BROWNY
1 111111 I'll' 11111111
02
T4ht 4 Qaea OCT 121, 1996
1
78-495 CALLE TAMPICO - LA QUINTA, CALIFORNI11
A C619)_7i77:-7050
FAX (619) 777-7011
APPLICATION FOR,
Fee $35.00 HOME OCCUPATION OF A BUSINESS
IN A
GATED COMMUNITY
Read each condition listed on the attachment to this form to see if the proposed activity
complies with the City's Home Occupation Regulations.
r
APPLICANT NAMES (List all owners, partners and/or corporation officers)
PROPERTY ADDRESS �q-%5% �Ww �G dxLU .
A . A A
• BUSINESS NAME ^
PROPERTY OWNER
MAILING ADDRESS (if different from business address)
R
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
PHONE._���0)�
BRIEF DES RIPTION OF HOW THE. BUSINESS WILL OPERA
no
NUMBER OF PERSONS INVOLVED IN BUSINESS y
LIST NAMES OF PERSONS EMPLOYED
SQ.UARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (exdlude garage)
.LOCATION AND SQUARE FOOTAGE -Of AREA OF BUSINESS ACTIVITY IN HOME (example;-'
•Iedroom - 125..sq. Ft.) S-0
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
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).
Sign ture 0cp
e Date I
Applicant's
OCCUPATION IS ALLOWED (conditions attached).
It is required that all applicants who reside in a gated community and are regulated by a
Home Owners Association must provide an original letter on letterhead stationery, stating the
:approval of the business operation at the residence by the current management company
and/or directly. from the Board of Directors of said association.
Initial home inspection, prior to application approval, will not be required unless requested
by the management company or the board of directors.
- Date
• Applicant's Signature
IF APPLICANT IS OTHER THAN. PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.
Date
Owner/Agent Signature
Agent Company Name Agent/Owner Contact Phone # 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 & SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION
1/ APPROVED DENIED SPECIAL CONDITIONS ATTACHED .
BY: 1. D. # DATE:
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.
J
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 permit.
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.
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 lawn 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: A, Applicant: J
• 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.
O
ISLANDS
HOMEOWNERS #2
51455 Desert Club Drive
• La Quinta, California
02253
0
Thursday; O tober 1.7; 1.996
City. of La Quinta
784495 Calle Tamp;e;,
La Quinta, CA 92253
Gentle--
Islands
entlem
Islands Homeowners Association #2 gives its permission for Linda Sue Brown,
doing business as Decor Unlimited', to operate her home business at her residence
49-757 <'oarheIIa Urine; La Quinta; CA 92253:
Yours"Very Truly,
La Quinta Homeowners Association #2
Charles A. Owen, ITI
President
T-itit 4 44 Oumt
1996 BUSINESS LICENSE APPLICATION FORM
COMMERCIAL ZONING & SIGN CLEARANCE APPROVED BY DATE
BUSINESS LICENSE APPROVAL APPROVED BY DATE
BUS. LIC. NO
PROOF OF WORKER'S COMPENSATION INSURANCE IS REQUIRED PRIOR TO ISSUANCE
1.. IS THIS BUSINESS LOCATED AT YOUR HOME: . YESy NO
2. Business Name:
3. Business Address: 1117.7 Lrh 'Lk 4. Mailing Address:K�-
5. Business Phone: ()
6. Owned By: CORPORATION _ PARTNERSHIP _ INDIVIDUAL
7. If Corporation or Partnership: TAX I.D.# ��)) -7
8. IF Individual Owner: Social Security #55 ��' ?S" c? 9 I 7 /
w
9. Name of Owner 0 �G : �1.�_�C }� Title:
• _ c'
or Officers
10. Type of Business:
11. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNTY HEALTH PERMIT:
YES CNO L 1 j.
o-yQ
12. SBERsale Number: `, l 1
13. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To Building
Contractors):
A. Estimate Gross Business Receipts for New Business Only:
S
B. Previou Year Gross Receipts for Established Businesses:
S
GOOD ONLY FOR JANUARY 1, 1996 THROUGH DECEMBER 31, 1996 •```
I HEREBY CERTIFY that all the information supplied by me is correct and any licensesrequired by the
County, State or Federal Government have been issued to me and are in full force and effect.
Signature
Title
Send Completed Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
78-495 Calle Tampico
P: 0. Box 1504
La Quinta, CA 92253
lD
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