Loading...
Porras25 • FEE $35.00 CITY OF LA QUINTA 78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253 HOME OCCUPATION PERMIT Read each condition listed on the attachment to this form to see if the proposed activity can comply with the City's Home Occupation Regulations. BUSINESS NAME Lie-L-Nomeiii HONE Sjq PROPERTY OWNER PHONE PROPERTY ADDRESS MAILING ADDRESS TYPE OF RESIDENCEsin le, multiple, mobil home, etc.) e_ TYPE OF BUS INES I ML � hy\� e OjAk e f \ BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE'VtxioCe_ r,)M n r V: NUMBER OF PERSONS-INVOLVBD IN BUSINESS LIST NAME OF PERSONS EMPLOYED SQUARE FOOTAGE OF USABLE FLOOR AREA �f 522 -0 IN HOUSE ( EXCLUDE GARAGE) ��.(x) SQ �! I,,j 3 i Z LOCATION AND SQUARE FOOTAGE OF AREA 3 o 5q OF BUSINESS ACTIVITY IN HOME (EXAMPLE, "BEDROOM -125 S.F.") DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS OPERATIONS I HAVE -READ UNDERSTAND AGREE WITH THE CONDITIONS BY WHICH A HOME OCAT 0 IS 'A WED ONDI` IONS ATTACHED) . APPLICANT S IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT IS REQUIRED. OWNER/AGENT SIGNATURE DATE IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH CONDITIONS LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT. ________________________________ �Building and Safety Department APPROVED DENIED CONDITIONS ATTACHED /s T /Z�' 11C,4 -Ur L-( Ca,n/�91'/Y 011514 .v� rvR 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (619) 777-7000 FAX (619) 777-7101 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.following: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury, one of the following declaration: 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 THE POLICY SHOWING THE AMOUNT OF COVERAGE AND EXPIRATION DATE -FOR WORKMEN'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 ection 3 Date: kt) 3 I (DApplicant: WARNING: Failure to secure workman's compensation coverage is unlawful, and shall subject an employer to criminal penalties and civic fines up to $100,000. In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. bus.fac 0LMAILING ADDRESS - P.O. BOX. 1504 - LA OUINTA, CALIFORNIA 92253 �. Copyright (C)1996 Dataquick Information Systems • rm • Page APN 773-333-002 Use: SINGLE RESIDENCE Phone (716)549-0211 Owners: FAHNESTOCK,FAYE L SCHLUETER,RENE A Pg-Grd: 224 -D2/879 -F2 Site 52790 AVENIDA MENDOZA*'LA QUINTA CA 92253 Census: 0451.047 1 716 HERR RD*ANGOLA NY 14006 Zoning: R1 F1oodP: Legal LOT 25 BLK 147 MB 018/092 SANTA CARMELITA VALE LA Map: MB -018-092 Tr/Lot/B1: 00000-00/L-0025/147 Assd $75,000 TRA 020017. SaleDt: Sale_Am: Land $18,750 Tax $1,214.14 Doc # 1st Td: PerImp: 750-o Sta/Ex: CUR Lender: Addl: Ownshp: JOINT TaxYr': 95-96 Title PrevDt: Last Trans W/O $: 09/01/90 331532 $/SgFt: PrevAm: Yr Blt: 1978 SgFeet: 1,286 OutImp: GarSgF: 437 BedBth: 4/2.0 Addtnl: StSurf: Y GarTyp: ATTACHED #Story: 1 Roof : ROLL COMP MscBdg: - CarSgF: #Units: 1 Electr: DEVELOPED Ht/Cl : B GarSF2: LotSz 4,791 Gas NO FirePl: GarTy2: Water DEVELOPED Pool CarSF2: Sewer NO View Copyright (C)1996 Dataquick Information Systems • rm • 1 -13 96 09:22 17:121PMW". 42W FEE�5�„DO T:6193427S86 P:01 cT2 t tt (-4 ILI CITY OF LA QUINTA 78-495 Calle Tampirc, P. O.Sox 1504, La Quint&, CA 9225I HOME OCCVPhTION PERMIT Read each condition listed on the attachment to thin form t4 se• if the proposed activity can comply with the City's Home OCGupation Regulations. =s+s���===ss:��s��a:=�:�z===:��.s�_:..■sw■ssrs:s��■�a�:a====�:�r.�a BUSINESS NAME MOVE'G'y�-- PROPERTY OWNER HONE PROPERTY ADDRRSS 1- 4 (k)U1ftA I `A 'Ta - RAILING ADDRESS TYPE OF RESIDENCE n e multi le, mobil hams, etc.) TYPE OF EUSINESS� ��: BRIEF DESCRIPTIO OF HOW THEUSIN LSS -GILL OPERATL_UJLK' _ C1C'r-. L( Wgo,aER DF PERsbt0_!N_VOLVtD IN BUSINESS _ r LIST NAME OF PERSONS EMPLOYED SQUARE FOOTAGE OF USABLE IrLOOR AREA 1 GJ + 3 �0 IN HOUSE (EXCLUDE GARAGE) j20(x) so {-f LOCATION AND'SQUARE'FOOTAGK OF AREA OF BUSINESS ACTIVITY IN HOME (MMPLEI "BEDROOM -125 S.F.") OrSC91VTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING US£fl -IN THE BUSINESS OPERATION I HAVE -READ ..UNDERS;Pk •AHp AGREE WITH THE COMA TIONS !3Y WHICH A KQME OC TxO� is D �ONUITIONS ATTACHED) . - � J _'�� L Apptic VT SIGNA'T'URE IF A ICANT IS „OTHER THAN PROPERTY OWNER, OR T IS r. AUTHORIZATION OF OWNER /v _W DATE _AQ IMPORTANT: FALSE OR MISLEADING INFORMATION SMALL BE GROUNDS FOR DINYSfdG'YDUR HOME OCCUPATION; FAILURE TO St�LL 8E GROUNDS LfOR ITH REVOCATIONONS OF LISTED ON THE ATTACHEJD PERMIT. ■:3__ozs='a�®saas=Stir■==s.�s�.■■ss_m:ate :.-��t�s�aa--caxa�-:aa.-s:ses► 9uildinv and Safety D• artr *nt- AiPPR01lEp DENIED CONDITIONS ATTACHED r ' �4 rte" .'',''- /��/7�''"[ si J�•��l'j�,�.r,rs�'.'!, _/�_ -" Y�=�'� '»,�L"`L �""'�'°. `�V •' �'f' • r ti 4f I".!i!..��".f -.d'_