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Y.V. box !�U9
La Quinta CA 9?253
CITY OF LA QUINTA (619) 564-2246
HOME OCCUPATION APPLICATION II'IIIII'I'II'lll���
78
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 1/.A -A ,4 4/L % PHONE/h/ 9%S�s� aoS 6
PROPERTY OWNER 9D CyTG6a2 PHONE
PROPERTY ADDRESS S;2 --6a-6 4</4E.t,Awg,,K 0,1. G44vl.t�r.,0
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS C' &,¢A,/,A-ti Sec o/l Ge S
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATEa -�
1Z,,,,G k1�.oirz�, ����i LCp e��-/h 5 /3&S/"5 c5n-4
NUMBER OF PERSONS INVOLVED IN BUSINESS o/L4-
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) CMfffgRM STAMP r>
LOCATION AND SQUARE FOOTAGE OF AREA OFMAY 121993 clic 0
• BUSINESS ACTIVITY IN HOME (EXAMPLE, /,
"BEDROOM - 125 S.F.") /0 a
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLI SED IN THE
BUSINESS OPERATION �,q-,•�i�-S S�.oa//�f
I -HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
APPLICANT SIGNATURE
- I -)-
DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED. I .
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.
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• B "ling and Safety Department
APPROVED BY DATE
DENIED BY DATE
CONDITIONS ATTACHED
oc
Tiaf 4
1993 BUSINESS LICENSE APPLICATION FORMS- /,Z_
......PROOF OF WORKERS COMPENSATION INSURANCCE IS REQUIRED........
APPROVED BY BUILDING & SAFETY DEPARTMENT
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES NO
2. Business Name:
3. Business Address: 5,;? - (,,-2_() Mailing Address:
5. Business Phone:( 9 ) j-& J - 0 0 Q
6. Owned By: CORPORATION PARTNERSHIP (I�NDIVIDU
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # nn t_.I - -10 - tp
9. Name of Owner Li n AcA
• Or Officers b a
10. Type of Business:
11. SBE Resale Number: 4114 1
Title:n �3_y-� S p,,
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors).-
A.
ontractors):A. Estimated Gross Business Receipts for New Businesses Only:
.10 $ V00 DQ UR
B. Previous Year Gross Receipts For Established Businesses:
$ G
********GOOD ONLY FOR JANUARY 1,1993 THRU DECEMBER 31,1993*******
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.
-
Signature Title Date
• Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253