ADOLPH��3
CITY OF to OUINTA 1AL ,f_ 42 —.23—i/
7e-105 Call* Eat
504
HOME OCCUPATION PERMIT� d % P.O.a o�l.l.ox � CA •
(619)664-2246
APPLICATION
Pead each condition listed on tte attachment to this form to see if the
proposed activity can comply with the city's Nome Occupation Regulations.
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(TYPE OR PRINT IN INK) xx
APPLICANT'S NAME D• 1.ar.�1. PHONE •O 1
PROPERTY OWNER AA PHONE.
PROPERTY ADDRESS I 914I�.RA_r.Ni '..�/�
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) 0`jW1. A;
TYPE OF BUSINESS C"�f�MOT
NUY.fER OF PERSONS INVOLVED IN BUSINESS
LIST NAY,ES OF PERSONS EMPLOYED .0-1
SQUARE FOOTAGE OF USABLE TI&Q04, ARR
IN
HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"HPDR OOM - 125 SQUE FEET")
DESCRIPTI F KACHINE , L UIPM.F�?
OPERATION '^,•w^R
CRY
JAN 231992
AND PLIES BEING USED IN THE BUSINESS
I HAVE READ, UNDER S AND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOW (CONDITIONS ATTACHED).
APPLIC T t1G TURF DATE
IF APPLICANT IS OTHER THIN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
OWNER/AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying your
Hb-ne Occupation; failure to comply with conditions listed on the attached page
shall be grounds for revocation of permit.
SUI ING i SAFETY DEPAR �j
APPROVED BY 5/ DATE y ?/ CONDITIONS ATTACHED ,.
T
DEN: ED BY DATE
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PGA WEST RESIDENTIAL ASSOCIATION, INC.
January 10, 1992
Mr. Don Adolph
55-105 Riviera
La,Quinta, CA. 92253
RE: Request for Permission to Operate A;,Business from Home
55-105 Riviera
Dear Mr. Adolph:
Pursuant to your recent request, this letterisi.to inform
you that the Board of Directors has approved you to
• operate a business—r--Environmental Engineering -- out
of your home, providing the business will be limited to
telephone calls only and that you will not be receiving
clients at your home.
Should you require any further assistance in this.matter,
please do not hesitate to give me a call.
Thank you.
Sincerely,
Bruce Frazrthpel�Board
operty Manager
On Behalf of Directors
P.O. Box 12710, Palm Desert, California 92255, Telephone 619-341-0393 FAX 619-346-5632
r
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L"- •c
14
OF
199t -BUSINESS LICENSE APPLICATION FORM
BUS. iirrIC. NO.
-,p �t k
*APPROVED INITIALS DATE
*DENIED INITIALS DATE
******************************************************************
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES NO
2. Business Name:f�[�1L1.Al6Q.,1�11'LOt�tilEl7il�l.C?,111Li
3. Business Address: � . ldCj RIy1�12P► 4. Mailing Address: 64AS
1� apt r� . �tiz53
5. Business Phone:
6. Owned By: CORPORATION PARTNERSHIP NDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # r
• 9. Name of. Owner aa. Af2QWJJ Title : PXMIM91
Or Officers
10. Type of Business C,p►,S�L'
11. SBE Resale Number:
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:
I HEREBY CERTIFY that all the information supplied by me is correct and
any lice ses required by the County, State or Federal Government have been
is Med, �t� me api ,are in full force and effect.-
V
i3emllrAWT 1 .I
Sigdature;l I Title
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253