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HERNANDEZ12/02/2002 10:08 a 7607777011 LA QUINTA PAGE 01 Cr�,@e 2 P.O. Box 1504 CITY OF LA OUINTA 78-495 CALLE TAMPICO Flt4A E1IEPT. (760) 77 i -7000 LA QUINTA, CALIFORNIA 92253 FAX (7.60) 777-7101 APPLICATION FOR HOME OCCUPATION OF A BUSINE S 2'1'0 3 FF-E cD 12<- (a INSPECTION DATE: 4 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. (Also, if you live in a gated community you will be required to obtain an approval letter from the home Owner's Association prior to City approval). PLICANT N S: t all owners, partners, ndlor cwrporatiom fficers %- PROPERTY ADDRESS: 1 �'" �(P' PHONE: d 1�t6 -6 6 MAILING ADDRESS: 0(2- �IF DIFFERENT FROM ABOVE) PROPERTY OWNER: TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.): TYPE OF BUSINESS: (!"A -5 • BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE;' pp A- Y-1 NUMBER OF PERSONS INVOLVED IN BUSINESS: SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): LOCATION AND SQUARE F T E OF AREA OF BUSMSS A� I M IN HOME (EX. BEDROOM 125 SQ FT.): Q�� Q�.zS- DESCRIPTION OHNR�QUIPATNT, AND SUP IES BEING U D IN THE BUSI SS OPERATION:JR 'I o a� I HAVE READ, UNDERST \ D, AND AGREE WITH THE CONDITIONS BY WHICH A HOME OC ATION IS A LLO (CONDITIONS ATTACHED). APPLIC S S NATURE DATE IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR RENTALILEASING AGENT IS REQUIRED. I II'lll'llll IIII II'I 65 . 12/02/2002 10: 06 760 / / / /bl'l LA WIN I A rr�a� uc i I • �V O GENT SIGNATURE DATE AGENT CONTANY NAME CONTACT PH. # DATE i XMPORTANT: FALSE OR MISLEAD INFORMATION SHALL BE GROUNDS FqR DENYING YOUR ROME OCCUPATION; FAILURE COMPLY WITH THE CONDITIONS LISTED ON THE ATTACHED PAGE SHALT, BE GROUNDS FO VOCATION OF PERMIT. wrw+wwwwrrws.Rwts�a•wwr*+wwwRs�wa•warss�rwww*wwwwM Mwfiss•••wwwww••sww«wwwwr�■■■rw.wwwrasw■s• I BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE SION: APPROVED ✓ DENIED SPECIAL ITIONS OFFICER I.D. # DATE • • 12/02/2002 10:0B 7607777011 LA QUINTA _PAGE 02 lip O GENT SIGNATURE DATE AGENT COMPANY NAME CONTACT PH. # DATE UWPORTANT: FALSE OR MISLEAD INFORMATION SHALL BE GROUNDS FOAt DENYING YOUR HOME OCCUPA?ION; FAILURE COMPLY WITH THE CONDITIONS LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FO VOCATION OF PERMIT. iiiiiiiiMyMttfikiiiw+YWr*Mw4iRii�tlii!!llYii!*y*wMM♦fiystst*iiirwatiiiii�wwwwwwM**yMwww�ws• BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE APPROVED DENIED OFFICER I.D. # 0 SPECIAL DATE - 12/02/2002 10:08 7607777011 LA QUINTA PAGE 03 1 • 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 MEAD AND UNDERSTAND THIS STATEMENT. Signature • 0 12/02/2002 10:08 7607777011 LA QUINTA PAGE 04 • HOME OCCU P&UtnN rnIVDITIONS AND CR ERIA ALL HOME OCCUPATIONS SHALT. COMPLY WUH THE FOLLOWING CONDMONS AND REQUIREMENTS: t. 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 dome Occupation shalt 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 totting Ordinance. 4, There shall be no outdoor storage of equipment. machinery, supplies, materiels, or merchandise. 5. There shall be no sales activity, either wholesale or retail, except mail order sales, pot 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.1 unless the hazardous materials are stored in a runner 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. • S. 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. The use shall meet reasonable special conditions as established and made of record in the Horne 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: CITY OF LA QUIPTI'A MUNIC1pAL CODES: 9.60.110, 9.160, and 9.210.060 C. 12/02/2002 10:08 7607777011 LA QUINTA PAGE 1.05 . t ' N:� r^lam P.O. Box 1504 78-495 GALLE TAMPICO (760) 7 7 7 - 7 0 0 0 LA QUINTA, CALIFORNIA 92255 FAX (760) 777-7101 CITY OF LA QUINTA WORKER'S COMPENSATION DECLARATION If your company has compensated employees, a copy of your WORKMAN'S COMPENSATION POLICY must accompany your BUSINESS LICENSE APPLICATION, showing the dates of coverage, including the expiration date, and the dollar amount. THIS PROOF OF COVERAGE MUST BE RECEIVED BEFORE YOUR BUSINESS LICENSE CAN BE PROCESSED. IF YOUR BUSINESS IS BEING OPERATED FROMA PRIVATE RESIDENCE WITHIN LA QUINTA, A HOME OCC UPATION PERMIT IS REQ UIRED BEFORE A B USINESS .LICENSE CAN BE ISSUED. Every employer who applies for a Business License or License renewal which is to be 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 ONE OF THE FOLD )WING: I HEREBY AFFIRM, UNDER PENALTY OF PERJURY, ONE OF THE FOLLOWING DECLARATIONS: (Cbeek One) • 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 conducted for which a Business License is issued. _I Have and will maintain Worker's Compensation Insurance, as required by Section 3700 for the duration of any business conducted for which a Business License is issued. Q WORKER'S COMPENSATION INSURANCE CARRIER: v POLICY NUMBS -a— EXPIRATION DATE-.'