JACOBS0
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P.O. BOX 1504 COMMUNITY SAFETY DIVISION
78-495 CALLS TAMPICO (760) 777-7050
LA QUINTA, CALIFORNIA 92247 FAX (760) 777-7011
HOME OCCUPATION PERMIT
Permit Number: 09-00004290
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) DOUGLAS E. JACOBS
Property address: 78725 AVENIDA LA JARITA Phone: (760) 485-4926
Mailing address: 78725 AVENIDA LA JARITA
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Property owner: STEINER IRREVOCABLE TRUST D $ 2009
Type of business: Pool Service
Brief description of how the business will operate: ren pF` n�pT`�
Square footage of usable floor area in house (exclude garage) 2400 Square Feet
Location and square footage of area of business activity in home (Example: Bedroom - 125 sq ft.)
Bedroom/Home Office, 300 Square Feet
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
OCCUPATION IS ALLOWED. (Conditions Attached)
7 8 -OF
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APPLI ANT SI ATURE 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 10:00-10:30 a.m. on 07-09-09.
Your inspector will be Wayne Campbell.
--------------------------------------------IN PECTO SE ONLY-----------------------------------------
16 k] APPROVED r)19 0
❑ DENIED Inspe for Signati4e Date
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P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
(760) 777-7000
FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
FEE $70.00 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
787a5 AveM IDA LA 3AfRITA
PROPERTY ADDRESS: LA !& U uTA QIN gaa53 PHONE: 74>0- <f65- L19at&
MAILING ADDRESS: (IF DIFFERENT FROM ABOVE)
PROPERTY OWNER P►.UErZ ARE vOC'Y46 — l RJ s7-
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.): Sl AL&LE
• TYPE OF BUSINESS: POOL SER \! l CF
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: SPA ClC,F1q R1 /,\l Co
NUMBER OF PERSONS INVOLVED IN BUSINESS: t
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): St;�-�
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EX. BEDROOM -
125 SQ FT.) - 3c� 562 i
DESCRIPTION OF MACHINERY, EQUIPMENT, 4ND SUPPLIES BEING USED IN TEE BUSINESS
OPERATION:LS hl R\t�► F Atm T� SoZo4 AJ5{-1
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATION IS ALLOWED. (CONDITIONS ATTACHED).
APP ANT'S SIG ATURE DATE
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
• RENTAL/LEASING AGENT IS REQUIRED.
F4w%
OWNER/AGENT SI NATURE DATE
AGENT COMPANY NAME CONTACT PH. # 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 SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION:
APPROVED DENIED SPECIAL CONDITIONS
OFFICER I.D. # DATE
•
0
PLEASE READ!
Please contact your Homeowner's Association prior to pa ' g for your Home
Occupation Permit. Your Homeowner's Association ay restrict or prohibit
home based businesses. N/A
I Hr1yt READ AND UNDERSTAND THIS
STATEMENT.
Signature
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 sip --a
declaration that crates the following*
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
ctivitiesconducted 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.
I certify that in the performance of any business activities for which this hoe nse is
issued, I shall not employ any person in any manner so as to become subject to the
workern
'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.
(!f' 0-11A7-8-0
APPLI T SIGNA DATE
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employVr
'. to criminal penalties"d 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.
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 CONDITIONS:
ZW&-Ag E- 3AE6a5
PRINJ NAME oo••
O L°o CJ4 �—
SIGNAT RE 14, DATE
Office Copy — White Customer Copy — Yellow