SULLIVANr 469,
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P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92247
! -I IIIIII VIII IIII IIII
38
COMMUNITY SAFETY DIVISION
HOME OCCUPATION PERMIT
Permit Number: 10-00002102
(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) PAUL SULLIVAN
Property address: 52930 AVENIDA MENDOZA Phone: (760) 200-7005
Mailing address: P.O. BOX 5626
Property owner: PAUL SULLIVAN
Type of business: Transportation
Brief description of how the business will operate:
Square footage of usable floor area in house (exclude garage) 1700 square feet
Location and square footage of area of business activity in home (Example: Bedroom — 125 sq ft.) bedroom, .
132 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)
a
APPLICANT IGNATURE ATE
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 on 04-22-2010.
Your inspector will be Wayne Campbell.
--------------------------------------------IN PECTO USE ONLY ----------------------------------------------------
• APPROVED ,X b 0
DENIED Inspe for Ignat a Date
CE HP
0
P.O. Box 1504
78-495 CALLE TAMPICo
LA QWNTA, CALIFORNIA 92253
(760) 177-7000
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/oroorpo ration officers AUL- G A4.
PROPERTY ADDRESS:
MAILING ADDRESS:
. 0 . . 5• './,l �:
PHONE: l / ) 2 -CD ---�Wr• .
.DIFFERENT FROM ABOVE)
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.):
TYPE OF BUSINESS:
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: CCA C/0 1
NUMBER OF PERSONS INVOLVED IN BUSINESS: `
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE):
LOCATION/ARE FOOTAGE IN OF AREA OF BUSINESS ACTIVITY HOME (Ex. BEDROOM
125 SQ FT.):.
-DESCRIPTION O EM�CHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION: 11 C�LF� r
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME 04NUPATION IS ALLOWED_ (CONDITIONS ATTACHED).. f
APPLI 'S SIGNATURE 16ATE
IF APPLICANT IS OTHER THAN THE -PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED_
OWNEPJAGENt SIGNATURE DATE
AGENT COMPANY NAME CONTACT PH..# DATE
IMPORTANT: FALSE OR MISLEADING rOR=TION S GROIINDS FOR DENYING
YOUR HOME OCCUPATION; FAILURE COLY THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR RE CATION OF PERMIT.
- BUI :DING AND SAFETY.DEP COMPLIANCE DIVISION:
APPROVED z, . DENIED SPECIAL. CONDITIONS
OFFICER I.D. # DATE
•
IC
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 HAVE READ AND UNDERSTAND THIS
STATEMENT.
Signature
0
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 HAVE READ AND UNDERSTAND THIS
STATEMENT.
Signature
0
Successful Credit Card Settlement Report.
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• 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 Qmplete and�jga a
declaration that states 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 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 Compensatio44nsurance carrier and policy number:
Carrier: F1Coa✓t f
Policy Number: 019 5_01% xpires:
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.
Sr 10
APPLICANT 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.
ACORDCERTIFICATE OF LIABILITY INSURANCE
DAT0312612010 Y)
TM.
POLICY NUMBER
PRODUCER Phone: (656)675.6444 Fax: (656)676.6M
KLINE TRANSPORTATION INS. A HUB INTERNATIONAL CO.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
16766 BERNARDO CENTER DR., #115
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
SAN DIEGO CA 92128
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
EACH OCCURRENCE
S
INSURERS AFFORDING COVERAGE
NAIC #
---- - ...........—
DAMAGES RF�DD
INSURED
INSURERA: Southern Insurance Company
---
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PAUL MARTIN, INC.
-
S
-
INSURER B:
DBA LION TRANSPORTATION SERVICES
- -' -
--
PO BOX 5626
INSURER C:
INSURER D:
LA QUINTA CA 92253
S
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOWHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATELIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
,NSR
LTR
INS TYPEOFINSURANCE
INS
POLICY NUMBER
POLICYEFFECTIVE
DATE M
POLICY EXPIRATION
DATE MMID
_-..
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S
COMMERCIAL GENERAL LIABILITY
7�
CLAIMS IUIOEF
I I OCCUR
DAMAGES RF�DD
$
MED. EXP (Anyone person)
---
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PERSONAL & ADV INJURY
-
S
GENERAL AGGREGATE
I I
S
GEN'L AGGREGATE LIMIT APPLIES PER
PRO-
POLICY JEC7 LOC
S
PRODUCTS COMP/OPAGG.
AUTOMOBILE LIABILITY
ANYAUTO
COMBINED SINGLE LIMIT
(EDeoddenq
$
ALLOWNEDAUTOS
BODILY INJURY
SCHEDULED AUTOS
(Per person)
$
I I
HIRED AUTOS
NON-OWNEDAUTOS
I
BODILY INJURY
(Peraccidenl)
$
I
PROPERTY DAMAGE
(Peraccident)
g
GARAGE LIABILITY
-
j
AUTO ONLY -EA ACCIDENT
$._
i ANY AUTO
— -
f
__—
$
OTHERTHAN EA ACC
AUTO ONLY: AGG
$
EXCESS 1 UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR I ' CLAIMS MADE
:... _.: t.__....i
$
AGGREGATE
DEDUCTIBLE
$
RETENTION S
S
IWORKERS COMPENSATION ANDKC
EMPLOYERS' uABllm
W8I0041 SB7-01
04/01110
04/01/11
STAN THER
TORY Dlarrs O
—
E.L. EACH ACCIDENT
A
ANY PROPREETOEUPARTNERPMCUTNE
OFFICER/MEMBER
(lyes, descdW under
g 1,000,000
E.L.DISEASE-EA EfdPLOYEE
$ 1,0_00,000
-
E.L. DISEASE -POLICY LIMIT ^
_ ._
S 1,000,000
ULL
SPECPROVISIONS below
OTHER:
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
Evidence of Insurance
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING INSURER WILLENDEAVORTO LWL30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE
TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,
EVIDENCE OF INSURANCE I ITS AGENTS OR REPRESENTATIVES.
Attention:
Rick line
r
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 9J 60 of the
Zoning Ordinance.
4. There shall be no outdoor storage of equipment, machinery, supplies, materials, or merchandise.
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 AWl_ THESE CONDITIONS:
PRINT NAMP
23 �a
SIGNATUR IJAE
Office Copy — White Customer Copy — Yellow