FRECHI I"III I�III II'I I"I
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78-495 CALLE TAMPICO — LA OUINTA, CALIFORNIA 92253/7/777-7000
APPLICATIO-N FOR FAX (760) 777-7101
XHOME OCCUPATION OF A BUSINESS TDD (760) 77711227
IN A
44""jam GATED COMMUNITY
Read each condition listed on the attachment to this for see if t
with the City's Home Occupation Regulations.
Fin3 . o
APPLICANT NAMES (List all owners, partners and/or corporation -officers) -
—r- —v9-ZC0 MA-gcsA 'R- e0i2Ai ty- F(LcG,�/
PROPERTY ADDRESS � ���LTN�A ur L C - CA__ -_ PHONE -?6y 777 TT -2
BUSINESS NAME 6l'l k 6A1Tc(LfP-LS E5'
PROPERTY OWNER GV-E,664Z�( d- M49 -LS -A F2CC, 0
• MAILING ADDRESS (if different from business address)
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) S )AtJG C-9
TYPE OF BUSINESS %N%t (4/yE-J-, V EtJ01Al&
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE C)/V LI M -E
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED 6&C-60Q�l OL. nk(L15A JF(Z
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (exclude garage)
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (example,
"bedroom - 125 sq. Ft.) 13 O
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS
• OPERATION Cn/4P�rEA 1'Arx . P��/vTr-2
1
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME;
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
OCCUPATION IS ALLOWED (conditions attached).
Signature
• App icant's
OCCUPATION IS ALLOWED (conditions attached).
Date C A / C-/
It is required that all applicants who reside in a gated community and are regulated by a .Home
Owners Association must provide an original letter on letterhead stationery, stating the
approval of the business operation at the residence by the current management company
and/or directly from the Board of Directors of said association.
Initial home inspection, prior to application approval, will not be required unless requested by
the management company or the board of directors.
Date O ZiLa Z--/
pplicant's Signature
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED. JVI,4
Date
• Owner/Agent Signature
Agent Company Name Agent/Owner Contact Phone # Date
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT.
BUILDING & SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION
BY:
0
APPROVED DENIED SPECIAL CONDITIONS ATTACHED.
I.D.# DATE:
OC^UPATION IS ALLOWED (conditions attached).
— - I'gnature -- - j
Date
App icant's
OCCUPATION IS ALLOWED (conditions attached).
It is required that all applicants who reside in a gated community and are regulated by. a .Home
Owners Association must provide an original letter on letterhead stationery, stating the
approval of the business operation at the residence by the current management company
and/or directly from the Board `of Directors of said association.
Initial home inspection, prior to application approval, will not be required unless requested by .
the management company, or the board of directors.
Date
pplicant's Signature
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.
Date
• Owner/Agent Signature
Agent Company Name Agent/Owner Contact Phone. # Date
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR HOME. OCCUPATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT.
nAPPROVED DENIED SPECIAL CONDITIONS ATTACHED.
-. I.D.#_f I DATE:
0
HOME OCCUPATION
CONDITIONS AND CRITERIA
ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS AND
• REQUIREMENTS:
1. No one other than the resident of the dwelling shall be employed on the premises in the conduct
of the Home Occupation.
2. The Home Occupation shall be conducted entirely within the enclosed area of the main building
& shall not occupy more than 25 percent of the total area of the structure.
3. A Home Occupation shall not be conducted within an accessory structure. There may be
storage of equipment or supplies in an accessory structure. Garage space may be used for the
conduct of a Home Occupation only when it does not interfere with the use of such space for
the off-street parking of vehicles required. by Chapter 9.160 of the Zoning Ordinance.
4. There shall be no outdoor storage of equipment, machinery, supplies, materials, or merchandise.
5. There shall be no sales activity, either wholesale or retail, except mail order sales, nor shall there
be the maintenance of an office open to the general public.
6. There shall be no supply of hazardous materials stored on the premises at any given time (i.e.
pool, chlorine, paint thinner, etc.) Unless the hazardous materials are stored in a manner
approved by the State Fire Marshall or any other regulating agency.
7. There shall be no dispatching of persons or equipment to or from the subject property, including
the use of vehicles which operate to and from the premises.
8. No vehicles or trailers except those normally incidental to residential use shall be parked at the
residence at any time.
9. There shall be no use of any mechanical equipment, appliance, or motor outside of the enclosed
building or which generated noise detectable from outside the building in which it is located that
is related to the business.
10. There shall be no signs or other devices identifying or advertising the home occupation.
11. In no way shall the appearance of the building or lot be so altered, or the home occupation be
so conducted, that the lot or building may be reasonably recognized as serving a non-residential
use (either by color; materials, construction, lighting, sounds, vibrations, etc.)
1.2. No Home Occupation shall create a nuisance by reason of noise, odor, dust, vibration, fumes,
smoke, electrical interference, traffic, or other causes.
13. The use shall meet reasonable special conditions as established and made of record in the Home
Occupation Permit, as may be deemed necessary to carry out the intent of this Section.
14. Listed below are special conditions which shall be considered a part of the conditions and
criteria directly related to this application 'and permit.
WORKER'S COMPENSATION
If your company has employees, a copy of the workman's compensation policy must accompany
the business license application, indicating dates of coverage and dollar amount. This proof of
• coverage must be received before the business license can be processed.
your company has employees, a copy of the workman's
If you do not have employees, please check the last line on the first page: "I certify that .....".
If your business is being operated from your home in La Quirita, a Home Occupation Permit is.,
required before a business license is used.
