BURNSC7
CITY OF LA OUINTA 78-105 C.11• Ealado
t �z P.O. Box 1504
HOME OCCUPATION PERMIT L. oulnt., CA 922:
(819)584-2248
APPLICATION
Read -each -condition -listed -on--tattachment
--to-- this
--form
--to-- see
--if--the
proposed activity can comply withhthe
the City's Home Occupation Regulations.
-------------------- --- -
(TYPE OR PRINT IN INK)
APPLICANT'S NAME
PROPERTY OWNER
PROPERTY ADDRESS
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
BRIEF
NUMBER OF PERSONS INVOLVED IN l
BUSINESS //�Y
LIST NAMES OF PERSONS EMPLOYED AV iA E.'
PHONE_ 9�1I7//'��oG
PHONE %v��i��`1�I��=S✓
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) �aftsmaAMP
NTA
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE, J U L 1 5 19"R."BEDROOM - 125 SQUARE FEET")
fijl%%7iS�AD/�
/Ago— -
DESCRIPTi6N
Aofo--
DESCRIPTION MAC}INERY, QUIP T, AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION ���/V�4 /—
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATI N IS ALLOWED (CONDITIONS ATTACHED).
IF APPLICANT
THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
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 QG i SAFETY DEPAR tT
APPROVED BY / DATE V ( CONDITIONS ATTACHED .
DENIED BY DATE
I
Y
12 i
7
•
CITY OF LA OUlN7A
%7
HOME OCCUPATION PERMIT
78-105 Call* Eatad
P.O. Box 1504
La Oulnia. CA 022
(810)684-2240
` y 0 r Tom`
APPLICATION
Read each condition listed on tte attachment to this form to see if the
proposed activity can comply with the City's Home Occupation Regulations.
------------------- ---
(TYPE OR PRINT IN INK)
APPLICANT'S NAME
PROPERTY OWNER /
PROPERTY ADDRESS
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF' BUSINESS / ��/V //t."/ w
PHONECO�
PHOn to j� ICU �J
NUMBER OF PERSONS INVOLVED IN BUSINE/SS•
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FL90R AREA IN
HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM, - 125 SQUARE FEET")
DESCRIPTIbN����C 1 TYi� �I
OPERATION
II
V
ta1F+•�AMP
i� 07 u
iU CASH i .TOTAL i. 35A0
JUL 151991
AND SUPPLIES BEING USED IN THE BUSINESS
I HAVE READ, UN::£RSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATIQN IS ALLOWED (CONDITIONS ATTACHED).
IF APPLICANT
THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
IMPORI'ANT: False or misleading information shall be grounds for denying your
Horne Occupation; failure to comply with conditions listed on the attached page
shall be grounds for revocation of permit.
BUILDING i SAFETY DEPARTKENT
APPROVED BY DATE CONDITIONS ATTACHED
DENIED BY DATE
IFIR
y
Tit$p 4. 4Q�w
1991 BUSINESS LICENSE APPLICATION FORM
Send Completed Form To:
CITY OF LA QUINTA ;+
BUSINESS LICENSE DIVISION I
P.O. Box 1504
La Quinta, CA 92253
BUS. LIC. /NO .
� v-"} .
Prior to the Issuance of a Business License Number, Businesses
Located In a Home Are Required to Have A Certificate of Use and
Occupancy, Obtainable_through the City's Planning Department.
1. Business Name:
2. Business Address:
3. Mailing Address:
4. Business Phone: ( Z,19 _) _
�5. Owned By: CORPORATION PARTNERSHIP _ D VIDUAL
6. If Corporation or Partnership: Tax I.D.#
7. If Individual Owner: Social Security #_
8. Name of Owner or Officers and Title:
9. Type of. Business: —
10. SBE Resale Number:
11. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA .(Thib
Contractors): fr
A. Estimated Gross Business Receipts for New Businesses Only:
B. Previous Year Gross Receipts For Established Businesses:
$
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 f a and effect.
Titl Date