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HARMONC: P.O. Box. 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92247 COMMUNITY SAFETY DIVISION HOME OCCUPATION PERMIT Permit Number': --,1Z-00002658 (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) DANE LUCAS HARMON Property address: 52180 AVENIDA MENDOZA Phone: (760)' -0697Q Q Mailing address: 52180 AVENIDA MENDOZA . MAY 16 2012 Property owner: DANE LUCAS HARMON CITY OF LA QUINTA Type of business: ELECTRICAL CONTRACTING FINANCE oEPT[_ Brief description of how the business will operate: • Square footage of usable floor area in house (exclude garage) 1866 SQFT Location and square footage of area of business activity in home (Example: Bedroom —125 sq ft.) DEN, 150 SQFT 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 OCCP-R�.TION IS ALLOWED. (Conditions Attached) ;Z AP ANT SIGNATURE DATE + If applicant is'other than the property owner, authorization of owner or rental/leasing agent is required. MF -1Y 16 1 1-o+ Z Your inspection has been scheduled for Home Occupation Inspection between 9:30 AM TO 10:00 AM. Your inspector will be Elizabeth Escatel. -----------------------------------------INSPECTOR USE ONLY ---------------------------------------------------- �APPROVED '' ❑ DENIED nspecto Signature Date CE HP F M � 3015m, P.O. Box 1504 78-495 CALLS 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 Eli-tDAj PROPERTY ADDRESS: �Zlgy AvE-AWM 14CAlb07A PHONE: WPO -,7-3'9 - 0&1 MAILING ADDRESS: TD BOX Z-19' to Qu Inrn4 q2-7-4-7 (ffi DIFFERENT FROM ABOVE) PROPERTY OWNER _ Al a r—Q H-av-m o TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.): • TYPE OF BUSINESS: ELL C7 -e! �% ClDkT12�C71�/� BRIEF DESCRIPTION OF HOW THE BUSINESS WILL. OPERATE: 6t -C /-MI Cif t S U[C.iE- akt I , Kirt) wIQ 15- above A, 6Acc aural 5/Dva�-2 NUMBER OF PERSONS INVOLVED IN BUSINESS: SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): LOCATION AND SQUARF�OOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EX. BEDROOM - 125 SQ FT.): bLN .` 1 ZC; - 15-6 :5c, ET - DESCRIPTION T DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN OPERATION: _ *U . c72i oqt- CD✓ll/tQL CtUVLdt u �'� �i S�+LY�S I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A TLICANT'S OCCUPA N IS ALLOWED. (CONDITIONS ATTACHED). � SIGNATURE DALE IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR • RENTAL/LEASING AGENT IS REQUIRED. N R/AGENT SIGNATURE DATE ff �c�c7RfC �r�r�� "7f�a -Zig-oCo4 rte" 2 AGENT COMPANY NAME CONTACT PH. # D AT E 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 • • PLEASE READ! Please contact your Homeowner's Association prior to paying for your Home Occupation Permit. Your Homeowner's Association may restrict or prohibit home based businesses. I HAREAD AND UNDERSTAND THIS STAXEMENT. Signature .• :7 v, 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 37.101 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:7EPE ffi4�T�o2 Policy Number: Sit L VDCA Expires: f l 30 y 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 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. ANT SIGNATURE 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 provided in Section 3706 of the Labor Code. • C] • AC40 121 * CERTIFICATE OF LIABILITY INSURANCE �'� `LD11 06/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE' HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE ORPRODUCER AND THE CER71FICAN HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED, the pollcy(tes) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Rau of such endorsement(s). PRODUCER Phone: 898.874.3800 Fax: 800-921-5506 CONSTRUCTION SPECIALTIES INSURANCE SERVICES 2450 VENTURE OAKS WAY, SUITE 220 OONE"Cr Gina Stanley N 919 921.8200 "x N, . (916) 921-8300 E"""� - gina@csisins.com PRODUCER CUSTOMER ID: 6303 SACRAMENTO CA 95833- .. MSU AFFORDING COVERAGE NAIC 8 Agency Ud1: 0835752 INSURED D C H ELECTRIC & LIGHTING 52180 AVENIDA MENDOZA LAQUINTA CA 92253 INSURER . Developers Surety and indemnity Company INSURER a : Hartford Underwriters Insurance Company INSURER ...... INSURER 0 D: INSURER E INSURER F �=O =N -AT YllMMlW % A'4111U RCrrrArVn numwlGn. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ISRR TYPE OF INSURANCE ADSL tNSR yj p POLICYNUMBER POLICY EFFm POUCnap-p Eta LIMITS A GENERAL Va6tury X COMMERCIAL GENERAL LIABILITY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SISOOO11693-M 09112/11 09112/12 EACH OCCURRENCE $ 1,000,000 oAM ro RtxrED S 100,000 MED. EXP (Any one person) $ 5,000 CLAIMS 17X I OCCUR ni-- wnnnn r-^n0^0ATrf1V All a.Jdc —.—A PERSONAL 9 ADV INJURY $ 1,000,000 -MADE ° GENERAL AGGREGATE $ 2,000,000 GEM AGGREGATE LIMIT APPLIES PER: — PRO- LOC POLICY PRODUCTS - COMP/OP AGG $ 2,000,000 $ '" AUTOMOBILE LABILITY COMBINED SINGLE LIMIT 8 (Ea accident) BODILY INJURY (Per person) S ANY AUTO - BODILY INJURY (Per accident) $ ALLOWNED AUTOS PROPERTY DAMAGE $ Per accident) SCHEDULED AUTOS HIRED•AUTOS $ NON -OWNED AUTOS ' UMBRELLA UA8OCCUR EACH OCCURRENCE $, AGGREGATE $ EXCESS Luc JCLAIMS- DEDUCTIBLE 8 WCSTA1lY roaruMrrs 12$ B RETENTION $ WORKERS COMPENSAMON AND EMPLOYERS' UAetLITY Y I N ANY PROPWETORRARTNERIExECU7TVE OFRCFRAlEYBEll EXCLUDED? I� Iwmdesc to NN) If rte. a rnoN t1ESaUPnoN of oPErunoNs eebr. NIA S7WECER1601 c n^ �� TcD �^ C'�7�J7�iKLv a 1 l - ` 03 - '�` 2' 10/11 1/3 11/30112 E.L. EACH ACCIDENT 1,000,0110 E.L.DISEASE-EA EMPLOYEE 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space la required) '10 DAYS NOTICE FOR NON-PAYMENT, 30 DAYS FOR ALL OTHER GCI(IIriv.pkic SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ALITHOR&MD REPRESEMTATNE Attention: Gina Stanley v ni-- wnnnn r-^n0^0ATrf1V All a.Jdc —.—A AGORD 25 (ZUU91U9) ..... , r....-.._ --.. _._..._. The ACORD name and logo are registered marks of ACORD 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 0 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: 0 PRINT NAME lk� ,M SIGNATURE DATE Office Copy -White Customer Copy - Yellow