BEAVERSP
FEE $35.00
p Y11 0 7`�4
Al CITYOF QU NTA
MAR 2 81994
CITY OF LA QUYNTA
BUILDING AND SAFETY DEPT.
78-495 Calle Tampico, P. O.Box 1504, La Quinta
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 FL -ITE BVIL- PHONE &1 0--243/0
PROPERTY OWNER BP- I A n/ 9&AyE"�S PHONE&1 9, - 33`t
PROPERTY ADDRESS 7!&-9-7,!S- 5A Mi'.4 Df L • ILLS Q,)t A-J'r c A G12z if -3
MAILING ADDRESS -7G-0-71S- S/A /v t TA D2• L-A. Qui /VA c -P ` 7-z53
TYPE OF RESIDENCE (single, multiple, mobil home, etc.) SiN&LE
TYPE OF BUSINESS & Nt;7( -AL- Lp/vTi ZA6T) N 6
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE / 50/y
W 0 0 IG , v G A"vAV Fri'+'! e:— ,
NUMBER OF PERSONS INVOLVED IN BUSINESS /
LIST NAME OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AR)�A
IN HOUSE ( EXCLUDE GARAGE) /Goy 7,y"�
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")���
DESCRIPTION OF MACHINERY, EQUIPMENT, A D SUPPLIES BEING USED IN THE
BUSINESS OPERATION 7�i�� sem.✓ X161-niD 7-000_S
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCGU�TIOrI/(CONDITIONS ATTACHED) . 312-,
g/Qy
APPLICANT SIG ATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS REQUIRED.
OWNER/AGENT SIGNATURE DATE
• 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.
Buil and Safety Department
APPROVED DENIED CONDITIONS ATTACHED
3 zp_9y
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