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CITY OF LA ii RU1NTA
HOME OCCUPATION PERMIT
78-105 Calls Estado
P.O. Box 1504
La QuInta, CA 82253
(019)564-2248
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.
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(TYPE OR PRINT IN INK)
APPLICANT'S NAME �Q Ss e �/�X PHONE TO 7,
PROPERTY OWNER . J )Wn Z PHO -i-Gk/-(,303
PROPERTY ADDRESS
TYPE OF RESIDENCE (single, multiple,. molZ,ile home, etc.) 3,-g .
TYPE OF BUSINESS
"I EF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE / le'a 4R K- -S`z4 NAL'- lei'/VS
r
c✓e/?/ ff" �
NUMBER OF PERSONS INVOLVED IN BUSINESS,
LIST NAMES OF PERSONS EMPLOYED '
,SQUARE FOOTAGE OF USABLE FLOG AREA IN
HOUSE (EXCLUDE GARAGE) AP
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE, MAR 2 R 1991
"BEDRogrM - 125 QUARE FEET")
DESCRIPTION CHItTERY, EQUI T, AND SU I .BUS ESS
OPERATIO �i /
I HAVE READ, UNDERST D, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWS (R NDITIONS ATTACHED).
V� t
A A
PPLICXNT SIGNATYkE 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.
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BUILD NG G SAFETY DEPART&T
APPROVED B v DATE / CONDITIONS ATTACHED
DENIED BY DATE
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