BRENNEIS� A I111111IIIIIIIIIIIII
50
• FEE $35.00
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
HOME OCCUPATION PERMIT
Read each condition listed on the attachment to this form to see if
the proposed activity can comply with the City's Home Occupation
Regulations.
BUSINESS NAME MULTI PRODUCTS DISTRIBUTIOBHONE (619)345-6747
PROPERTY OWNER JAMES BRENNEIS PHONE (619)345-6747
PROPERTY ADDRESS 78-835 VILLETA DRIVE LA QUINTTA, CA 92253
MAILING ADDRESS 78-835 VILLETA DRIVE LA QUINTA, CA 92253
TYPE OF RESIDENCE (single, multiple, mobil home, etc.) SINGLE
TYPE OF BUSINESS PRODUCT DISTRIBUTION
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
CONTACT SELLERS AND HOOK THEM UP WITH BUYERS
NUMBER OF PERSONS INVOLVED IN BUSINESS AAAfLY
LIST NAME OF PERSONS EMPLOYED
is
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) 160
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.") OFFICE 160 S.F.
•
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION PHONE, ANSWERING MACHINE, COMPUTER, FAX
FAX, GENERAL OFFICE SUPPLIES
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUP ION IS AL OWED (CONDITIONS ATTACHED). Q /141q
1, lotu4D A,
APPL ANT SIGNATURE
1. a
o
DATE
IF APPLICANT IS OTHER
THAN PROPERTY OWNER,
AUTHO
ATION OF OWNER
OR AGENT IS REQUIRED.
OCT 2 5
1994
�20
QWNER/AGENT
SIGNATURE
DATE
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR
DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH CONDITIONS
LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF
PERMIT.
Building and Safety Department
APPROVED DENIED
Ir-( 9(-131^
CONDITIONS ATTACHED
00 PREAA1S1S —
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MEW-CHRiV D15 L`
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BUS. LIC. NO.
1994 BUSINESS LICENSE APPLICATI
ON FORM
*APPROVED BY t
* DATE
...... PROOF OF WORKERS COMPENSATION INSURANCE IS REQUIRED........
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES_
_ NO
2. Business Name:
3. Business Address:ing Address:
S. Business Phone:
6. Owned By: CORPORATION ARTNERSHIP
INDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: SQQc'al Security #
9 . Name of Owner iz c&, (/ !4%9,e--y7-q 1944". �,�Title: 0 -Al -f We
Or Officers
10
Type of -.,Business:
11. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNT ,HEALTH PERMIT:
"YES NO
12. SHE Resale
Numbe-6--F
.C`171�
- ._r: -,� ��
13. BUSINESS LOCATED WITHIN -THE CITY OF LA QUINTA (Does Not Apply To
-Building Contractors)
A. Estimated Gross Business Receipts for•New."
777 � � \_/� •_.iV .f +�ir1t '.'.. ...+I 1', -" �,l,ppG"�' ..�
8. Previous Year Gross Receipts ForEstablis edaus2 eigses
********GOOD ONLY FOR JANUARY 1,1994 THRU DECEMB
I HEREBY CERTIFY that all the information supplied by me is correct and
any li enses required by the County, State or Federal Government have been
i;44;Xa
n full force d fect.
Title / to
Submit Form To: -
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION 't