SCHURKENSIj(i BUS. LIC. NO.
", /Y
FORM I Ililll VIII IIII IIII
1-4
1992 BUSINESS LICENSE APPLICATION 0 3s
*APPROVED INITIALS 005ANT -? -
*DENIED INITIALS i0DArMEH i - *� 30.00
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES X NO
2. Business Name:—N. C Schu kens ATcp
3. Business Address:80082 Palm Circle 4. Mailing Address: P. 0. Box 2917
LaQuinta, CA 92253 Palm Desert, CA 92261-291
5. Business Phone:(619 )..773-0182
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL yes
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # 225-46-1648
Ej
Name of Owner N. C. Schurkens
Or Officers
Title: consultant
10. Type of Business: Planning Consultant (Certified Planner)
11. SBE Resale Number: N/A
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ 50,000
B.. Previous Year Gross Receipts For Established Businesses:
$ N/A
********GOOD ONLY FOR JANUARY -1,1992 THRU DECEMBER 31,1992*******
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 full force and effect.
owner 4/17/92
4) Signature
Title
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. •Box .1504
La Quinta, CA 92253
Date
78-105 Calle Estado
j_ P.O. Box 1504
La Quinta, CA 92253
CITY OF LA QUINTA (619) 564-2246
HOME OCCUPATION 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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APPLICANT'S NAME -fJ C'. SeG/curc.�'eNS. PHONE -341' 5-30
PROPERTY OWNER /ii.R i'L o6y k I l so J PHONE 341- 9 3 9(o
PROPERTY ADDRESS So 0 8?- P11
TYPE OF RESIDENCE ((sing , multiple, mobile home, etc.)
TYPE OF BUSINESS ` `,ASN :rope d Con, MJ,vA 4 �odner`� CoA)so I In,,,(�_
,EFy� DES CR PTION OF HOW TH�7E BUSINESS WILL
/ .OPERATE
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED /V. (!. S'e kue.i<oA1 c_
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
.HOUSE (.EXCLUDE GARAGE) J5-00
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN H24E j EXAMPLE,
"BEDROOM - 125 S.F.")
APR 2 11992
STAMP
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION 'ems
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. ;
0M,_ ffAm
SIGNATURE
04:4
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.
Bui.Xding and Safety a artment
APPROVED BY -V DATE �J� CONDITIONS ATTACHED
DENIED BY DATE
:7
690
16-7021/3220
41.2 19 / 7 .1i
PALM
/72- 05 HIGHWAY W AOYF111, SUITE
TE
COAST A-1
PALM DESERT, CA 92260.3308
SAVINGS
. MEMO
;A:3220?02134 &13021?7B091i- 0690
•
oTA
M OF
NON -EMPLOYER CERTIFICATE
I certify what in the performance of work for which this City of La
Quinta business license is issued I shall not employ any person in
any manner so as to become subject to the workers' compensation
laws of California.
Note: If :after signing the certificate, you hire any employee, you
become subject to the workers' compensation provisions of the
California Labor Code, and you must immediately comply with the
provisions of Section 3700 or your license immediately becomes
revoked.
Business Name: N. C. Schurkens, AICP
Business License Applicant:N. C. Schurkens
Date: 4/17/92
•4 �Gw BUS. LIC. NO.
1992 BUSINESS LICENSE APPLICATION FORM _..
******************************************************************
*APPROVED INITIALS DATE
*DENIED INITIALS DATE *.
******************************************************************
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES X NO
2. Business Name: N. c. Schurkens. AICP
3. Business:, Address: 80082 Palm Circle 4. Mailing Address: p. 0. Bax 2917
LaQuinta, CA 92253 Palm Desert, CA 92261-2�
5. Business Phone:(619 ) .773-0182
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL yes
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # 225-46-1648
9. Name of Owner N. C. Schurkens Title: consultant
Or Officers
10. Type of Business: Planning Consultant (Certified Planner)
11. SBE Resale Number: N/A
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ 50,000
B.. Previous Year Gross Receipts For Established Businesses:
$ N/A
********GOOD ONLY FOR JANUARY 1,1992 THRU DECEMBER 31,1992*******
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 /ar /in full force and effect.
owner 4/17/92
Signature Title Date
• Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253