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I IIIIII VIII 1111 I'll ` y :• � ` � I' t
T 04 -- f BUs i `rIC • NO • ;
OF
1991 BUSINESS LICENSE APPLICATION FORM
*APPROVED,.INITIALSATE `
*DENIED INITIALS DATE
• IS THIS BUSINESS LOCATED'AT YOUR HOME: YES ✓ A NO
Business Name: P�-r��f`j
Business Address: 4. +Mailing Address:,'
7d'- ?S"O� Lc�
s� , 922 S93
Business Phone:( 6/ g ) 77Z y03 Z
.Owned By: C CORPORATION PARTNERSHIP INDIVIDUAL',
If Corporation or Partnership:, Tax I . D. # 33—'.02 y e -7 1V
8. If Individual Owner: Social`, curity #.
.� 9. Name of Owner
f
10.
11.
12.
Or Officers
�: v _
9
Titled
• �S'�c.�c�fc�-y
Type of Business: Pes ,y�
SBE Resale Number:s ,J a3= 871/ X93
BUSINESS LOCATED 'WITHIN T ;'CITY AF -LA ,,QUINTA'� j Does Wot Apply 'To
Building
A. Estimated >Gross.-Susine$'s Mc1aipts T,ioi:;;New"'Busin®sses -,Only'*.
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$ 300 — e&)00
B. Previous Year Grossjteceipts�For Established 'Businesses:
s.
I 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 force and effect. -
Signature Title Date
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253,
0
T4ht 4 4a Qum&
78-105 CALLE ESTADO — LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617
September 11, 1991
Mr. Thomas Patzke
Berry Enterprises, Inc.
78-950 Skyward Way
La Quinta, CA 92253
Dear Mr. Patzke:
A Home Occupation Permit is needed when a business is run out of a
home in La Quinta. When approved, a Business License can then be
issued.
I am returning your business license permit and the check. I have
enclosed a Home Occupation Permit for you to fill'out and return to
the City.
Thank you.
BUILDING AND SAFETY DEPARTMENT
01(Ellie Shepherd
Secretary
/ES
Enclosures: Check, Business License Permit, Home Occupation Permit
MEMOES.58
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253