CARPENTER11111111111111111111
21
HOME OCCUPATION PERMIT
APPLICATION
'CITY OF LA OWNT/
to -105 Celle Est•s•
P.O. Box 1504
L• oulnt•,CA.92253
,i•�f) 664 -1146
564-2246J PLANNING DIVISION f �� 5/87
ead each Condition stedon the revers e side o this form to see f
2 5 the proposed activity can comply with the City's Home Occupation
✓ Regulations. $35.00 fee
Square footage of usable floor area in
house (exclude garage) 1'7QQ Validation Stamp
Location and square footage of area of
business activity in home (example: 005182 10 2313.10-t7-88 t0
bedrooms; 125 square feet) S.0 CASH i TOTAL t 35.00
<A, F 7 -
to
Description of machinery, equipment, and supplies being used in the
,business operation'11.1>i�Lc I.LE/9hLZ'iifL-� ROTC L7f=
�(aDa��
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
k-5?-
kP"XNT SIGNATURE DATE
If licant ins other than property owner, authorisation of owner or agent
retuied.
e&z�- e D
OWNER OR AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
. • • • • f • t f /
—APPROVED �f/ Initials / d �� 7 � as Date
CONDITIONS ATT ED
DENIED Initials Date
LQHOMOCC.PRT ,
TYPE OR PRINT IN INK
�~''S ��RP
t
APPLICANT'S NAME
PROPERTY OWNER
��c.4
PHONE
PHONE it <<
I `
PROPERTY ADDRESS
-71 '
OR
1 Street)
a
-
(City)
(State)
(Lip) T
Type of residence
(Single, Multiple, mobile
home, etc.) 7Y.�rl�CC
Type of business
Brief description
of how the business wi 1
operate
-
� &
-
-
s
Number of persons
involved in business ;;k
List names of persons employed C- -S
,[
Square footage of usable floor area in
house (exclude garage) 1'7QQ Validation Stamp
Location and square footage of area of
business activity in home (example: 005182 10 2313.10-t7-88 t0
bedrooms; 125 square feet) S.0 CASH i TOTAL t 35.00
<A, F 7 -
to
Description of machinery, equipment, and supplies being used in the
,business operation'11.1>i�Lc I.LE/9hLZ'iifL-� ROTC L7f=
�(aDa��
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
k-5?-
kP"XNT SIGNATURE DATE
If licant ins other than property owner, authorisation of owner or agent
retuied.
e&z�- e D
OWNER OR AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
. • • • • f • t f /
—APPROVED �f/ Initials / d �� 7 � as Date
CONDITIONS ATT ED
DENIED Initials Date
LQHOMOCC.PRT ,
I
9