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Talley=I 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 t t Z-L,.Y -r�/ 09 COMMUNITY SAFETY DIvISION HOME OCCUPATION PERMIT Permit Number: 13-00001400 (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) TALLEY MATTHEW & NACOLA Property address: 79170 CAMINO ROSADA Phone: (760) 345-7793 Mailing address: 79170 CAMINO ROSADA Property owner: TALLEY MATTHEW & NACOLA Type of business: EQUIP RENTAL LIGHTING & SOUND Brief description of how the business will operate: footage of usable floor area in house (exclude garage) 2300 SQ FT 'D e )�= 02 2013 CITY OF LA QUINTA FINANCE DEPT. Location and square footage of area of business activity in home (Example: Bedroom — 125 sq ft.) BEDROOM, 120 SQ FT 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) APPLICAN IG RE 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 8:00-8:30 AM MOISES RODARTE. Your inspector will be Moises Rodarte. ------------ - --------------------------INSPECT USE Y -- ---------- i • APPROVED ❑ DENIED I spector Signature CE HP Date CJ P.O. Box 1504 78-495 CALLE TAMPICO (760) 777-7000 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101 0 APPLICATION FOR HOME OCCUPATION OF A BUSINESS FEE $70.00 INSPECTION DATE:. Please read each condition listed on the attachment in this packet to see if the proposed activity complies with the City's Home Occupation Regulations. - MAILING ADDRESS: !� ✓5 _ as i PROPERTY OWNER rwz UI TYPE OF RESIDENCE, (SINGLE,MULTIPLE, MOBILE HOME, ETC.): TYPE OF BUSINESS: ' JJ .J BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE:_� .DIFFERENT FROM ABOVE) SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): LOCATION ANDS FOOTAGE OF AREA OF BUS S ACTIVITY IN NOME (EX. BEDROOM - 125 SQ FT.): D DESCRIPTION OF HINERY EQ MENT,Allp SUPPLIES EiNG ,$ED IN THE BUSINESS OPERATION.:�//'J/�/ /A �� /J j�/� /J� ' / //•/� 9/ oth �A//J/ , 6 ✓-//V/ll/ice/I'/(i6 //Y �'//��.Y //./i��/// �iYt / U//A'/:z, _' I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME OCCUPATION IS ALLOWED. (CONDITIONS ATTACHED)..- /_ z Is 'S ATURE DATE IF APPLIC IS THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR RENTAL/LEA G AGENT IS REQUIRED_' D/ .mss) Eei IV, OWNER/ GENT SIGNA 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 VQ DENIED SPECIAL CONDITIONS OFFICER U LD. # -i DATE • 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. Hyatt 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 questiions,"piease contact the Code Compliance Division at 777-7050. Every employer who applies for arry 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 com leteand sign 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. y 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 ssued My Worker' o on insurance er and policy number: Carrier: � Policy Number: /3 Expires: %A ao� 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. APPLIC SIGDATE WARNING: Fay )IJ secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties'and civil fines up to 5100,000. 