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:.-- HOME OCCUPATION PERMIT
= `s' - APPLICATION
"CITY OF LA QMJ
18-105 color tatede
P.O. BOX 1504
toulft"A.92:51
1619) 664-1146
664-2246 PLANNING DIVISION 5/07
ad each condition listed on the reverside side of this form to see if
the proposed activity can comply with the City's Nome Occupation
Uegulations. $35.00 fee
TYPE OR PRINT IN INK
APPLICANT'S NAME
PROPERTY OWNER_
PROPERTY ADDRESS
PHONE SZ V iCS"'S✓S/
PHONE .s G S- ?.r+S Z
(Street)
4A , --4 917.2, s
(city) (State) (Zip)
Type of residence in le Multiple, mobile home, etc.)
Type of business
Brief description of how the business will operate ['2�.���.�
�., 7- �t�, n t.n.r or
Number of persons involved in business
List names of persons employed
Square footage -'of usable floor area in
house (exclude garage) /�2 W n --
Location and square footage of area of
business.activity in home (example:
bedrooms; 125 square feet)
GA Afig E to ac / > 149.A _-ZaL e7—
Description of machinery equipment, and
business operation o: 41- az' A'af✓1.0 2 &M
lid�ati n St p
ems•
Les being used in
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
APPLICANT SIGN DATE
If Applicant is other than property owner, authorization of owner or agent
required.
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
reverses all be grounds for revocation of permit.
• • • • • • • • • • • •
APPROVED �J Initials 1�� /' " Date
CONDITIONS ATTACHED'
DENIED -Initials Date
LQHOMOCC.PRT
•
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1992 BUSINESS LICENSE APPLICATION FORM
BUS. LIC. NO.
�� I II'lll ll'll ll'l llll
- - 12 -
********************************* **************************
*APPROVED INITIAL**** DATE
*DENIED INITIALS DATE
******************************************************************
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES_ NO
2. Business Name: S',141-ct .CRw-os 4Ai✓10-ce ffo1N5
3. Business Address: _S;?7o/ //,/6 4. Mailing Address: PO, ,C3'ox
v : rv��4 �a �4 �i s/ r✓�A �' i9
5. Business Phone:( 4/9 ) SGS y
6. Owned By: CORPORATION PARTNERSHIPDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # 'S`70 9G
9. Name of Owner Title: Qwn�E�
Or Officers
10. Type of Business: 1X1vysc4AE
11. SBE Resale Number:
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
B. -Previous Year Gross Receipts For Established Businesses:
********GOOD ONLY FOR JANUARY 1,1992 THRU DECEMBER 31,1992*******
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
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
r
Date