Morrisp8p10goxa1504Estado
18
La Quinta, CA 92253
CITY OF LA QUINTA (619) 564-2246
•44OF n+� HOME OCCUPATION APPLICATION
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
PROPERTY OWNER
PROPERTY ADDRESS
�,�' rl �, � 1� �� IL .!/111 • � ' •� '
TYPE OF RESIDENCE/(single,
TYPE OF BUSINESS
BRIEF DESCRIPTIO)r OF HOW
AM
ltiple, mobile home, etc.)
BUSINES§ DILL OPERATE
.NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FL OR AR IN
•HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HO (EXAMPLE,
"BEDROOM - 125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPL
BUSINESS OPERATION n,
I HAVE READ, UNDERSTAND, AND AGREE WITH THE
MYOFLAOmA
VALIDATION- STAMP.
FEB 21 1992 (I
BBUILDING AND SAFE EPT. , F6 .4
USED IN THE
ONS BY WHICH A HOME
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___________________
Bui din and Safet artment
APPROVED BYNA�35bATE Os� 1 V CONDITIONS ATTACHED
DENIED BY DATE ,
•
•
•
BUS—LIC. NO.
1991 BUSINESS LICENSE APPLICATION FORM /6
1 -) 2-
******************************************************************
*APPROVED' INITIALS DATE
*DENIED INITIALS DATE
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES V NO
2. Business Name:
3.
5.
Business Address: J ,�r
1-6 ha, PA cja8AK
Business Phone:(
Mailing Address:
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual n
Owner:Social
,�Security # 62-50.019 9
9. Name of Owner 4P--h9L1nb I"IL) yiS Title:
Or Officers KA l AI+, Aa 11S
10. Type of Business: -
11. SBE Resale Number: L)KEkc %3- 9YU4 a
12.- BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
B. Previous Year Gross Recbipts For Established Businesses:
$ .,:6 5 c
********GOOD ONLY FOR JANUARY 1,1991 THRU DECEMBER 31,1991*******
I HEREBY CERTIFY that all the information supplied by me is correct and
any licenses req d by the County, State or Federal Government have been
issue to me a ar in full force and effect.
C1a---�
Si6natufe Title Date
• Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253