Loading...
CAMARENA13 'tit 14 P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92247 COMMUNITY SAFETY DIVISION HOME OCCUPATION PERMIT Permit Number: 11-00004617 (760) 777-7050 FAX (760) 777-7011 Please read each condition listed. on the attachment in this packet to see if the proposed activity complies with the City's Home Occupation Regulations. Applicant name(s): (List all owners, partners, and/or corporation officers) MARTIN S. CAMARENA Property address: 51590 AVENIDA CARRANZA Phone: (760) 594-1779 Mailing address: 51590 AVENIDA CARRANZA MFC Property owner: RODRIGUEZ JOEL Type of business: INTERNET SALES (AUTOPARTS) Brief description of how the business will operate: Square footage of usable floor area in house (exclude garage) 1500 Location and square footage of area of business activity in home (Example: Bedroom — 125 sq ft.) LIVING ROOM, 25 Description of machinery, equipment, and supplies being used in the business operation: I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME OCCUPATI ALLOWED. (Conditions Attached) A ICANT IGNATURE DATE If applicant is other than the property owner, authorization of owner or rental/leasing agent is required. Your inspection has been scheduled for Home Occupation Inspection between FRIDAY 08/26/20119-9:30, AM.: Your inspector will be,Moises Rodarte. ------=---------------------------------INSP U O -------------------------- -------------------- APPROVED r� ❑ DENIED 4vswctor Signature D e CE HP FEE $70.00 P.O. Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 (7 60) 777-7000 FAX (760ay777-7101 APPLICATION FOR HOME OCCUPATION OF A BUSINE INSPECTION DATE: Please read each condition listed on the attachment in this packet to see if the proposed activity complies with the City's Home Occupation Regulations. APPLICANT NAMES: (List all owners, partners, and/or corporation officers (., "44,0*je eA PROPERTY ADDRESS: % 5107 19 VQvI to(i ("apr4111APHONE: 9-6a— MAILING -6a—MAILING ADDRESS: 434 A4A-- Q sg,,j oy IF DIFFERENT FROM ABOVE) PROPERTY OWNER: TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.): ;►,4 Q TYPE OF BUSINESS:�_ BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: rh>zT4� Q.,r NUMBER OF PERSONS INVOLVED IN BUSINESS:_ SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): ET- LOCATION TLOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME- (EX. BEDROOM - 125 SQ FT.): ,(' o335 sa El 'DESCRIPTION OF M INERY, �QUIPMENT, AND SUPPLIES SING USED IN THE BUSINESS OPERATION: (�C t trd'p�� 0"O/� a���jal� I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME OC U A IS ALLOWED. (CONDITIONS ATTACHED). LICANT'S SIGNATURE DATE IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR RENTAL/LEASING AGENT IS REQUIRED. • 75 I1�, 0eZ--) OWNER/AGENT ' GNATURE AGENT COMPANY NAME qv -C96-&'?I CONTACT PH. # DATE 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 AND SAFE DEPARTMENT/CODE COMPLIANCE DIVISION: APPROVED DENIED SPECIAL CONDITIONS OFFICER I.D. # DATE • • 11 40 0 PLEASE READ! Please contact your Homeowner's Association prior to paying forpuf Home Occupation Permit. Your Homeowner's Association may rests' or prohibit home based businesses. I HAVE READ AND UNDERSTAND THIS STATEMENT. Signature • C� 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. If you do not have employees, please check the last section on this page: "I Certify that......" If your business is being operated from your home in La Quinta; a Home Occupation Permit is required before a business license is issued. If you have any questions, please contact the Code Compliance Division at 777-7050. Every employer who applies for any license or 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 following: 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: Expires: 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. 1PL19CANT I 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, I will provide the City with a policy or certificate copy within ten (10) days of the change in requirements. DATE WARNING: Failure to secure Worker's Compensation coverage is unlawful, 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 proAded in Section 3706 of the Labor Code.