Atchison & GiacopuzziT-0�df 4.4 QW, (V -
1993 BUSINESS LICENSE APPLICATION FORM
BUS. LIC. N0.
+� I IIIIII VIII IIII IIII
33
......PROOF OF WORKERS COMPENSATION INSURANCE IS REQUIRED........
APPROVED BY BUILDING & SAFETY DEPARTMENT
1.
IS THIS BUSINESS LOCATED AT YOUR HOME:
YES NO
2.
Business Name: J S
3.
Business Address : &,a -S � t St?�
iling Address: C . . ��A 3-7 (.4
Cf °I a S 3
5.
Business Phone:( ) 34
6.
Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7.
If Corporation or Partnership: Tax I.D.#
8.
If Individual Owner: Social Security #
II'' II II rr
�n.VhQ� C1C-L:407Zi
9.
Name of Owner Irt
Title:
•
Or Officers L- `0.0
ZZ
10.
Type of Business:
/Y\'o�-t C_ 1
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:
$ loo Doc)
B. Previous Year Gross Receipts For Established Businesses:
********GOOD ONLY FOR JANUARY 1,1993 THRU DECEMBER 31,1993*******
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
ued to me a are in full force and effect.
Signature 4 X Title Date
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quinta, CA 92253
0
r.v. VUA 17vH
La Quinta, CA 92253
�.;,j� CITY OF LA QUINTA (619) 564-2246
HOME OCCUPATION APPLICATION
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.
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'GL VV-- S j oL Cro Q'7--7 1 l I �j
APPLICANT'S NAME So.OtK W`Q-S"� '�L/ \� I /�>r PHONE `T - a t
PROPERTY OWNER V l 0. C-0 ny 7?- -0 1 SNE '3q -� 1 l
PROPERTY ADDRESS �- S . V \ S ��G� A -e- V\, z\
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS lt�)` C -I
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
NUMBER OF PERSONS INVOLVED IN BUSINESS L
S0.vy\es 0—'—. 0ZZ 1
LIST NAMES OF PERSONS EMPLOYED �• \ � 11 l—• (� 1 A- L. o 0 UZ z
SQUARE FOOTAGE OF USABLE FLOOR AR IN
HOUSE (EXCLUDE GARAGE) cns- gfi 1
LOCATION AND SQUARE FOOTAGE OF AREA OF I
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 S.F.") ReA/borr,-10DSyfH. 811111
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLILT-
BUSINESSOPERATION+{-Ej-e Q Kb (i 4) ('c� LA (A6- c -
r -a �u I � r , ,hQ t x) rV +f r- SAY\
W'V�A STAMP
Aj oc
MAY 2 61993
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY
nP,AT;N IS ALLOWED (CONDITIONS ATTACHED).
/&; //A/)� z �
APPLIC T SIGN T E D T
U i
1 4—
CH A HOME _
PPLICANT IS OTHER T AN PROPERTY OWNER, AUTHORIZATION OF 0 a�E
I RED . 0/-- I----
-5 X�Kj
AGENT SIGNATURE
DA
OR AGENT
r!tt
ORTANT: False or misleadinq'Jinformation shall be grounds for denying
r Home Occupation; failure to comply with conditions listed on the
ached page shall be grounds for revocation of permit.
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Buildirfa and Safety D a tment C,
APPROVED B 5Z—DATE CONDITIONS ATTACHED
DENIED BY DATE