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1504
59 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 (s PHONE gt+ 04-0-?
PROPERTY OWNER PHONE
PROPERTY ADDRESS 5,1 - 02S 0AUE, 2az & LA
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) s Gly -
TYPE OF BUSINESS ROCP&) r .
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE 0_,,Jsa,
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
• HOUSE (EXCLUDE GARAGE) '� VALIDATION STAMP
005182 10 0439 06-12-92 0
LOCATION AND SQUARE FOOTAGE OF AREA OF i0 CASH i TOTAL 1 35.00
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 S.F.") 13S,4oi
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION ktrr 'Tfta- 9450FiniC-, -VZ-1TLQ_ f 9zCFr;Af= /ha, -w &I
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
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 Safety Department
APPROVED BY DATE CONDITIONS ATTACHED
DENIED BY DATE