TinoBUS. LIC. NO.
1994 BUSINESS LICENSE APPLICATION FORM
.IVIII'IIIIII'IIIIII
*APPROVED BY
DATE 39
***************WWWWWW,sWWWW
......PROOF OF WORKERS COMPENSATION INSURANCE IS REQQUUIRED........
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES !/ NO
2. Business Name:.l/�L
3. Business Address:543qG, C1.g7A14k1AT- m,4. Mailing Address:
LJO I A 51tQ C 63
5. Business Phone:(
6. Owned By: CORPORATION PARTNERSHIP INDIV
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # 5
9. Name of Owner .f = I TWO Title: S
Or Officers
0 10 Type of Business: -T)el Vt A/ ) / E -L-
11. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNTY HEALTH PERMIT:
YES NO
12. SBE Resale Number:
13. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
S
A. Estimated Gross Business Receipts for New Businesses Only:/s
$
B.. Previous Year Gross Receipts For Established Businesses:
********GOOD ONLY FOR JANUARY 1,1994 THRU DECEMBER 31,1994*******
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 of ect.'
9 Signature
I
e
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
78-495 Calle Tampico
La Quinta, CA 92253
0
FEE $35.00
D
OCT 13 1994
CITY
�wpo IN-r.M CAJi
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
C L
' S PHONE
(- U
PROPERTY OWNER
ZI PHONE
PROPERTY ADDRESS
S
d
MAILING ADDRESS
I;g77-7
TYPE OF RESIDENCE
(single,
multiple, mobil home, etc.)
S[N&L-8
TYPE OF BUSINESS
1j [!�-CoUAi
)T- 7-Ae9VEL_
BRIEF DESCRIPTION
OF HOW THE BUSINESS WILL OPERATE CLIE%U
TS &)/LL
07AIL G7ili2 4/VYVL)/}L
UIS600AT772,4IIL
C[_ya�
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
( EXAMPLE , "BEDROOM -125 S.F.,,) U V INC -P
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION AJOTCf;Tn):�- COn4PLrflFP, I rqY , PRtA)TRL
AN, ru�eZjml1 2 QFr- SCE SrJpOP icS. , rA4f/2
I HAVE READ; UNDERSTAND,'AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCC U ION �IS_ALLgWED (CONDITIONS ATTACHED) .
APP ICA T SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS 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'THF. ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF
PERMIT.
Bui din ---n ---fet De artment___________________________________
VE DENIED CONDITIONS ATTACHED �—
ro�a�y