LEVANDFR•
47
FEE $35.00
q`t'y 4 444 aluba
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA
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 9,4,1 (�oQ/ cvinrYoui -/-j�4rn9 PHONE
PROPERTY OWNER AZ
GFPHONE
PROPERTY ADDRESS AIR j2, -
MAILING ADDRESS 7? -.365- dwa /// A If4l /.r9 Q
TYPE OF RESIDENCE (single, multiple, mobil homy
TYPE OF BUSINESS bo I n 4 o LA) -f (ri+l n c)
BRIEF DESCRIPTION OF HOW THE BUS.
NUMBER OF PERSONS INVOLVED IN BU
LIST NAME OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR ---A
IN HOUSE (EXCLUDE GARAGE) #A,O o
771 - 0079
771-00-79
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION "d C4 . 194 10ho7U S
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATION IS ALLOWED (CONDITIONS ATTACHED)./,,,.— _ k,
APPLtC,ANT SIGNATURE @ATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS REQUIRED.-
OWNER/AGENT SI�GNA 'URE DATE
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR
DENYING YOUR HOME OCCUPATIOid; FAILURE TO COMPLY WITH CONDITIONS
LISTED ON%THE ATTACHED -J -PAGE SHALL BE GROUNDS FOR REVOCATION OF
PERMIT.
B ildin===nd SafetV Department
P ROVED DENIED CONDITIONS ATTACHED