WORKa.,a VuliJLct, LA y1153
CITY OF LA QUINTA
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Ofr", HOME OCCUPATION APPLICATION
QI n 3 CG
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
PHONE6{®�
PROPERTY OWNER
PHONE 3q7"I R_ 36 fl SS
PROPERTY ADDRESS � l e'%')a " ���� L 0L,(1
q-2 Z,53
TYPE OF RESIDENCE (si,�nc.le, multiple, mobile home,
etc.) S(r)! P1
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATEc((��
. NUMBER OF PERSONS INVOIyVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED Cot(-
`TzeJO VVL�IOQ,
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
PAID ME
t HOUSE ( EXCLUDE GARAGE) 1 SO S F
VAL A ON _ °STAMP 6.3
LOCATION AND SQUARE FOOTAGE OF .AREA OF
JAN< 1993
BUSINESS ACTIVITY IN HOME. (EXAMPLE, 2ox2v
"BEDROOM
DEPT. C`3
- 125 S . F . ") L'c,rr; �a� �� p' S E (=,
•
BUK DING
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES
BEING USED IN THE
BUSINESS OPERATION EC�rn�,,.� �►-��yL�� }o.�t��
_ I HAVE READ, UNDERSTAND, AND AGREE WITH THE. CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
OWNER/AGENT SIGNATURE DATE
yPOj:1T: 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.
BuildAq and Safety Department
• APPROVED BY LDATE � CONDITIONS ATTACHED
DENIED. BY DATE
1993 BUSINESS LICENSE APPLICATION FORM
Send Completed Form To:
. CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
76
BUS. LIC. NO.
.x.._ 1
. 1
1. Business Name: J�P_. C:�T J`,cc/ �cn 2K,
2. Business Address : ---? --) _?'Do (?r? q-n`�SE�rt--�
3. Mailing Address:
4. Business Phone: 3 8OS
5. Owned By:. CORPORATION PARTNERSHIP INDIVIDUAL
6. If Corporation or Partnership: Tax I.D.#
7. If Individual Owner: Social Security
8. Name of Owner or Officers and Title:
Mck)
9. SBEResale Number:
10. Number of Decals Needed:
11. CONTRACTORS ONLY: COPY OF STATE CONTRACTORS LICENSE IS REQUIRD
A. Type of Contractor: S ( VIGLy
B. Classification: 35'
C . State License Number: 3 30
CONTRACTORS - GENERAL $100.00 Per Year or $50.00 Semi-annual
CONTRACTORS -'SUB $ 50.00 Per Year or $25.00'Semi-annual
CONTRACTORS ARE ON A CALENDAR YEAR BASIS ONLY; ANNUAL FROM JANUARY 1ST
THROUGH DECEMBER 31ST. SEMI-ANNUAL FROM JANUARY 1ST THROUGH JUNE
30TH; OR JULY 1ST THROUGH DECEMBER 31ST.
1
•I HEREBY CERTIFY that all the information supplied by me is correct and
any licenses required by the County, State or Federal Government have been
issued to me and are in full force and effect.
Sigbature Title Date