SIMONSON�J
•
uf
�fj(/ BUS. LIC. NO. l 4
1992 BUSINESS LICENSE APPLICATION FORM3a oe
*APPROVED INITIALS DATE
*DENIED INITIALS DATE
*****************************************************************
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES X NO
2. Business Namea .eA /_9 r s e •J
3. Business Address :jo/mac/ din 1,z/2eG6 4. Mailing Address:
5. Business Phone: (_�) ✓� `�a aad
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # -6--549- 26
9. Name of owner Title:
Or Officers
10. Type of Business:
11. SBE Resale Number: /y C' 5;"9�
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A.'Estimated Gross Business Receipts for New Businesses Only:
B. Previous Year Gross Receipts For Established Businesses:
$
********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 in full force and effect.
ggniture Title
• l Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box.1504
La Quinta, CA 92253
Date
I I'll"
VIII III 1111
34
•
D
b
V M
to
s s
H H
ff
•
±'ll
M
"'
OVM
N
!drR
•GR
M N
N
CG
v
W
G
t
i
ro<
Y7N
�Zy
I�7w�f
H
Z
p
H
N
M
N
Z
VI
M
��xrr
N
p �Vr
N•
(yUl
P
~�
1 O
1A
0
m
►1
H
uP M tll
do
FI M
^
N
yy,
Y
c
00
7Me
IZiP
s
G
M N
\
� M
CMZ'M
L7 IP
N
G
yy
�
tlH
"
(rjS
Z
gyros$
Mio
M
s
O
<
«
�
1
� •
K
H M Gni
11��'�1
t%'
MV
y
w
i
O
M
p
tv
p
yM
►►'i1
h
,'O
M
Z
tA
N
Pb
K
74
`
N
M
M
4
CY
5
•d
. 1
n
Pp.P
Z.
VIS
.;N.
y
d
Z7s
7•
\
f
N
..
M
M
N
M
M
M
'V
ro
r
n
C
rn
Y
H
N
M
N
Z
VI
M
N
n
(yUl
s
v
o'
�
^
yy,
Y
c
s
G
M•
\
II
M
v
�
1
r
A
IV
w
O
p
tv
p
h
Z
Z
tn
v
N
�o
r N
N
n
N wA 1/
1,400
n O
11 N A
N A �
a 7
a •
n n n
w � C
n v _
N < n
N V
N A �
v
n p
N A 7
N •
i a �►•
e rlw
N w
� Nv o
I n .•• T
fe
ro
I NK O V
I N D
I n t T
I n ►^ v
I N A A
In A
i n w •
1 N P. •
n N Q
N N A3 p
N N Q
w 1"i Pf fo
N N c 7
M
N N PP
w
R
y0
nnw
O
N N •
n N N
N n r w
N n o A
N N w
N N
N N N
n n
n N
n n P•
N N 7
n N A
O
m
.L