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APR 27 194
CITY OF LA QUINTA
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78-495 Calle Tampico, P. O.Box.1504,-La Qui ta, CA
HOME OCCUPATION PERMIT
80
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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 1 j . ,S ' I:bo(, PHONE +—I I —0� P r>
PROPERTY OWNER ' i r,,,,,��.1 maj- PHONE
PROPERTY ADDRESS SY a,) S -A-:,-- ,-,P,laj en
MAILING ADDRESS
TYPE OF RESIDENCE in le multiple, mobil home, etc.)
TYPE OF BUSINESS ?m,-
BRIEF DESCRIPTION OF HOW THE -BUSINESS WILL OPERATE
NUMBER OF PERSONS INVOLVED IN BUSINESS )
J LIST NAME OF PERSONS EMPLOYED
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.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION G(..lart�.�• — ii�lc�_,
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCCUEATIONS ALLOWED (CONDITIONS ATTACHED).
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APPLI5PT SIGNATURE DATE,
IF -APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
AG NT I S RE RED.
OWNER/AGENT SIG ATU� 'DATE
I PORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR
D NYING YOUR1'HOME OCCUPATION; FAILURE TO COMPLY WITH CONDITIONS
LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF
PERMIT.
Build' d SafetyDepartment
APPROVED DENIED CONDITIONS ATTACHED
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