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2015 Applications STVR & BLCity of La Quinta Finance Department Business License Division 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-71-50 (760) 777-73-05 fax finance@la-quinta.org Finance Stamp FPFMAR 12 2015 DEPT, SHORT-TERM VACATION RENTAL BUSINESS LICENSE APPLICATION FORM BUSINESS LICENSE APPROVAL: APPROVED BY DATE CLASS BUSINESS NAME: BUSINESS ADDRESS: A[ CITY/STATE: � ayk ZIPCODE: 9 ZZ�� MAILING ADDRESS: o5—T C)V C-C r;;,07z, 7 Cae CITY/STATE: C ZIP CODE: BUSINESS PHONE: (40o _�.;-I- &s4� E-MAIL ADDRESS: C e C <<-e c441- K NAMES OF OWNERS OR OFFICERS AND TITLE: eectL 1. a. ESTIMATED GROSS BUSINESS RECEIPTS (NEW BUSINESSES ONLY) b. PREVIOUS YEAR GROSS RECEIPTS FOR ESTABLISHED BUSINESSES: * SB-1186 State Fee TOTAL FEES: BUSINESS TAX SCHEDULE $ S zz�m�6--�) $ $1.00 HOMEOWNER PROPERTY MANAGEMENT CO. CLASS 2 CLASS 3 GROSS RECEIPTS RANGE: _ 0 - 25,000 9.8.00 $21.00 251003. - 50,000 30.00 36.00 ce © 2 1 ! �,Iz) 501002-100,000 36.00 43.00 100,000-250,000 46.00 66.o0 .j C;iY01"LA01 I HEREBY CERTIFY that all information supplied by me is correct and any licenses required by the County, State or Federal Government have been issued to me and are in full force and effect. SIGNATURE: _ 1� _ DATE: ak City of La Quinta Business License No.:� Finance Department, 1. 78-495 Calle Tampico Date Processed: La Quinta, CA 92253 (76o) 777-7150 (760) 777-7105 fax financeQa la-quinta.org HOMEOWNER APPLICATION FOR SHORT-TERM VACATION RENTAL REGISTRATION PERMIT APPLICATION Chapter 3.25 of the La Quinta Municipal Code requires a valid registration certificate of all short-term vacation rental units rented 30 consecutive days or less. The annual registration fee of'$zs (per unit) must accompany this aVlication. A business license is required. PLEASE PRINT OWNER NAME(S): C L C L +\ l QA MAILING ADDRESS: n0 �"t,C 11 CITY, STATE, ZIP: l r PHONE NO.: E-MAIL ADDRESS: (Please provide the best numberto be reached at) VACATION RENTAL PROPERTY Attach additional sheets as necessa�ryy),� _7_ PROPERTY ADDRESS: S —Pik ,' cc. V� NO. OF BEDROOM - j HOA CONTACT NAME (if applicable): HOA CONTACT NO: INTERNET LISTING SITE- T" (R LISTING NO.: PERMIT NO.: If you do not utilize a management company and rent directly by owner, you must authorize a local contact person who is available 24/7/36S to answer and respond to hotline complaint calls within 45 minutes. ?1�c heck here if the owner will be local contact person. Otherwise, please fill out section below. LOCAL CONTACT PERSON: CELL PHONE NO: LOCAL CONTACT PERSON'S ADDRESS: PHONE NO.: Good Neighbor Brochures must be placed in prominent locations in all rental properties as well as provided to the designated 'responsible person' in each rental party. By signing this Short-term Vacation Rental Permit Application, you acknowledge that you have received copies of the Good Neighbor Brochure and understand and accept the responsibility of giving copies to the responsible person in each rental party as well as placing brochures in rental properties. if, ��1 ��1 V If your property is located within a Homeowner Association (HOA) it is your responsibility to adhere to any HOA rictions regarding sho term vacation rentals. L015 I declare under penalty that this information is to the best of my knowledge, true, correct, and complete. (15' .)F i ti. CHJRi ]A 4PPLICATION BY -)IGNATURE: FOR CITY USE ONLY Date Paid: DATE: 00 Amount Paid: .. W� - - - Check Number: Checked By: