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LINDSEYuu-c1' ce w ,• FE$35.00 CITY OF LA QUINTA • 78-495 Calle Tampico, P. O.Box 1504, La Quinta, HOME OCCUPATION PERMIT 7, 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 (�nOCO I, S 6 PHONE &IJ S7&q - PROPERTY OWNER PHONE PROPERTY ADDRES � 7 A.5 Vc- n Aa. Vti,1 0- Lo Qv..%.-ra . CA . 9ZZS 3 MAILING ADDRESS o ' TYPE OF RESIDENCE Ing a multiple, mobil home, etc.) TYPE.OF BUSINESS BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE OST C9f O�_C� 1,'bt � o�sSP NUMBER OF PERSONS INVOLVED IN BUSINESS LIST NAME OF PERSONS EMPLOYED fZav�n �1► ►.s+.t SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE) 13 SO LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME ( EXAMPLE , "BEDROOM -125 S.F.") Off 1Lq_ too S g DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING, USED IN THE BUSINESS OPERATION CA_ V t - ViJW n-cLI e. I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS -BY WHICH -A HOME �OCCUPATION IS ALLOWED (CONDITIONS ATTACHED). if1��,���"2,/ 3 - 3 -- 45 APPLICANT SIGNATURE DATE IF APPLICANT IS OTHER THAN PROPERTY OWNER, OR AGENT IS REQUIRED. e OWNER/AGENT SIGNATURE AUTHORIZATION OF OWNER ? -3- 9S 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 Builyrn-q and Safety Department APPROVED DENIED CONDITIONS ATTACHED I• BT -400 -MIP (S2F) REV. 8 (9-94) APPLICATION FOR SELLER'S PERMIT AND REGISTRATION AS A RETAILER (INDIVIDUALS/PARTNERS) STATE OF CALIFORNIA BOARD OF EQUALIZATION CTION I: OWNERSHIP INFORMATION _4t a �FOR�BOARD USE ONLY° 4. 1. PLEASE CHECK TYPE OF OWNERSHIP (use additional sheet to include information about additional ? fes; a` " ,QBE co-owners or partners) %Sole Owner ❑ Husband/Wife Co -ownership ElPartnership it .. , BUSINESS CODE'"' r ­,tz- y j k=� 4, % AREA.CODE PREPAREii z s : N JP rR ZIP CODE C 7-7-573 OWNER OR PARTNER CO-OWNER OR PARTNER RAV L 14 2. FULL NAME (first, middle, last) 3. MAILING ADDRESS (it different from No. 2 above) 0 Boy., LOTZ CITY f,.a 3. RESIDENCE ADDRESS (enter full address S3 Z 2 v et&id q ZIP CODE I %:L S'3 4. DATE YOU WILL BEGIN SALES (month, day & year) including zip code) L a Q V %Krq . ZZ s s TUESDR 4. RESIDENCE TELEPHONE NO. _ 5. SOCIAL SECURITY NO. 367 — S State of California - Board Of Equalization � N 0 -1-LL 136 '%A • 1 G Z 42-700 Bob Hope Drive, Suite 301 Rancho Mirage, CA 92270 V K &VA `(� 6. DRIVER'S LICENSE NO.Q & DATE OF BIRTH 7. PRESENT/PAST EMPLOYER (enter full address induding zip code & telephone no.) O [/^\ I � 8. SPOUSE'S NAME 6. TYPE OF BUSINESS (check one) Robert Liley I Branch Office Supervisor (619) 346-80% 9. SPOUSE'S SOCIAL SECURITY NO. SPOUSE'S DRIVER'S F Mail LICENSE NO. & DATE ❑ Service OF BIRTH ❑ Full Time 11. NAME, ADDRESS & TELEPHONE NO. OF , DQNe LL wO s a vt v` 619 X4 *-21 TWO PERSONAL REFERENCES ` 2. JtA ����L dt� +� to — OOO AvE (*I` SI"& «'V 2' L 026 q 12. SIGNATURE SECTION II: BUSINESS INFORMATION 1. BUSINESS NAME Ro.v t u% w: l t LZ BUSINESS TELEPHONE - 2. BUSINESS ADDRESS.