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78-495 CALLE TAMPICO — LA QUINTA,` CALIFORNIA 92253 - (619) 777-7050
FAX (619) 777-7011
APPLICATION FOR
Fee $35.00 HOME OCCUPATION OF A BUSINESS
Read each condition listed on the attachment to this form to see if the proposed activity
complies with the City's Home Occupation Regulations.
APPLICANT NAMES (List all _owners, partners and/or corporation officers)
PROPERTY ADDRESS 53-lo(o AyjEAQA vuAsco 4-1 C.u,nITA. M. 922S3PHONE 6/9-77/-2-28
BUSINESS NAME
PROPERTY OWNER
A
• MAILING ADDRESS (if different from business address) 1A- CITY QE! A09WA
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) Si,MQLE IA&mE—
TYPE OF BUSINESS C'onvtPwre?- Ss&gQa a-+
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE SupPo2-r CL.s-raMLe-s ax
T�LE�1�o,�lE , un+or._o2 Co�/T/1;AeT.
NUMBER OF PERSONS INVOLVED IN BUSINESS 0NF- `
LIST NAMES OF PERSONS EMPLOYED J0149 RA'46UV-iy All-LCf? �1R ,
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (exclude garage) fl�o
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (example,
"bedroom - 1.25 sq. Ft.) (2M -A& -E q5
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED-II,.jT-HE:,BUSINESS
OPERATION 1 aL��uo,�� oma, P� rF �A� l�it2rs
MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 `®(
U
I HAVE READ, UNDERSTAND, AND AGREE, WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION ISALLOWED (conditions attached).
Date
pplicant's Signature
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER .OR
RENTAL/EASING AGENT I$ REQUIRED.
Date
Owner/Agent Signat
Date
Agent Company Name Agent/Owner Contact Phone,#
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 & SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION
X APPROVED `� S% DENIED SPECIAL CONDITIONS ATTACHED
BY: I. D. # S'' DATE y q
countera
HOME OCCUPATION
CONDITIONS AND CRITERIA
ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS AND REQUIREMENTS:
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 & 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 by 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 (eithee 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 and criteria directly
related to this application and permit.
"'F` WORKER'S COMPENSATION
of
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.
your company has employees, a copy of the workman's
If you do not have employees, please check the last line on the first 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 used.
If you have any questions, please contact the Code Compliance Division at 777-7050.
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 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:
Policy Number:
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, 1 will provide the City with a policy
or certificate copy within ten (10) days of the change in requirements.
Date: y - / - 97 Applicant:
WARNING: Failure to secure worker's compensation co rage 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.
1997 BUSINESS LICENSE APPLICATION FORM
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BUS. LIC. NO
COMMERCIAL ZONING & SIGN CLEARANCE APPROVED BY DATE
BUSINESS LICENSE APPROVAL APPROVED BY�ACe_- DATE 1 f,
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PROOF OF WORKER'S COMPENSATION INSURANCE IS REQUIRED PRIOR TO ISSUANCE
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES NO
2. Business Name: A % C c—
,5 3 - /v e,
S3-/ve, A✓E. s/[GgSGc7 "C�. 0c1X (Ulf 33
- - 3. Business Address: I C/4. 92ZS3 4. Mailing Address: 'PIL41 i��S¢,(_'T, C,,1 9 222. sl
5. Business Phone: (01) '77/- 2-_F5
6. Owned By: CORPORATION — PARTNERSHIP _ INDIVIDUAL
7. If Corporation or Partnership: TAX I.D.#
8. IF Individual Owner: Social Security # 57�;L
9. Name of Owner �Jo,-//v A/ygz:r°N ��Lc,6�e JR. Title:
• or Officers
10. Type of Business: - Comp&( Tzar_' S� r'Pa2T Si ;2v; GL
11.. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNTY HEALTH PERMIT:
YES NO
12. SBERsale Number:
13. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To Building
Contractors):
A. EstirDLated Gross Business Receipts for New Business Only:
$ '116 oo
B. Previous Year Gross Receipts for Established Businesses:
g
►""`• GOOD ONLY FOR JANUARY 1, 1997 THROUGH DECEMBER 31, 1997 •`•`
I HEREBY CERTIFY that all the information supplied by me is correct and any licenses required by the
County, tate orLVeral Government he been issued to me and are in full force and effect.
Signature Title date
MA In
Send Completed Form To: rfMU
• CITY OF LA QUINTA APR 21 1997
BUSINESS LICENSE DIVISION
78-495 Calle Tampico Cf� OF � QUINTA
P. 0. Box 1504
La Quinta, CA 92253
*---------------------------• MetroScan / Riverside
Parcel :774 055 004 Pos Int
Owner :Young Deborah S
CoOwner
Site
Jail
fered
Price
LoanAmt
Lender
VestTyp
Use
Plat
Census
S
Bedrms
BthFull
Bth3Qtr
BthHalf
Cnt1Ht
Cnt1A/C
:53106 Avenida Velasco La Quinta 92253
:53106 Avenida Velasdo La Quinta Ca 92253
:10/13/93 Doc # :401040
:$96,500 Full Deed :Deed
:$96,102 Loan :Veterans Adm
:Admin Of Vet Affairs IntTyp:Fixed
:Unmarried Person
:R01 Res,Single Family Residences
:20
:Tract:451.04 Block:8
T: R: Q:
<3
:2
:Yes
:Yes
Stories :1
Fireplace:Yes
Pool :Yes
RmAddtns :Yes
AddPkgTyp:
Roof Type:Tile
Acres :.11
LotSgFt :4,791
Bldg SF :1,456
AddOnSF .
GarSgFt :441
GarType :Attached
•------------=--------------*
Ref APN :000 000 000
Land :$23,375
Struct :$70,125
Other
Total :$93,500
Exempt
Type
% Imprvd :75
% Owned :100
Tax Area :20-015
96-97Tax :$1,342.24
Map Grid :879 F2
OwnerPh
TenantPh
Year Built
:1986
Street Type
:Paved
Waterfront
Gas Service
:None
Water Source
:,Developed
Sewer Type
:None
AgriPreserve
. '
The Information Provided Is Deemed Reliable, But Is Not Guaranteed.