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Forrest��), AAP6 �z 7. y 01 rr+� Read each condition listed on tte attachment to this form to see if the proposed activity can comply with the City's Home Occupation Regulations. (TYPE OR PRINT IN INK) 01' P -n f7005-e- 571vao ) • • CITY OF LA OUINTA 0\1 HOME OCCUPATION PERMIT APPLICATION 78-105 Call* Estad P.O. Boa 1504 Le Oulnta. CA 022 (6115)564-2246 APPLICANT'S NAME Z:tjVi/,eS` .�LC: iUUPHONE J NO PROPERTY OWNER MI P/i�jf l ch eI� # PHONE�I�' �O'-0Jo 0 PROPERTY ADDRESS TYPE OF RESIDENCE (single, multiple, mobile home, etc.) �](i1 D Q TYPE OF BUSINESS --1 � f r/T��I� SGV tp t(II-Pr EF DESgRIPTION,OF HOW THE BUSINESS WILL al NUMEE P R �t75'INVO ED IN BUSINES S U' , ,fJ /,?71JS LIST NAMES OF PERSONS EMPLOYED /10110/1 ti - L biz t u�p n gyp' SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE) 2 OL y� VALIDATION STAMP LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EX LE, "BEDROOM - 25 SQUARE FEET") _ DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS OPERATION NZ 1 5'tS f'T a f P 1�I CZ 1 HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER AGENT REQUIREI)IAA " /! / 1 � � . // -/"7— . . /AGENT SIGMA IMPORTANNT: 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 SAFETY DEPAR APPRDVED BY S ATE GLo2 �' CONDITIONS ATTACHED , DENTED BY DATE 11111111111111111111 20 1991 BUSINESS LICENSE APPLICATION FORM *APPROVED INITIALS DATE *DENIED INITIALS DATE BUS.__LIC. NO. 1. IS THIS BUSINESS LOCATED AT YOUR HOME: ^ YES_ NO 2. Business Name: 3. Business Address:. /x-- 5. Business Phone:( (D1 ) 6. Owned By: CORPORATION 7. 8. is 9. 10. 11. �—r 4. �f Sailing Address: ^d, lay. PARTNERSHIP INDIVIDUAL If Corporation or Partnership: Tax I.D.# If Individual Owner: Social Security # Name of Owner Title: Or Officers , Type of Business: SBE Resale Number: 12.- BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA ] y b SN�g 11 1 C��fiLIl r3c iii' ��� i4 Building Contractors): A. Estimated Gross Business Receipts for N�e.,w[ Businesses Only: B. Previous Year Gross Receipts For Established Businesses: ********GOOD ONLY FOR JANUARY 1,1991 THRU DECEMBER 31,1991******* 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., • "`""Title Date Signature Submit Form To: CITY OF LA QUINTA BUSINESS LICENSE DIVISION P.O. Box 1504 La Quinta, CA 92253 t caY)far-� 0' p en, flous_e Vt 2 5 4- 5(L)0V • CItY OF LA OUINTA NOME OCCUPATION PERMIT APPLICATION 76-105 Call* Esta P.O. fox 1606 Ls Oulnla. CA 92 (610)664-2249 each condition listed on tte attachment to this form to see if the proposed activity can comply with the City's Home Occupation Regulations. i!___--- (TYPE OR PRINT IN INK) APPLICANT'S NAME ��_rl jl le_Ct PROPERTY OWNER M lT File e r PHONES(05 -/5 L PHONE�&"-0 go() PROPERTY ADDRESS - / ►` I ` "' TYPE OF RESIDENCE (single, multiple, mobile home, etc.) TYPE OF BUSINESS BR EF DESgRIPTION OF HOW THE BUSINESS WILL OPERA7E N E% Yl l•eW)? -_ -G nccj urho e a ������PPw ��e Se1h711 It t �`. NU E !C P R DNS'INVO ED IN BUSINESS �' LIST NAMES OF PERSONS EMPLOYED /MOI? t✓ SQUARE FOOTAGE OF USABLE FLOOR EA IN VALIDATION STAMP HOUSE (EXCLUDE GARAGE)q� LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (Ex LE, "BEDROOM - 125 SQUARE FEET") _ DESCRIPTION OF MACHINERY, EQUIPVExT, AND SUPPLIES BEING USED IN THE BUSINESS OPERATION ii rte 5 ��_ _f'► l t7. T P �� HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME CUPAT IS ALLOWE (CNDIONS ATTACHED). 9 "PLIC T SRE T rw Le 140`1 0x:1991 0 IF APPPLL7C�ANT IS OTHER THAN 7/A,0KrA Ty OWNER, AUTHORIZATION OF OWNER O�jA;ENT REQUIR/ { � � ! /AGENT SIGNA IKPOR:A.v : False or misleading information shall be grounds for denying your Home Occupation; fsilure to comply with conditions listed on the attached page shall be grounds for revocation of permit. ------------- ------------------ ------ ------------- ----- ---------------------------------------- - --- ______.-- BUILDING,,e SAFETY DEBYP5 A�f APPROVED ATE GLoZ- ' CONDITIONS ATTACHED DEN:ED BY DATE • • 0 6 � C/ BUS—LIC. NO. D ; ,j; is 1991 BUSINESS LICENSE APPLICATION FORM *APPROVED -f INITIALS /C— DATE /0 "3,4 'tel *DENIED INITIALS DATE 1. IS THIS BUSINESS LOCATED AT 2. Business Name: 3. Business Address:.. 5. Business Phone:( 6. Owned By: CORPORATION HOME: ^ YES_ 'NO, 4. Mailing Address: PARTNERSHIP INDIVIDUAL 7. If Corporation or Partnership: Tax I.D.# 8. If Individual Owner: Social Security 9. Name of Owner Or Officers 10. Type of Business: 11. SBE Resale Number:i'CZ� / 12.- BUSINESS LOCATED WITHIN THE CITY OF LA;QUINTA,EO5 S i11T 13"ii8.00 i4 Building Contractors): A. Estimated Gross Business Receipts for New Businesses Only: B. Previous Year Gross Receipts For Established Businesses: $ ********GOOD ONLY FOR JANUARY 1,1991 THRU DECEMBER 31,1991******* 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 tame—and—are in full force and effect I Signature " Title Submit Form To: CITY OF LA QUINTA BUSINESS LICENSE DIVISION P.O. Box 1504 1a Quintal CA 92253