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CITY OF LA QUINTA
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 :�_P A Ve-0 nQ PHONE 390-5913
PROPERTY OWNER _
PROPERTY ADDRESS
MAILING ADDRESS
TYPE OF RESIDENCE
TYPE OF BUSINESS
BRIEF DESCRIPTION
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(single, multiple, mobil home, etc.)
OF HOW THE BUSINESS WILL OPERATE
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NUMBER OF PERSONS INVOLVED IN BUSINESS -
LIST NAME OF PERSONS EMPLOYED ^long
SQUARE FOOTAGE OF USABLE FLOOR AREA
• IN HOUSE (EXCLUDE GARAGE) Z610 F
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
( EXAMPLE , "BEDROOM -125 S.F.") I o 5,F
DESCRIPTION OF MACHINERY,/ EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION VP�7.1JAA /nAd nGS S.ch-.s , aGA" , CaP&
I HAVE READ, UNDERSTAND, ANW AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUIIS 'LhO (CONDITIONS ATTACHED,) a dd_�,>
APPLICANT-`SIGNATUME 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.
.,
Buil =====and Safety Department
APPROVED DENIED CONDITIONS�ATTACHED—
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