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FEE $35.00
CITY OF LA QUINTA
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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 wc'
PROPERTY OWNER 0.,"',
PROPERTY ADDRESS
MAILING ADDRESS
TYPE OF RESIDENCE
TYPE OF BUSINESS
single, mu�tiplle,,'mobil'home,
BRIEF DESCRIPTION OF HOW THE BUSIN SS &WILL OPE
NUM OF P ON NVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE ( EXCLUDE GARAGE)''��►L, ^ Z\r�O
0
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BE G USED IN THE
BUSINESS OPERATION
I IINME READ, N)NDERST NP AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPY O I LL D (C)NIISTIONS ATTACHED)
CANT
IF APPLICANT IS OTHER TF.AN:PR-&P'ERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS REQUIRED.
OWNER/AGENT SIGNK-1bAE "DATE
IMPORTANT: FALSE OR MISLERDING INFORMATION SHAtt BE GROUNDS FOR
DENYING YOUR HOME OCCUPAT_�RN; FAILURE TO COMPLI- WITH CONDITIONS
LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF
PERMIT.
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Buil 'Safes ,- pe artment
ROVED - DENIED CONDITIONS ATTACHED -G
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