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FEE $35.00
CITY OF LA QUINTA
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
Reaulations.
BUSINESS NAME A-Vp np 5;' l YI%/} �t��5 PHONE T- Q-¢,?
PROPERTY OWNERS-hn r�;�f _ �>rz� �.� PHONE S,> ���
PROPERTY ADDRESS
MAILING ADDRESS 4z/77 0_
TYPE OF RESIDENCE (single, multiple, mobil home, etc.)
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE -T-
40E
NUMBER
NUMBER OF PERSONS INVOLVED IN BUSINESS (ofIz-
LIST NAME OF PERSONS EMPLOYED I�Id�/lz-
. SQUARE FOOTAGE OF USABLEFLO R AR��(E
IN HOUSE (EXCLUDE GARAGEA cq F
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME-
( EXAMPLE , "BEDROOM -125 S.F.") 71 I tC,44. . �� `� �•
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIESEING USED IN THE
BUSINESS • OPERATION 4 ,. inch � lctCGiLrLe-, nry-(( 12 Q./ in C-Cc�_0
I HAVE READ," UNDERSTAND, AND-)GAGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATIODJ IS,ALLOWED (CONDITIONS ATTACHED).
LI
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS REQUIRED.
OWNER/AGENT SIGNATURE 15ATE
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR
DENYING YOUR, HOMt OCCUPATION; FAILURE TO COMPLY WITH CONDITIONS
LISTED ON THi�t`�ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF
PERMIT.
SBuild' and Safety Department
PROVED DENIED CONDITIONS ATTACHED