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CLAYTON• FEE $35.00 4 04a am�tm 36 - CITY OF LA QUINTA 78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253 HOME OCCUPATION PERMIT Read each condition listed on the attachment to this form to see if the proposed activity can comply with the City's Home Occupation. Regulations. BUSINESS NAME ,OGkT- I-'OdG_S PHONE %%q W.0141- PROPERTY .0fPROPERTY OWNER 1;777) PHONE PROPERTY ADDRESS MAILING ADDRESS /,, i. TYPE OF RESIDENCE (single, multiple, mobil home, etc.) TYPE OF BUSINESS /�DepL SCF -,4 -,!//LC - BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE NUMBER OF PERSONS INVOLVED IN BUSIN S LIST NAME OF PERSONS EMPLOYED y • SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE) / SO LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EXAMPLE, "BEDROOM -125 S.F.") DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS OPERATION I HAVE READ, UN D RS 49/, AND AGREE WITH THE CONDITIONS BY WHICH A HOME OCC ,11 WED CONDITIONS ATTACHED). 16 --7 APPLICANT SIrAkt RE DATE IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT IS REQUIRED. OWNER/AGENT SIGNATURE DATE IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH CONDITIONS LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT. •Buil ing and Safety Department /APPROVED DENIED CONDITIONS ATTACHED qt r C� Al BUS. LIC. No. 1994 BUSINESS LICENSE APPLICATION FORM �asas�atare�s�►u* w�rbrmsva4 .*APPROVED 'B S�! DATE a • • • • .. PROOF OF WORKER$ COMPENSATION INSURAWC�%: 7' 5 REQUIRED _ , , , .. _ . IS THIS BUSINESS LOCATED AT YOUR HCS;., YES. pope, NO Business _Name: &EILLs ,,,71-{, - f Business Address: 78e'V-,' ' A! �f'? 4 1-4' ✓i4- 7—,oq 13us"iness Phone: (_ Maill-r q Address- Fb u r. Owned -By: CORPORATION PARTNERSHIP^ If Corporation or Partnership: Tans X ,_D; # INDIVIDUAL 6 • It Individual Owner: Social Security� Lc) _73 9. Nate of Omer ��ij%r��L �LLv��-l?�Title:_ O��fiZ Or Officers Type ak•. Business S�; ►�,_, �.+v c :�t,�r�c .. l l • IF YOU ARE A FOOD vZ=0R, 00 YOU HAVE A COUNTS.' HEALTH s no 7. S3, SBE e 13. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA y'(Does Not . RUildlnq. Contractors ): APp1Y .�©° . A. Estimated Gross Business Receipts for .'!ew Businesses Only: B: Previous -Year Gross Receipts For £stabtfshed Businesses: 2- 7— 000 *******'*GOOD ONLY FOR JANUARY 1,1994 THRU DECEMBER 31,,.1994******* I HEREBY CERTIFY that all the information supplied by me is correct and any licenses re u red by the County, State or Federal Government have been issued tof� re in 'full force and affect. Submit Form TO: CITY DF LA QUI'1TA BUSINESS LICENSE .Da9'TSION T-pp7�7 .�aay, aa�•wrw3erRea pn.-7 :Da