ABBOTT78-105
lle
I IIIIII IIT II I IS I P.O. Boxa1504Estado
1 22 La Quinta, CA 92253
�\ CITY OF LA QUINTA (619) 564-2246
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 _CLPHONE 576
PROPERTY OWNER w QUU�. PHONE 3f S O 7 (o
PROPERTY ADDRESS S-3363 Almyra--' lA ", a,,
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) /-y..gf q��J
TYPE OF BUSINESS
V PAID =35.10 e -r- M --Tc
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE CRY OF LACAJKTA
D F C I1 1991
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED 0,1^
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) VALIDATION STAMP.
•LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 S.F.") /3..ej,
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BBEING USED .IN THE
BUSINESS OPERATION
0
I HAVE READ,, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION JS ALLOWED (CONDITIONS ATTACHED).
APPLICANT SIGNATURE
_ '
DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER -OR AGENT
REQUIRED.
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.
• Building and Safety Department
APPROVED BY DATE / Z �� Cf CONDITIONS ATTACHED
DENIED BY DATE
`A
1.
2.
uiK,�w
1991 BUSINESS LICENSE APPLICATION FORM
. _ •BUS._LIC. N0.
C"
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
*APPROVED INITIALS ' DATE/S—/
*DENIED INITIALS DATE
IS THIS BUSINESS LOCATED AT YOUR HOME: YES L----`4 NO
Business Name: iv.X� c ►-c►,a �, cn,
3. Business Address: S 3 3�o 3 4. Mailing Address:13 t SCI '7b
5. Business Phone:( ) S6 y PLY 5-7
6. Owned By: CORPORATION PARTNERSHIP
7.
If Corporation or Partnership: Tax I.D.#,
IVIDUA
8. If Individual Owner: Social Security # ( q qV-�-P-L
9. Name of Owner Title: (yu�
Or Officers
10. Type of Business: 4-
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:
$ �� . 0 0 U
B. Previous Year Gross Receipts For Established Businesses:
$ '
********GOOD ONLY FOR JANUARY 1,199"- HRU DECEMBER 31,199 *******
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
• Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
Date
°, kk
9