( 0 b (IF YOU DO NOT HAVE ANY EMPLOYEES, PLEASE INDICATE BELOW) Certify that in the performance of any Business activity for wbich a Business License is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of the state of California, and I 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. •llfflf!lARflf•RRR�RRRRRRR�RIRRRRRRRRA1111RR1► RRRRRRRRI►RRRRRR RRRtRRRRRR!•ftRRRRRRRRRRRRRRRRRR� Annlirant, 1:/1/ /-2 A A �111�C�A /i �� Date WARNING: FAILURE TO SECURE WORKER' CO ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINArPENALTIES AND CIVIL FINES UP TO S100,000. IN ADDITION TO FINES AND PENALTIES, ADDITIONAL COMPENSATION DAMAGES, INTEREST AND ATTORNEY'S FEES MAY BE ASSESSED TO YOU AS PROVIDED IN SECTION 3706 OF THE LABOR CODE. November 21, 2002 Mike Hernandez Pink, Inc. 77450 Calle Chillon La Quinta, CA 92253 Dear Mr. Hernandez: Please find the enclosed Home Occupation Permit form to obtain City approval for your 2nd home -based business. The fee will be $35.00 because you have had a permit on your previous address on Eisenhower Drive. • After we receive the completed paperwork and fee, we can then schedule a time for a home inspection (usually the next business day between 9:30am and 4:00 pm). We will try to schedule it at a time that is convenient for you. It takes about 10 to 15 minutes and we will schedule a half-hour window for the inspection time. After the approval, the renewal of your City Business License will be processed. Thank you for your attention to this matter. If I can be of assistance, please do not hesitate to call me at 777-7050. Sincerely, Gina McElroy Counter Technician/Code Compliance Department • CONTRACTOR INFORMATION COMPANY NAME 0 COMPANY ADDRESS ? 7 ` MAILING ADDRESS PHONE NO.nC CONTACT NAME CONTRACTOR'S LICENSE NO. TYPE OF CONTRACTOR'S LICENSE 7. Pj CONTRACTOR'S LICENSE EXPIRATION DATE''? Zg Initial • ' �J ?' by BLDG. WORKER'S COMPENSATION INSURANCE J" T7 j POLICY NO. l� f' POLICY EXPIRATION DATE CITY BUSINESS LICENSE NO. AUTHORIZED PERSONS TO SIGN PERMITS EXPIRES �OTE: Your certificate of worker's compensation insurance must be presented at the unter at the time of license issuance. PLEASE RETURN THIS FORM TO BUILDING & SAF TY 2::i—_ Initial by BLDG. Initial by Finance OF y P.O. Box 1504 N 4 78-495 CALLE TAMPICO p (760) 777 7000 Brighter Than Eve, LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101 FINANCE DEPARTMENT 01 Q `�110 I BUSINESS LICENSE DIVISION ` BUSINESS LICENSE RENEWAL To avoid incurring penalties (Ordinance 3.28.380), please return this invoice along with your check prior to your expiration date of: 09/21/2002 To: PINK INC � P.O. BOX 1012 U 4 I, PALM DESERT, CA 92261- LICENSE NO.: 04807 k(ry r r 0 ,�;r� �� ,� BUSINESS ���C�C,q`' INFORMATION NOTICE Subject to the provisions of the La Quinta Municipal Code Section 3.28.410, every person engaged in the business of contracting which requires a state contractor's license shall pay a business license fee either annually or semi-annually. • Please complete form and return to the above address by 08/23/2002. Please mail $25 If renewing for six months or $50 If renewing for one year. (Circle ©`ne) Sub-Contrac r /Annual or emi-Annual Name of Owner(s) f"Officer(s.) d Title-(s). i - In f' " C��' Q_� Owned by: Corporation Partnership Individual If Corporation or Partnership: Tax I.D. #: '-S3 ---,02-1 4 ,15 CT If Individual Owner(s): S.S.N.: Please make any changes, including mailing address, as necessary. If you are no longer conducting business within the City, please complete the information below and return this invoice to the City. Should your business resume operations, it will be necessary to obtain a valid City Business License. IM/e have ceased all business activity within the City of La Quinta effective Thank You I declare under penalty of perjury that to my knowledge, all information in this statement is true and orrect. Signature(s)� i �iG� tle s .4 ' ,�` G� c -