LESSO�1_
•
1111111 IIIII IIII IIII �.�t � -�
u�',K,1� - 62
141s �44
CITY OF LA QUINTA
72 7-5
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
PROPERTY OWNER Q
PROPERTY ADDRESS S" U
MAILING ADDRESS
TYPE OF RESIDENCE (single, multiple,
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THI BUSINE'
NUMBER-OF/PERSONS INVOLVED IN B S
LIST NAME OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) �_6'
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACH IR E UIPMENT,
BUSINESS OPERATION ���. C
PHONE 7 %% _ Ojl'r
PHONE ;77/
it home, etc.)
S WILL.OPERATE
SUPP
NG USED IN THE
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME` OCCUPATIQN Ij$ AJ,LOWED (CONDITIONS ATTACHED) .
APPLICANT SIGNATURE
�-- 9
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 THE ATTACHED PAGE SHALL BE, GROUNDS FOR REVOCATION OF
PERMIT. -
Building
ERMIT.-Bui din and Safety Department
APPROVED DENIED CONDITIONS ATTACHED 2y&j,¢„
APPROVED