COIAss M Y`Of= QPAID U NTA
Ti'T 4 4v Quin&r � � 0 4� 19
{- �_ � 94
BUILL} G 0 ETY
BY
CITY OF LA QUINTA (-I 0--a
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
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
CS 1VS4(uc Pov PHONE s6 e-1
PROPERTY OWNER Aj CO K PHONE q - X q
PROPERTY ADDRESS -5--2 - ve v%Lla CAt v,a v z.o.
MAILING ADDRESS gtA vin IF
TYPE OF RESIDENCEsingle; multi�/le, mobil home, etc.)
TYPE OF BUSINESS N �fUC-7i* /f No -ie A1q/;t14.A1Q1vC P
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE P
douse I ktAd WOfk W01 be CoNDvc O RUrafuovS LoCq�JavJ.
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED Z-4 rt C.;- OwNP�
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF AREA
OEXAMPLEBUSINESS
BEDROOMACTIVITY
125NSHFME)gD�CoFFi'te� � � %S s'
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION CO VAN Mfr , r.41 , 240nJe , I ype W1 4el- —
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OC=ATIQ�I IS ALLOWED (CONDITIONS ATTACHED)
fes+, (� � g - q - 9 N
SIGNATURE
DATE
IF APPLIC T IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGE7XEQUIRED.
ca-zo
ER/AGENT S NATURE 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.
Buil;Kq and Safety Department
APPROVED DENIED CONDITIONS ATTACHED
•
qP
CIM OF LA OUINIA,>��
HOME OCCUPATION PERMIT
APPLICATION
E.t
P.O. Sox 1504
L• QuInta. CA •
2to)ae4�z40
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.
!L-LS--L-_-LLi L---SS--cSLCSLLSLS=L-LLSLLlSLlLLLSCLlL!!CL!!!LLlCLSLCLS--S LSCSLSLL
ILLL----S----LCc-LS----c-S�SCSlLLlcc-LLL!lLLtLLLt!!!lLSStL!-lSSLLSLStSl-SS-LSSS-
(TYPE OR PRINT IN INK)
APPLI CANT'S NAMEI fc� /C PHONES 6y - °Z'Sq L/
PROPERTY OWNER-R2,2� l ole �1 �l� • PHONE'^'l G -
PROPERTY ADDRESS 53 3 l S CJCk1
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) SNAJa1 e
TYPE OF BUSINESS C., l CC4
BRIEF DESCRIPTION OF gow T'jiE BUSINESS WILL PE TE
S 1'�• e. N� (; w��o �` 5` 5 •� w i g �.t o V s e.
P.Iea L .� uP S-rj _ OV V YUV IJP. ICe
NUMEER OF PERSONS INVOLVED IN BUSINESS MF 1 _
1 NAME$ OF PE SONS EMPLOYE UIC,�� N� U ARACI
je,v U A PER
V fV f 1, �qw e ZN V IaW e u
SQUARE FOOTAGE OF HOUSE 4E%CLUDE GARAGE►BLO
ALE I�SOAREA
O; F4-
LOCATION AND SQUARE FOOTAGE.OF AREA OF
BUSINESS ACTIVITY IN HOME LE,
"BEDROOM - I SQUARE FEET")
Wt5-i A 7X 1;s Say f�•
DESCRIPTION OF MACHINERYEQUIPMFi`T.
OPERATION ONLY-5LQI,'ES - w"A
ME
SEP 2 61991
1 HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION ISt�WED I
(CONDTIONS ATTACHED).
C � a5 -q
IF APP ANT IS OTHER THAW PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIR D.
ER/AG SIGNATURE DATE
IMPDRTA.VT: 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.
-----=---------TSL=LLS-SSS==S=2=Sr=LLS=lLrrrsLrrr!lr==SC==O=S===== .
UUILDIN SAFETY DEPARTt�IiT
APPRDVED BY DATE �D " L/ CONDITIONS ATTACHED '.
DEN: ED BY DATE
% 1 111111 111111111111
20
t
BUS. ]rI C . NO.
•Oy —
1991 BUSINESS LICENSE APPLICATION FORM /
*APPROVED INITIALS DATE
*DENIED INITIALS DATE
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES_ NO
2. Business Name:
6
3. Business Address: �??-3q5 4. Mailing Address: �-► L
cajyGIV2q igVP
5. Business Phone:( 56�� S -q L/'
6. Owned By: CORPORATION PARTNERSHIP INDIVIDW�L
'i. If Corporation or Partnership: Tax.I.D.#
8. If Individual Owner: Social Security #
09.
0
Name of Owner Qf2�`� col/'4 sk'
Or Officers
10. Type of Business C- PaAVriv� Sir ✓i'C
11. SBE Resale Number:
Title: 0("//t,<i?
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New B� �AS,0gi TII PfF 27-9136.00 14
$ ,o C) 0 Y/ Fv riy,
B. Previous Year Gross Receipts For Established Businesses:
$
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 me and 'a a in full force and effect.-
Gt�w� coA w1ve12
ign
Title
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
Date
RECEIVED
OCT 0 1 1991
CITY OF U QUINTA
COMMUNITY SAFETY DEPT.