If you have any questions,. please contact the Code Compliance Division at 777-7050.
Every employer who applies for any license or a renewal of any license for a business issued
pursuant to Section 37101 of .the Government Code or Section 7284 of the Revenue and
Taxation Code shall. complete and sign a declaration that states the follovvina:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury, one of the following declarations:
I have and will maintain a certificate of consent to self -insure for worker's compensation,
as provided by Section 3700 for the duration of any business activities conducted for
which this license is issued.
• _ I have and will maintain worker's compensation insurance, as required by Section 3700
for the duration of any business activities conducted for which this license is issued.
My worker's compensation insurance carrier and policy number:
Carrier:
Policy Number:
A "COPY' OF SAID POLICY OR CERTIFICATE OF CONSENT SHOWING THE AMOUNT OF
COVERAGE AND ' EXPIRATION DATE FOR WORKER'S COMPENSATION IS REQUIRED TO
PROCESS THIS APPLICATION.
2�, 1 certify that in the performance of any business activities for which this license is issued,
I shall not employ any person in any manner so as to become subject to the worker's
compensation laws of California, and agree that if I should become subject to the worker's
compensation provisions of Section 3700, 1 will provide the City with a policy or certificate
copy within ten (10) days of the change in requirements.
Date: �l �/ �L� Applicant•
WARNING: Failure to secure worker's compensation coverage is ulawful, and shall subject an
employer to criminal penalties and civil fines up to $100,000. In addition to the cost of
•compensation, damages, interest, and attorney's fees may be assessed to you as provided in
Section 3706 of the Labor Code.
0
0
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
(760) 777-7000
FAX (76.0) 777-7101
FINANCE DEPARTMENT
BUSINESS LICENSE DIVISIO
To: GMK ENTERPRISES
CA C
9 I _
ZUSI=ESSMLICEN=EO. 06455 �.
To avoid incurring penalties "Ordinance 3:28.380)9 pease return his invoice along
with your check prior to your license expiration date of: 5/9/2004
BUSINESS LICENSE RENEWA
Subject to the provisions of the La Quinta Municipal Code Section 3.28.390, persons
with a fixed place of business within the City of La Quinta shall pay an annual
business license fee based upon actual gross receipts for the past twelve months.
Please complete form and return to the above address by 04/19/2004.
Use attached schedule to calculate fee and return payment with this form.
Vill,� /� L( -I I N / / /V i ��- IG l c i
Type of Business (� � r4 Gi
Gross business receipts during last twelve (12) months: S iy U
Name of Owner(s) or Officer(s) and Title(s):
690601'-4
T • 'rn Ec r
- ) p IS4
p.
Owned by:
Corporation
Partnership
Individug.:-4
If Corporation or Partnership: Tax I.D. #:
If Individual Owner(s): S.S.N.:
State Board of Equalization Re -Sale #:
Please make any changes, including mailing address, as necessary.
-7
PLEASE INDICATE ALL VEHICLE -PLATE NUMBERS THAT WILL BE USED IN THE
BUSINESS.
License Number
q yC 0
Permit Number (FINANCE USE ONLY)
HOME OCCUPATION CONDITIONS
ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS:
1. No one, other than the resident of the dwelling shall be employed on the premises in the conduct of the Home
Occupation.
2. The Home Occupation shall be conducted entirely within the enclosed area of the main building and shall not occupy
more than 25 percent of the total area of the structure.
3. A Home Occupation shall not be conducted within an accessory structure. There may be storage of equipment or
supplies in an accessory structure. Garage space may be used for the conduct of a Home Occupation only when it
does not interfere with the use of such space for the off-street parking of vehicles required by Chapter 9.160 of the
Zoning Ordinance.
4. There shall be no outdoor storage of equipment, machinery, supplies, materials, or merchandise.
5. There shall be no sales activity, either wholesale or retail, except mail order sales, nor shall there be the maintenance
of an office open to the general public.
6. There shall be no supply of hazardous materials stored on the premises at any given time (i.e. pool, chlorine, paint
thinner, etc.), unless the hazardous materials are stored in a manner approved the State Fire Marshall or any other
regulating agency.
7. There shall be no dispatching of persons or equipment to or from the subject property, including the use of vehicles
which operate to and from the premises.
8. No vehicles or trailers, except those normally incidental to residential use, shall be parked at the residence at any
time.
9. There shall be no use of any mechanical equipment, appliance, or motor outside of the enclosed building or which
•
generated noise detectable from outside the building in which it is located that is related to the business.
10. There shall be no signs or other devices identifying or advertising the home occupation.
11. In no way shall the appearance of the building or lot be so altered, or the home occupation be so conducted, that the
lot or building may be reasonably recognized as serving a non-residential use (either by color, materials, construction,
lighting, sounds, vibrations, etc.)
12. No Home Occupation shall create a nuisance by reason of noise, odor, dust, vibration, fumes, smoke, electrical
interference, traffic, or other causes.
13. The use shall meet reasonable special conditions as established and made of record in the Home Occupation Permit,
as may be deemed necessary to carry out the intent of this section.
14. Listed below are special conditions which shall be considered a part of the conditions directly related to this
application and this permit:
MY SIGNATURE BELOW INDICATES THAT I HAVE READ, UNDERSTAND AND AGREE TO COMPLY
WITH ALL OF THESE CODENTIONS: i
-PAINT NAME
),'n,/-44 b_� I D� 6�
• SIGNATURE DATE
Z+ qR� annffije4�opyhite Customer Copy -Yellow