXCLUDE GARAGE) / �So VALIDA
LOCATION AND SQUARE FOOTAGE OF AREA OF MAR 31992,;,.
BUSINESS ACTIVITY IN HOME (EXAMPLE,.
"BEDROOM - 12 5 S.F.")
/ •11"` /< °. 5�,f� BUILDING AW!' T.
�.
BY
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED
BUSINESS OPERATION, .tJ�-%7,-, g d-� ' �P�y✓le_ ��10'� L✓'
I HAVE.READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
-3--,�w -,5'z
CANT 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.
Buildin nd Safety Department AP '
PROVED BY DATE C,� cam
�0"' CONDITIONS ATTACHED �bt,,,
DENIED BY DATE
Q"-
BUS. LIC. NO.
1992 BUSINESS LICENSE APPLICATION FORM
?,3, 7
......PROOF OF WORKERS COMPENSATION INSURANCE IS REQUIRED........
*****************************************************************
*APPROVED INITIALS DATE 3_ 9-!2
*DENIED INITIALS DATE
******************************************************************
1.
IS THIS BUSINESS LOCATED AT YOUR
HOME: YES NO
2.
Business
Name:-
ame:-3.
3.
Business
Address i 7 .Sy,�,fO 4Vf
4. Mailing Address :54�ab A%
VC, lie
'w Q14.�41-tl
V� Lee e2. QC r I',•,T2
5.
Business
Phone: --,c- 4�
Ll 2 D 9
6.
Owned By:
CORPORATION PARTNERSHIPNDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security
9. Name of Owner /%'4 611A1 al,"S Title: e 41�Ele-e
Or Officers
10. Type .of Business: CIO 0 7 V1 Xk-
11. SBE Resale Number: if//��
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ 6 p00-1, /�O�d
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 licenses required by the County, State or Federal Government have been
issued to m_9 and are in ful force and effect.
Ile
• Signature Title Date
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
\ I,� Quinta, CA 92253
`1
BUSINESS LOCATED IN THE CITY OF.LA QUINTA ONLY
GROSS RECEIPTS
RANGE
CLASS 1
CLASS 2
CLASS 3
0
-. 25,000
$ 15.00
$ 18.00
$ 21.00
25,001
- 50,000
25.00
30.00
36.00
50,001
- 100,000
30.00
36:00
43.00
100,001
- 250,000
46.0.0,
55.00
66.00
250,001
- 500,000
76.00
90.00
108.00
500,001
- 750,000
114.00
--x135.00
162.00
750,001
- 1,000,:0,00
150.00
180.00
216.00
1,000,001•
- 2,000,000_
400.0.0
500.00
600.00
2,000,001
- 3,000,000
500.00
625.00
750.00
3,000,001
- 4,000,000
600.00
750.00
900.00
4,000,001
- 5,000,000
700.00
875.00
1,050.00
5,000,001
- 10;000,000
1,000.00
1,250.00
1,500.00
10,000,001
- and up.
1,500.00
1,875.00
2,250.00
CLASS 1 Automobile Repair and Services; Laundry, Dry Cleaning &
Garment Services; Manufacturing; detail & Wholesale
Trade. �_---
CLASS 2 Amusement & Recreation Services, including Motion
Pictures; Architectural Services; Automotive Sales;
Barbers & Hairstylists; Beauty Shops; Engineering
Services; Landscape & Horticultural Services; Operators
Renters & Lessors of Commercial Property; Services to
Buildings; and all other persons engaged in business
not specifically listed elsewhere.
CLASS 3 Accounting, Auditing &.Bookkeeping Services; Financial
Services; Insurance Brokers & Services; Legal Services;
Management & Public Relations Services; Medical &
Health Services; Real -Estate Agents, Brokers, Managers
& Services.
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0