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FISHERReceived= 6/16/04 10.35AM; 7607777011 -> Dave Fisher Construction, Inc.; Page 1 s:1 06/16/2004 10:21 7607777011 s I_ MPINJUIV! PAGE p01. "V • 05�010o u�ft,�cv I 111111 11111 IIII IIII _ 61 P.O. Box 1504 78-495 CALLE TAMPICO_ Ln QUIN7A, CALIF�ORfA 92= 53 (7 60) 777-7000 FAX (760) 777-7101 APPLXCA HOME10C2, 4A ON OF A BUSINES �( i\ )F'EE $70.00 SP V �l Please read each condition liste on attachment in this packet to see if the proposed� activity complies with the City's ome Occupation Regulations. APPLICANT NAMES: (List all owners, partners, and/or corporation officers `5C1`//cc is Li en PROPERTY ADDRESS: 77-106 6S1q ,C�E So � PHONE: 7Ko -7-7 /,6 / MAILING ADDRESS: JL,L,60( /772. A QWLw a- (IF DIFFERENT FROM AEOVE) PROPERTY OWNER: / `sc� TYPE OF RESMENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.): SEN g,L� • TYPE OF BUSINESS: 65it cZ Gtr 11,w! 4v%�T1D�czc BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE:. /,Xj 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 - 125SQFT.); _ 'r- 4c. o{Fic-c DESCRIPTION O MAC RY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS OPERATION: D e I c c o I RAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BX WHICH A ;LIC CUI'ATION IS L WED. ONDITIONSATTACHED). ANT'S SIGNA DATE IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR RENTAL/LEASING AGENT IS REQUIRED. • mMOMisart Received: 6/16/04 10:36AM; @5/16/2004 10:21 7607777011 r1 L_J 0 0 OWNER/AGENT SIGNATURE 7607777011 -> Dave Fisher Construction, Inc.; Page 2 LA QUINTA PAGE 02 DATE —moo 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 RAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT. •****#********************ass«********s***********************►*«***»*«*******�s**:********** )BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION: APPROVED DENIED SPECIAL CONDITIONS OFFICER I.D. # DATE Received: 6/16/04 10:36AM; RG/16/2004 10:21 7607777011 • r• OWNTMVAGENT SIG 1 ATURE 0- • 7607777011 -> Dave Fisher Construction,_Inc..; Page 2 LA QUINTA PAGE 02 DATE ' -766 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 SHALT. BE GROUNDS FOR REVOCATION OF PERMIT. BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION: AMYROVEDDENIED SPECIAL CONDITION S OPFI y �i,Cw I.D. #-- Received: 6/16/04 10:36AM; 7607777077 -> Dave Fisher Construction, Inc.; Page 3 06/16/2004 10:21 7607777011 LA QUINTA PAGE 03 • rw 1 Please contact your HomeownWs Association prior to paying for your Home Occupation Permit. Your HonmeownWs Association may restrict or prohibit biome based businesses. I HAVE READ AND UNDERSTAND THIS STATEMENT. Received: 6/16/04 10:36AM; • 0 7607777077 -> Dave Fisher Construction, Inc.; Page 5 06/16/2004 10:21 7607777011 LA QUINTA PAGE 05 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. If you do not have employees, please check the last section on this page: "I Certify that......" Ifyour 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 7281 of the Revenue and Taxation code shall complete a_ ^ nd si A declara 'on that saes the following: WORKERaLMHENSABDAMI—CLAUATIM affirm unde enalty 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 fox which this license is issued. I have and will maintain Worker's Compensation Insurance, as 3700 for the duration of any business activities conducted for which uthis byensetisn issued. My Worker's orrtpensatio insurance carrier and policy number: Carrier: T Policy Number: 3 Oo E�cpzres:_ 1—�- jjs A COPY OF S ICY OR CERTIFICATE OF CONSENT SHOWING TRE AMOUNT OF COV'EPA AND M TION DATE FOR WORKER'S COMPENSATION IS REQUIRED TO PROC 9 APPT.r TTA,v L— 'I certify that in the performance of any business activities for which this license is 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 pcyor certificate copy within ten (10) days of the change in requirements. APPLICANT 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. 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. H. 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 CONDITIONS: T1�2 qtr PRINT ME • S GNATURE— O? DATE V r� , opy -White Customer Copy -Yellow