GRAFF (2)IV
Fee $35.00
37
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78-495 CALLE TAMPICO •— LA QUINTA, CALIFORNIA 92253 - (619) 777-7050
FAX (619) 777-7011
APPLICATION FOR PAID
HOME OCCUPATION OF A BUSINESS DEC 051997
CITY OF: LA► QItIWA
Read each condition listed on the attachment to this form to see if the proposed activity
complies with the City's Home Occupation Regulations.
APPLICANT NAMES (List all owner,��partners and/or corporation officers)
na�;el t'. N GcO . CPA
PROPERTY ADDRESS
• BUSINESS NAME
gqo�,o fii 0,0_ V (,ce PHONE
)(In't eJ F, �j . r,, q. rPA
PROPERTY OWNER �ol�r1 a(n0 f�ebeC-Co- CLk(�e r)
MAILING ADDRESS (if different from business address)
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) iNGLC
TYPE OF BUSINESS 0CC0�`^k- ,A 9 R- %axes
BRIEF DESCRIPTION
1O/F HOW THE Bn
BUSINESS WILL OPERATE l/ee� 4/"A
rf-ak- refu,rkiS 1-b be- done a f - k b ass iv? ec 9 Qcvd/PS'S,
NUMBER OF PERSONS INVOLVED IN BUSINESS �--
LIST NAMES OF PERSONS EMPLOYED .N A
SQUARE FOOTAGE OF USABLE. FLOOR AREA IN HOUSE (exclude garage) ppr°X No C)
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS, ACTIVITY IN HOME jexample,
"bedroom - 125 sq. Ft.)
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED JN THE I�, SINESS
OPERATION Comeukr ?`ekPhw1e- , CQle4146r-
_ Lehc(1 S , and ofkr / csnel%1eoc,.r scf,alies
MAILING ADDRESS - P.O. BOX 1504 - LA OUINT'. CAI
• I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOW D (c ditiioons attached).
c 09� Date
Applicant's Signature
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR
R AL/LEASING AGENT IS REQUIRED.
Date 'A '
0 ner/Agent Signature
Agent Company Name
Date
Agent/Owner Contact Phone #
IMPORTANT: FALSE vR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT.
BUILDING & SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION
y APPROVED DENIED SPECIAL CONDITIONS ATTACHED
BY: I . D. # S 2�' DATE 12-- 1
0