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. 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. A114 I HAVE READ AND UNDERSTAND THIS STATEMENT. Signature C STATE COMPENSATION I N S U R A N C E FUND HOME OFFICE SAN FRANCISCO POLICY DECLARATIONS CALIFORNIA WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY POLICY THESE DECLARATIONS ARE A PART OF THE WORKERS' COMPENSATION POLICY INDICATED HEREON.. HIS INSURANCE IS EFFECTIVE FROM 12:01 A.M., PACIFIC STANDARD TIME 11-09-13 TO 11-09-14 AND SHALL AUTOMATICALLY RENEW EACH 11-09 UNTIL CANCELLED :'ROC RIGGING, INC 79-170 CAMINO ROSADA LA QUINTA, CALIF 92253 NAME.OF EMPLOYER - TRADE NAMES- LOCATIONS- 001 CONTINUOUS POLICY 9078488-13 DEPOSIT PREMIUM $702.00 MINIMUM PREMIUM $310.00 PREMIUM ADJUSTMENT PERIOD MONTHLY N SC ROC RIGGING, INC (A CORPORATION) ROC RIGGING, INC 79170 CAMINO ROSADA LA QUINTA CA 92253 1_ WORKERS' COMPENSATION INSURANCE - PART ONE OF THIS POLICY APPLIES TO THE WORKERS' COMPENSATION LAWS OF THE STATE OF CALIFORNIA. 2. EMPLOYER'S LIABILITY INSURANCE - PART TWO OF THIS POLICY APPLIES TO LIABILITY UNDER THE LAWS OF THE STATE OF CALIFORNIA. THE LIMIT OF OUR LIABILITY INCLUDING DEFENSE COSTS UNDER PART TWO IS, $1,000,000 CODE NO. PRINCIPAL WORK AND RATES EFFECTIVE FROM 11-09-13 TO 11-09-14 INTERIM PREMIUM BASE BILLING BASIS RATE RATE* 9154-1 THEATERS --NOT MOTION PICTURE --ALL 80000 9.11 8.78 EMPLOYEES OTHER THAN PERFORMERS AND' DIRECTORS OF PERFORMERS --INCLUDING MANAGERS, STAGE HANDS, BOX OFFICE EMPLOYEES OR USHERS 9151-1 THEATERS --MUSIC ENSEMBLES -=ALL PERFOR- 0 2.47 2.38 MERS AND DIRECTORS OF PERFORMERS. THE ACTUAL REMUNERATION OF PERFORMERS AND DIRECTORS OF PERFORMERS MUST BE Ll TOTAL ESTIMATED ANNUAL PREMIUM $7,020 /T/�T T\TR1T1T l�T/T\TT.fT T1TT\ T/1 IT 1TT}T 11T /�11T T�1T\TATfT /TA \T /�T 1TJ\fT�T}T -in 9 !1 P\/1T T/T!f T T\1 /'.T -1 A ' 11'Vlll�lYl f11J IJ IYVI M GILL• JCIYV IVV IVI VIVCI UIYLCJJ JIM ICMCNI IJ CIVL•LV JtIJ : r a: HOME OFFICE SAN FRANCISCO POLICY DECLARATIONS .INSURANCE FUND CALIFORNIA WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY POLICY THESE DECLARATIONS ARE A PART OF THE WORKERS' COMPENSATION POLICY INDICATED HEREON.. CONTINUOUS POLICY 9078488-13 INCLUDED, SUBJECT, HOWEVER,, TO A MAXIMUM OF $106,600 PER YEAR PER PER- SON. WHEN -SUCH EMPLOYEES DO NOT WORK THE ENTIRE YEAR, THE PAYROLL LIMITA- TION SHALL BE PRORATED BASED UPON THE NUMBER OF WEEKS IN WHICH SUCH EMPLOYEES WORKED DURING THE POLICY PERIOD. 9156-1 THEATERS --DANCE, OPERA AND THEATER COMPANIES --ALL PERFORMERS AND DIRECTORS OF PERFORMERS--N.O.C. THE ACTUAL REMUNERATION OF PERFORMERS AND DIRECTORS OF PERFORMERS MUST BE INCLUDED, SUBJECT, HOWEVER, TO A MAXI- MUM OF $106,600 PER YEAR PER PERSON. WHEN SUCH EMPLOYEES DO NOT WORK THE ENTIRE YEAR, THE PAYROLL LIMITATION SHALL,BE PRORATED BASED UPON THE NUMBER OF WEEKS IN WHICH SUCH EMPLOYEES WORKED DURING THE POLICY PERIOD. INTERIM PREMIUM BASE BILLING BASIS RATE RATE* 10 19.2.4 18.53 ********BUREAU NOTE INFORMATION******** TALLEY, MATT P,S,T 