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FEDOR
P.O. Bok'1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 9225 `00PPLICATION FOR HOME FEE .00 a/✓% Nov 0 6 2003 48 (7 60) 777-7000 FAX (760) 777-7101 XPATION OF A BUSINESS _ 3 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 J o&& PROPERTY ADDRESS: /V JS d/�/2��T�PHONE:C7d�J 77a-3U�6 MAILING ADDRESS: P0, ,gypx 122, q % (IF DIFFERENT FROM ABOVE) PROPERTY OWNER: .,TlgM e�:S-4%p TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.): -S/ %U 6 L C - TYPE OF BUSINESS: Ail, foAjic • BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: 0 FF i (- h C)r\.) 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 INNHOME (EX. BEDROOM - 125 SQ FT.): f 9kV DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS OPERATION: CI) FP) ce I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOM CCUPATION I ALLOWED. (CONDITIONS ATTACHED). LICANT'S SI NATURE DA IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR RENTAL/LEASING AGENT IS REQUIRED. n'gw� �1 i OWNER/AGENT SIGNATURE DATE AGENT COMPANY NAME CONTACT PH. # DATE 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 r� L C7 • OWNER/AGENT SIGNATURE DATE AGENT COMPANY NAME CONTACT PH. # DATE 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 OFFICER I.D. # SPECIAL CONDITIONS DATE 4 i -f • 0 40 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. re • 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. (Spouses are okay) 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 or 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 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 and criteria directly related to this application and this permit: 0 CITY OF LA QUINTA MUNICIPAL CODES: 9.60.110, 9.160, and 9.210.060 • ,i i� WORKER'S COMPENSATION • If your company has employees, a copy of the Workman's Compensation Policy must accompany the business license application, has. 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 complete and signa 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: Expires: . A COPY OF SAID POLICY OR CERTIFICATE OF CONSENT SHOWING THE AMOUNT OF COVERAGE AND EXPIRATION DATE FOR WORKER'S COMPENSATION IS REQUIRED TO PROCES HI 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. PLICANT 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. • License Detail California Home Page 1 of 2 Thursday, Noveml License Detail CALIFORNIA CONTRACTORS STATE LICEN. Contractor License # 757720 DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: . CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below. Click on the lin button to obtain complaint and/or legal action information. . Per B&P 7071.17, only construction related civil judgments known to the CSLB are di: . Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. . Due to workload, there may be relevant information that has not yet been entered ont Board's license data base. Extract Date: 11/06/2003 * * * Business Information * * * . JAMES FEDOR MASONRY P O BOX 1397 LA QUINTA, CA 92253 Business Phone Number: (760) 772-3036 Entity: Sole Ownership Issue Date: 01/06/1999 Expire Date: 01/31/2005 * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * Class Description C29 MASONRY * * * Bonding Information * * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 832644311 in the a $7,500 with the bonding company • GULF INSURANCE COMPANY. Effective Date: 12/18/2001 http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 11/6/2003 • • License Detail Contractor's Bonding History * * * Workers Compensation Information * * * Page 2 of 2 This license is exempt from having workers' compensation insurance; they certified that employees are provided by a leasing company and are covered by a certificate of worts compensation from that firm. Effective Date: 11/11/2002 Expire Date: None Workers Compensation History Personnel listed on this license (current or disassociated) are listed on other licei Personnel List Other Licenses License Number Request Contractor Name Request Personnel Name Request Salesperson Request Salesperson Name Request © 2003 State of California. Conditions of Use Privacy Policy http://www2.cslb.ca.gov/CSLB—LIBRARY/License+Detail.asp 11/6/2003 Is 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 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. 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.) No Home Occupation shall create a nuisance by reason of noise, odor, dust, vibration, fumes, smoke, electrical interference, traffic, or other causes. 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. 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: PR AME S NATURE DATE v W /,e 1 3 Office Copy -White Customer Copy -Yellow