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FEE $35.00
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
HOME OCCUPATION PERMIT
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.
BUSINESS NAME 'V3xxxo.s G1usS Sy►--av:orS PHONE •z -g2 1064
PROPERTY OWNER PHONE :3 -7Z --401-1
PROPERTY ADDRESS %&o So. ,JtQ 1pr
MAILING ADDRESS 51a e,
TYPE OF RESIDENCE (single, multiple, mobil home, etc.)
TYPE OF BUSINESS 'k, -40-,k e� S�nuLc.e
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
�.rC nhCm r->'Jro 4- C— ,4 .t,%rA
NUMBER OF PERSONS INVOLVED IN SYJSINESS ehP_
LIST NAME OF PERSONS EMPLOYED
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) -LsZ �\ j
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
( EXAMPLE , "BEDROOM -12 5 S.F.") MA 03 1 4 U
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEINGEUSED N T E
BUSINESS OPERATION t - - r
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHI A
HOME OCC PATION_IS ALLOWED (CONDITIONS ATTACHED).
QU ha3
APP ICAN SIGNATURE EJATE
"IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT I S. REQUI RED .
sr_ ; 4
OWNER/AGENT SIGNATURE DATE.
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BES GROUNDS FOR
` DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH CONDITIONS
.. LISTED ON THE ATTACHED PAGE SHALE., BE GROUNDS FOR: _RK-VGCATION OF
PERMIT.
---------------
Bui and Safety Department
` APPROVEDDENIED CONDITIONS ATTACHED