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SULLIVAN• �� 1111111 IIIII IIII IIII28 P.O. Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92247 COMMUNITY SAFETY DIVISION HOME OCCUPATION PERMIT wPLermit-Number: 141-00006762` (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) JASON SULLIVAN Property address: 54035 EISENHOWER DR Phone: (760) 200-8531 Mailing address: 79405 HIGHWAY 111 STE 9-211 Property owner: JASON SULLIVAN D e Type of business: CONSULTANT DEC 2 2011 Brief description of how the business will operate: CITY OF LA QUINTA Square footage of usable floor area in house (exclude garage) 1230 Location and square footage of area of business activity in home (Example: Bedroom — 125 sq ft.) DINING ROOM; 50 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) APPLICANT SIGNATURE 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 DAY °12/30/2011-@ 1;001:30P`. Your inspector will be Michael Morris: ------ --------------------------------INSPECTOR USE ONLY ---------------------------------------------------- �• --- ❑ APPROVED O DENIED Inspector Signature Date CE HP P.O. 'Box 1504 78-495 CALLS TAMPICo LA QUINTA, CALIFORNIA 92255 N (760) 777-7000 FAX (760)-777-7101 APPLICATION FOR H//O�� MEE OCCUPATION OF A BUSINESS ,_FEE $7 . 0' (l/ INSPECTION DATE: ` `�/ Please read each condition listed on the attachment in this packet to see it the proposed activity complies with the City's Home Occupation Regulations. APPLICANT NAMES: (List all owners, partners, and/or corporation officers r -�� S -T eta-&VV,Ck1 .. PROPERTY ADDRESS:�' r. —Tbo o aQ O _ PHONE: - MAILING ADDRESS 22EGD s -I'lJ�� j (� 5t of -a, 11 DIFFERENT FROM ABOVE) PROPERTY OWNER: amsc)r \ TYPE OF RESIDENCE, (SINGLE, MULTIPLE, 'MOBILE HOME, ETC.): S i nG I Q. TYPE OF BUSINESS: Ci) y\ � (/j t ` ,A Y11— BRIEF 1 1 BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE:. C9 0 +z) fQ 1A W NUMBER OF PERSONS INVOLVED IN BUSINESS: L SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): LOCATION AND 125 SQ FT.): FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EX. BEDROOM - OPERATION. 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 LL- OWED. (CONDITIONS ATTACHED). ---AP LICANT_'S-SIGNATURE--- IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR RENTAI. LEASING AGENT IS REQUIRED. ,r mLu ri r!'(Q eal iat�^,•`•.,. ,'5: .:.�)i.a; ..r...•` ^t. e.v}yTj.,'-'"''. • O AGENT SIGNATURE DATE esu v. S, vot n `�fa a a.o o -s 3 ( �- 2--c ( 1 AGENT COMPANY NAME CONTACT PH. # DA INSPORTANT: 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 -, A. 7.9� `c°z OFFICER I.D. # DATE 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. FHAVE READ AND UNDERSTAND THIS STATEMENT. VSiature 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......" If your business is being operated from your home in La Quinta, a Home Occupation Permit is required before a. business license is issued. IfYan 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 sign a declaration that �.ates Lhe followine WORKER' COMPENSATION DECLARAT70N I hereby affirm under penalty of perjury, one of the following declarations: V 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 Workeff, 's Compensation ince carrier and policy number: Carrier: J Policy Number: Vy '7k h -J,`6 — VA Expires: 0 3 D 1 ^ 1 a— 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. —AP4 C-AN3=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.Sloo,000. In addition to the cost of compensation, damages, interest, and attorney's tees may be assessed to you as provided in Section 3706 of the Labor Code. 11 i HOME OCCUPATION CONDITIONS ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS: 0No 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 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 directly related to this application and this permit: MY SIGNATURE BELOW INDICATES THAT I HAVE READ, UNDERSTAND AND AGREE TO COMPLY WI1U ALL OF THESE CONDITIONS: PRINT NAME �/Vvk' l h 0 h • SIGNATURE DA Office Copy -White Customer Copy - Yellow 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. 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. 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 directly related to this application and this permit: MY SIGNATURE BELOW INDICATES THAT I HAVE READ, UNDERSTAND AND AGREE TO COMPLY WI1U ALL OF THESE CONDITIONS: PRINT NAME �/Vvk' l h 0 h • SIGNATURE DA Office Copy -White Customer Copy - Yellow