( not list O. Box or mailing service) "O. ���l. C TY l� ©�.�.-I:v STATE c q_ ZIP CODE C 7-7-573 ss-�Zt '%V4 3. MAILING ADDRESS (it different from No. 2 above) 0 Boy., LOTZ CITY f,.a GJ L%; , .(:Q , -u.s 3 STATE cq . ZIP CODE I %:L S'3 4. DATE YOU WILL BEGIN SALES (month, day & year) 5. DAYS & HOURS SUNDAY MONDAI TUESDR I WEDNESDAY ITHUR!JLAY I FRIDA SATURDAY Z 2 3— `T — 95, 1 OF OPERATION 6. TYPE OF BUSINESS (check one) CHECK ONE F Mail ❑ Retail ❑ Wholesale ❑ Mfg. ❑ Repair ❑ Service ❑ Construction Contractor ❑ Full Time ❑ Part Time Order 7. TYPE OF ITEMS SOLD v ; dpi =r'aaes 8. ARE YOU Starting a new business? ❑ Adding/dropping partner? ❑ Other? _ ,❑ Buying a business? (indicate name & account number in area at right) FORMER OWNER'S NAME ACCOUNTNUMBER (!PURCHASE PRICE 110. VALUE OF FIXTURES & EQUIPMENT I 11. NUMBER OF SELLING LOCATIONS (if 2 or more attach list of all locations) $ .r 12. IF ALCOHOLIC BEVERAGES ARE SOLD, PLEASE LIST YOUR ALCOHOLIC BEVERAGE CONTROL LICENSE NO. AND TYPE E.+J BT -400 -MIP (S2B) REV. 8 (9-94) 13. NAME, ADDRESS &JELE PHONE NUMBER OF ACCOUNTANTBOOKKEEPER Sei 14. NAME, ADDRESS 8 TELEPHONE NUMBER OF BUSINESS LANDLORD 1A0 %AA — T VC MA L► rfIA" 15. NAME & LOCATION OF BANK OR OTHER FINANCIAL INSTITUTION r4 up l Caws ./ ck V 1 v1.4bS 16. NAME & ADDRESS OF MAJOR SLWPLIFR5 STbr-t 33 o7 901%.4 U"Cxer, , CA. 92- 17. OTHER ACCOUNT NUMBERS ISSUED TO YOU BY THE BOARD CHECKING AND SAVINGS ACCOUNT NUMBER 5-17084 7- 3 PRODUCTS PURCHASED cd Za SECTION III: INCOME AND EXPENSES REGULATIONS 1. PROJECTED MONTHLY 2. PROJECTED MONTHLY 3. INFORMATION CONCERNING EMPLOYMENT DEVELOPMENT DEPARTMENT (EDD) SECURITY REVIEW tJ BT -400Y BT -467 BUSINESS EXPENSES BUSINESS REVENUE. a. Are you registered with EDD? ❑ Yes y� .til No •*%&a ka!r: TOTAL GROSS REVENUE $ SOD b. If no, will your payroll exceed per quarte(? ❑Yes &No RENT 1 BT -1241 C If yes, you must make application with EDD. T APPROVED BY PAYROLL $ NON-TAXABLE $ Number of employees See pamphlet DE 4525, "Employer Guide.' lsc. $ 1-15 TAXABLE $ c. I have already received pamphlet DE 4525. C Yes JRNo BY d. I have already received pamphlet DE 44, TOTAL $ i 7 S TAX $ "Employers Withholding Guide' Yes &.No • SECTION V: CERTIFICATION The statements contained herein are hereby certified to be correct to the -best knowledge and belief of the undersigned who is duly authorized to sin this application. SIGNATURE TITLE ►t�s�-,, � owH�r NAME (typed orpTft) •' •• - DATE N►n Wtl1t �w►s 3�1�" Qs FOR BOARD USE ONLY Fumished to Taxpayer REPORTING BASIS. REGULATIONS y GA -324A DE -44 SECURITY REVIEW tJ BT -400Y BT -467 ❑ DE -4525 LLJ OTHER BT -598 $ 1 �. PAMPHLETS BT -1009 EDBT-519 BT -968 BY 1 BT -1241 C T APPROVED BY ,. REG. 1668 REMOTE INPUT DATE RETURNS DREG. 1698 BY REG. 1700 I o Permit Issued A341i6,, t