DeanCITY OF LA OUINTA'IIIIIIIIIIIIIIIIIIII'
L 19
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HOME OCCUPATION PERMIT
APPLICATION
78-106 Celle Estad
P.O. Box 1601
La Oulnta. CA 022
(810)661-2218
•
SQUARE FOOTAGE OF USABLE F4QOR AREA.IN ~ w
HOUSE (EXCLUDE GARAGE) Gi(L1f�fi<<A�,4ull�lF
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
-'BEDROOM - 125 SQUARE FEET")
DESCRIPTION OF MACHINERY, EQUIPMENT,
OPERATION 111b
SEP p 51991
AND SUPP)*S BEING USED'_ IN TH SXNESS
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (GOND ONS ATTACHED).
q/11/1
. I _�TIA nlA. R- C,
CANT SI
IF APPLICANT IS OTHER. THIN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
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.
SUAING i SAFETY DEPARTKENT
APPROVED BY DATE CONDITIONS ATTACHED '..
T
DENIED BY DATE
Read each condition listed on tt.e attachment to this form to see if the
proposed activity can comply with the City's Home Occupation Regulations.
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(TYPE OR PRINT IN
INK)
`
APPLICANT'S NAME
,SNf- b fAM I NY
G Q.
I b� PHONE
PROPERTY OWNER
S', ►jc'J�C� /,"�C�y�
PHONE
PROPERTY ADDRESS
�1IT
`�� `L -'I T yc /[/t.f ) G'
r d e,
TYPE OF RESIDENCE
(single, multiple, mobile home,
/�
etc.) �l "le,
'
TYPE OF BUSINESS
1 4 k I l Or d,eeora ' lU
I
BRIEF DESCRIPTION
OF HOW THE BUSINESS WILL OPERATE h D /te-,
NUMFER OF PERSONS
INVOLVED IN BUSINESS
LIST NAMES OF PERSONS
EMPLOYED
•
SQUARE FOOTAGE OF USABLE F4QOR AREA.IN ~ w
HOUSE (EXCLUDE GARAGE) Gi(L1f�fi<<A�,4ull�lF
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
-'BEDROOM - 125 SQUARE FEET")
DESCRIPTION OF MACHINERY, EQUIPMENT,
OPERATION 111b
SEP p 51991
AND SUPP)*S BEING USED'_ IN TH SXNESS
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (GOND ONS ATTACHED).
q/11/1
. I _�TIA nlA. R- C,
CANT SI
IF APPLICANT IS OTHER. THIN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
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.
SUAING i SAFETY DEPARTKENT
APPROVED BY DATE CONDITIONS ATTACHED '..
T
DENIED BY DATE
BUS. LIC. N .
1991 BUSINESS LICENSE APPLICATION FORM
P
*•k***�k*******�tr�lr********�Ir***�Ir�lr**�Ir*�Ir**�Irilr�lr**�k�lr**�Ir�k**�t*�tolr*fir*�Ir�lr*�Ir�lr**�It*�Ir
*APPROVED INITIALS DATE
*DENIED INITIALS DATE
* •k * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * �lr * * * * * * * * * * * * * *ale * * * * tk * * * * * * * *
I. IS THIS BUSINESS LOCATED AT YOUR HOME: YES_ NO
2. Business Name: S �} lNI j ��25
3. Business Address : q��}55 (,;r&,4. Mailing Address:
5.
Business Phone:( A2,9!3
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
If Corporation.or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # ZZ9• oto 1fo19101
• 9. Name of Owner SAt-�< Title:
Or Officers
10. Type of ,Bus'iness :
11. SBE Resale Number:. S4
12. BUSINESS LOCATED WITHIN THE.CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ fs
B. Previous Year Gross Receipts For Established��.7sT AL 9i i i - 9
ii8.�(1 io
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
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
I -b-9 i
Date