100.00% FEIN 404018524 • C7 /�/YTT\TfRT�TI fV T/'�\1TT\ T11T TfY I9TT7�1 - - T�TITITATIY /Y/Y 1tl�T 1T.11 R\T1T\ '1^ ^^4 � -'/ -/ T --- ^ /YT A Iv —c l --aa J 1 h 1 CIVICIV I IJ CM LU CU. HOME OFFICE SAN FRANCISCO POLICY DECLARATIONS CALIFORNIA WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY POLICY THESE DECLARATIONS ARE A PART OF THE WORKERS' COMPENSATION POLICY INDICATED HEREON. CONTINUOUS POLICY 9078488-13 * INTERIM BILLING RATES WILL BE USED ON PAYROLL REPORTS. THEY TAKE INTO ACCOUNT RATING PLAN CREDITS (OR DEBITS) WHICH WILL APPLY AT FINAL.BILLING AND AN ESTIMATE OF YOUR PREMIUM DISCOUNT AS DETAILED BELOW. RATING PLAN CREDITS (DEBITS) EFFECTIVE FROM 11-09-13 TO 11-09-14 RATING PLAN MODIFIER 0.99855 ESTIMATED PREMIUM DISCOUNT MODIFIER COMPOSITE FACTOR APPLIED TO BASE RATES TO DERIVE INTERIM BILLING RATES 0.96328 YOUR BROKER RECEIVES A 10.0% COMMISSION ON THIS POLICY. THE COMMISSION LEVEL ASSIGNED DOES NOT AFFECT THE PRICE OF THIS POLICY. 0 N ****************'fM**'k**�Ir*aFie�F*****************fie****�k*�k********eft*******•k*•k********** * * PREMIUM DISCOUNT SCHEDULE EFFECTIVE FROM 11-09-13 TO 11-09-14 * ESTIMATED MODIFIED PREMIUM IS DISCOUNTED ACCORDING TO THE FOLLOWING SCHEDULE: * FIRST ABOVE * $5,000 $5,000 * 0.0% 11.3% * * ********************************************************************************* THE ESTIMATED PREMIUM DISCOUNT IS BASED ON'AN ESTIMATE OF YOUR PAYROLL. ACTUAL PREMIUM DISCOUNT APPLIED AT FINAL BILLING WILL BE BASED ON THE ACTUAL PAYROLL REPORTED ON YOUR POLICY AND SUBJECT TO AUDIT. /�ATT1fTA7TnT/.�1T.�T w\TT Tnnf T'�n wT nw�T T.•f.\w 1.I.T nI.i1 �. �. R��InT�11 w n nnw w w Tom.. t ww n+. � � STATE COMPENSATION INSURANCE FUND IMPORTANT - THIS IS NOT A BILL. SEND NO MONEY UNLESS STATEMENT IS ENCLOSED. ' HOME OFFICE SAN FRANCISCO POLICY DECLARATIONS CALIFORNIA WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY POLICY THESE DECLARATIONS ARE A PART OF THE WORKERS' COMPENSATION POLICY INDICATED HEREON. , CONTINUOUS POLICY 9078488-13 Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions agreements or limitations of the Policy other than as herein stated When countersigned by a duly authorized officer or representative of the State Compensation Insurance Fund, these declarations shall be valid and form part of the Policy. AUTHORIZED REPRESENTATIVE PRESIDENT AND CEO • • is ,:��---C SIF r� SIA 'JF.DRIVERLICENSEcu+ss �c ?X dRFSi017f7`ISrr" i:• NACOLA,/.ANN TACLEY ° �791.70CAMINO*ROSADA•°�'. �LA WIN7A. ' `q ti �• SEX•;F HAIR.BLN: Q'i B`L HT'S=04 WT 125 D08 ,01- T 2 12/03�/2009'235_RBV FD/15 -.. .i- • is ,:��---C SIF r� SIA 'JF.DRIVERLICENSEcu+ss �c ?X dRFSi017f7`ISrr" i:• NACOLA,/.ANN TACLEY ° �791.70CAMINO*ROSADA•°�'. �LA WIN7A. ' `q ti �• SEX•;F HAIR.BLN: Q'i B`L HT'S=04 WT 125 D08 ,01- T 2 12/03�/2009'235_RBV FD/15 -.. 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. 1 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 AL OF THESE CON ITIONS: NIAhl PRINT NAME SIGNATURitr EFATE Office Copy — White Customer Copy — Yellow