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COMMUNITY SAFETY DIVISION
78-495 CALLE TAMPICO (760) 777-7050
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
HOME OCCUPATION PERMIT
. Permit Number: 13-00001004
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) VIRGIN KIP & KRIS
Property address: 53610 AVENIDA MONTEZUMA Phone: (760) 567-0938
Mailing address: 53610 AVENIDA MONTEZUMA
Property owner: VIRGIN KIP & KRIS
Type of business: HOUSE CLEANING/MAINTENCE
Brief description of how the business will operate:
Square footage of usable floor area in house (exclude garage) 1800 SQ FT
Location and square footage of area of business activity in home (Example: Bedroom —125 sq ft.) FAMILY
ROOM, 400 SQ FT LIZ ESCATEL
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)
APPLICANT SIGNATURE 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 9:30- 10:00AM 09/12/2013.
Your inspector will be Elizabeth Escatel.
--------------------------------------------INSPECTOR USE ON--------�------------------=------------ ------
• APPROVED t
❑DENIED InsP e t r Signature Date
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P.O. Box 1504
78-495 CALL£ TAMPICo
LA QUINTA, CALIFORNIA 92253
(760) 777-7000
FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS u
.FEE $70.00 INSPECTION DATE:. G`\
Please read each condition listed on the attachment in this packet to see if the o os�
activity complies with the City's Home Occupation Regulations. C17Y of LA QUINTA
FINANCE DEPT.
APPLICANT NAMES: (List ail owners, partners, and/or corporation officers / /0
PROPERTY ADDRESS: U to I 0 A V ] A2 / !J A PHONE: ,(-7 &, U) 5 b 7 - D Y 3 g'
MoAJ-i-c ZJMA
MAILING ADDRESS: (IF -DIFFERENT FROM ABOVE)
PROPERTY OWNER: /3 C - I- R_O-U iv X0
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.):
• TYPE OF BUSINESS: -- l /O t� 7 (f -L --E q AJ) n7 071K Y�'7_4
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: kO UJ C C�- L- r-_ A,,,) iN C-
Aax ,n 41 l9 t -f 'T y"! A i N -r A
e
NUMBER OF PERSONS INVOLVED IN BUSINESS:
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE):
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EX. BEDROOM
125 SQ FT.): - 4 A �-r o r= j._ ,A-rn r i- Y
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION: V A L U o m 7-oy L_ S C_/LFiF..y Gt_ ,q .J r N Cs
SJP94-1 5
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
-HOME OCCUPATION IS ALLOWED. (CONDITIONS ATTACHED)..
AP ICANT'S 9IGNATURE DATE
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.
Lr z �s c.¢�
OWNER/AGENT SIGNATURE
q-11-2013
DATE
AGENT COMPANY NAME CONTACT PH. # DATE
01PORTANT: 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
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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
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WORKER'S COMPENSATION
If your company has'employees, a copy of the Workman's Compensation Policy must accompany the
license application, indicating dates of coverage and dollar amount. This proof of coverage must be i
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
business license is issued.
If you have any questions,' please contact the Code Compliance Division at 777-7050
before a
Every employer who applies for any license or renewal of any license for a busines issued pursuant to Section
37101 of the government Code or Section 7284 of the Revenue and Taxation CO shall complete and sin a
declaration that states the following:
WORKER'S COMPENSATION DECLA ON
I hereby affirm under penalty of perjury, one of the folio ' g declarations:
I have and will maintain a certificat of consent to self -insure for Worker's
Compensation, as provided by Sec on 3700 for the duration of any business activities
conducted for which this license s issued.
I have and will maintain W key's Compensation Insurance, as required by Section
3700 for the durationof a business activities conducted for which this license is
issued.
My Worker's
Carrier:
Policy Numb
A COPY OF SAID POLICY OR (
COVERAGE AND EXPIRATIO
PROCESS THIS APPLICATION.
insurance carrier and policy number:
TIFICATE OF CONSENT SHOWING THE AMOUNT OF
.TE FOR WORKER'S COMPENSATION IS REQUIRED TO
�L V I 'fy that in the performance of any business activities for which this license is
i sued, 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.
SIGNATURE
DATE
WARN G: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer
to cri nal penalties'and civil fines up to $100,000. In addition to the cost of compensation, damages,
inter st, and attorney's fees maybe 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 9.60 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 CO ITIONS:
PRINT NAME V
SIGNATURE DATE
Office Copy — White Customer Copy — Yellow
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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 9.60 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 busi� ess.
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
f 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 maybe-
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: r`` \l
'MV SIGNATURE `BELOW INDICATES THAT I HAVE READ, UNDERSTAND AND AGREE TO COMPLY
WITH ALL OF THESE CO ITIONS:
{
PRINT NAME /
W.-6�
• SIGNATURE DATE
Office Copy — White Customer Copy — Yellow