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/ FEE $35.00
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CITY OF LA QUINTA
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MAY 2 4 1994
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78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253 `3S
HOME OCCUPATION PERMIT
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 J 4a /
PROPERTY OWNER
PROPERTY ADDRESS
MAILING ADDRESS
TYPE OF RESIDENC
TYPE OF BUSINESS
BRIEF, P_E..SCRIPTIO
PHONE%S
PHONE
singled multiple, ipobil home, etc.)
BUSINESS
LIST NAME OF PERSONS EMPLOYED -tt:9�—
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE)
LL OPERATE
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
( EXAMPLE , "BEDROOM -125 S.F.") gzqiCm�,
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION
I HAVE FEAD, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME Qaj&A�JQN ,;S ALLOWED ( CONDITIONS ATTACHED) . _ _ , .- W
SIGNATURE
DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS 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 _and SafetA Department
'APPROVEDENIED CONDITIONS ATTACHED x�`
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