GUMTZ (2)P.0 Box 1504
F i
La Quinta, CA 92253
(619) 564-2246
ITY OF LA QUINTAHO7-
-i
OCCUPATION APPLICATIONOF 20
AD.Read eaccond 'ste n the attachment to this form to see if thei"h
proposed activity ca o ly with the City's Home Occupation Regulations.
APPLICANT'S NAME ./jt(/T//c �/j/L,Ii� �CiM 7Z PHONE c5 zz /�Z2 /
PROPERTY OWNER
PROPERTY ADDRESS
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
G
B IEF DESCRIPTION OF HOW T BU NESS WILL OPERATE
�
�elf �� s
o�DLfSiN�ER
tjq INVOLVE 1W BUSINESS
LIST NAMES OF PERSONS E OYED
I
SQUARE FOOTAGE OF USABL FLOG AREA IN
HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF.AREA
BUSINESS ACTIVITY IN HOME.(EXAMPLE,
"BEDROOM - 125 S.F.") %00 S.
DESCRIPTION OF MACHINERY, EQUIPMENT,
BUSINESS OPERATION • Alj�— �-
` PAID �00a' 0/- r
STAMP
JAN 121993
DEPT,.
SUPPLIES BEING USED_IN THE
I HAVE READ, UNDERSTAND, AN AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPA,TIOON IS ALLOWED (COND TIONS ATTACHED).
��i�S��/�iFW`.
.. _ �_
IF APPLICANT IS OTHER THAN PROPERTY OWNER,�IZATION OF OWNER OR AGENT
REQUIRED.
OWNER/AGENT SIGNATURE < DATE
MPORTANT: False or misleading info m i sh 1 be grounds for denying
your Home Occupation; failure to co ly i ondi s listed on the
attached page shall be grounds for evoc t ori o ermit.
----------------------------------- -- - --- ---------------------------
:.: Building and Safety Department
APPROVED BY DATE CONDITIONS ATTACHED
a
DENIED BY DATE
_ Z
�y OF THt
MEMORANDUM
TO: John Risley, Accounting Supervisor
FROM:;; Tom Hartung, Building and Safety.Director
DATE: January 15, 1993
.SUBJECT: Reimbursement of Home Odcupation Permit
Please reimburse Lawrence Gumtz for the Home Occupation Permit fee
of $35.00. The Home Occupation permit should not have been
requested.
Please mail to: Lawrence Gumtz
48=529 Via Encanto
La Quinta, CA 92253
Thank you.
TH:es
BUS. LIC. NO.
M2 BUSINESS LICENSE APPLICATION FORM
Send Completed Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
1.
Business Name:
Z_: }4 ,C'Z
/"j TZ
2.
Business Address:
ZA-
CX- aC7`2 2 s 3
3.
Mailing Address:
-SA*
4.
Business Phone: (��
�/� ( 7;7 6L - q /?2 I
5.
Owned By: CbRPORATION
PARTNERSHIP INDIVIDUAL
6.
If Corporation or
Partnership: Tax I.D.#
7.
If Individual Owner: Social
Security #
8. Name of Owner or Of f icers and Title: rZ
9. SBE Resale Number:
10. Number of Decals Needed:
11. CONTRACTORS ONLY:
A. Type of Contractor:
B. Classification:
C. State License Number:
CONTRACTORS - GENERAL $100.00 Per Year
CONTRACTORS - SUB $ 50.00 Per Year
or -annual
or $25.00 Semi-annual'
CONTRACTORS ARE ON A•CALENDAR;YEAR BASIS ONLY; ANNUAL FROM JANUARY 1ST
THROUGH DECEMBER 31ST. SEMI-ANNUAL FROM JANUARY'1ST THROUGH JUNE 30TH; OR
JULY 1st THROUGH DECEMBER 31ST.
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.
Siqnature
Title
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