Thompson & Woodc 17 F A r
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CITY OF LA QUINTA
HOME OCCUPATION APPLICATION
78-105 Calle Estado
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
40
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 C-L46�,)c r-l-rck n.
PROPERTY OWNER K T lq0M p�YJ
PHONE
PHONE 61c)
PROPERTY ADDRESS 4L� -Z I 1� &oLTM J?o10 GKe �LA Civ► rIMQ� CA, C9ZZ9 3
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)-j,tr4o16
TYPE OF BUSINESS CDNVc`T1 Zal.1
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE kJf_ I Jkk CONT)?w-'"
Y.ITG��'1 �rJY� 1�omt z��mo�� iw�
'F
NUMBER OF PERSONS INVOLVED IN BUSINESS i
LIST NAMES OF PERSONS EMPLOYED _Tl0yyl PS4)1'J
SQUARE FOOTAGE OF USABLE FLOOR ARA IN
40 HOUSE (.EXCLUDE GARAGE) ZI y U fa
LOCATION AND SQUARE FOOTAGE OF AREA OF
,iv'INESS ACTIVITY IN HOME (EXAMPLE,
"I " 'OM - 125 S.F.") I'zo fz
VALIDATION -STAMP
009 4 CASIIg OTOT-[8-9`
DE:._. •.'TION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION
I HAVE E , UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPA , ONjtS ,1nLOWED ( CONDITIONS ATTACHED) .
CAST SIGNATURE DATE
IF APPLICANT IS OTHER THAN 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.
Buildinq and Safety D rptment
APPROVED BY J DATE~gay CONDITIONS ATTACHED
DENIED BY DATE
BUS. LIC. NO
1992 BUSINESS LICENSE APPLICATION FORM
I
Send Completed Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504 005182 10 9993 05-22-92 14
'La Quinta, CA 92253 10 CASH i TOTAL 1 100.00
1. Business Name • CLASSIC KITCHENS OF La QUINTA
2.
3.
4.
5.
6.
7.
8.
Business Address: 44215 GOLDNEROD CIRCLE
La QUINTA, CA 92253.
Mailing Address:. SAME AS ABOVE
Business Phone: ( 619 , ) 345-5950
Owned By: CORPORATION
If Corporation or Partnership:
IPS INDIVIDUAL
Tax I . D. # 77-0136784
If Individual Owner: Social Security #
Name of Owner or Officers and Title: DANIEL W. WOOD - PRESIDENT
LINDA C. WOOD - SECRETARY KEITH KERSHNER - CHIEF FINANCIAL OFFICER
9. SBE Resale Number: SRGH 26-779716
10. Number of Decals Needed:' 3
11. CONTRACTORS ONLY:
A. Type of Contractor: GENERAL
B. Classification: B
C. State License Number:: 5 127
CONTRACTORS - GENERAL Per Y or $5.0.00 Semi-annual
CONTRACTORS - SUB $ 50i.UO Per Year or $25.00 Semi-annual
CONTRACTORS ARE ON A CALENDAR�YEAR BASIS ONLY; ANNUAL FROM JANUARY 1ST
THROUGH DECEMBER 31ST. SEMI -.ANNUAL FROM JANUARY 1ST THROUGH JUNE 30TH; OR
JULY 1st THROUGH DECEMBER 31ST.
I HEREBY CERTIFY that all the information supplied by me is correct and .
y l4kenses required by the County, State or Federal Government have been
1%91*s.ueA to Ofe and are in full force and effect.
Signature
Chief Financial Officer
Title
April 21, 1992
Date