Jackson - Space 131
r
20
HOME OCCUPATION PERMIT
APPLICATION
'CITY Of LA QUINTA
T11-105 Celle tstefe
P.O. sox 1504
t
OvinM,CA.92253
(sit) 564 - 2146
664-2246 PLANNING DIVISION 6/07
Wad each condition listed on t e reveraide side of this form to see It
the proposed activity can comply with the City's Home Occupation
Regulations. $35.00 fee
TYPE OR PRINT IN INK
APPLICANT'S NAME JQ h K lir) �.I ' r PHONE
PROPERTY OWNER r f; PHONE 61 G - N7-_'',41
pROPERTy ADDRESS 420- q061 Q01Ve. 811115 KA A 17,
(Street)
_
La 0 »> nka * A Q1).S
(City) (State) (tip) 11__ LI -
Type of residence JSingl6, Multiple, mobile home, etc.)(i101 E ko m L'
Type of business coonU�ucon Seery ees
,.. _ i
Brief„Agscriptiol, 4 how JKS bws�cs, willc)pe� to
Number of persons involved in business 0
- List names of persons employed
Square footage of usable floor area in
- house (exclude garage) ((On
Location and square footage of area of
business activity in home (example:
bedrooms; ,125 sVare .feet)
� nG on V,n 14 y
Description of machinery, equipment, and
business operation C.n1Y :oo-ie �I
ValidationStamp
O$518EASH i ZTOTAL-?3-89 35.0010
ies being used in the
I have read and understand and agree with the conditions by which a
home occupation s a lowed (Conditions on reverse side).
APICANT SIGNA DATE
If A plicant is other than property owner, authorisation of owner or agent
re ' ed.
OR AG6 NA DTE
IMPORTANT: alae or misleading information shall be grounds fol denying
your Home Oc upation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
APPROVED Initials " 073- Date
CONDITIONS A HED
DENIED 7 -Initials Date
LQHOMOCC.PRT ,