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LANGER (2)FEE $35.00 a Cjj Tiiv/ 4 aa!Kra CITY OF LA QUINTA 78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253 HOME OCCUPATION PERMIT Read each condition listed on the attachment to this form to see if the proposed activity can comply with the City's Home Occupation Regulations. BUSINESS NAME �0MM4rIrr4 I✓1.W6 &"Ic k.Ts PHONE PROPERTY OWNER M A a ,- 9 1- A A1 4c: A-- PHONE zL,4-.7- PROPERTY zPROPERTY ADDRESS 4q99 C -j_ C,AujL_r), LA Qu.INra a y 2xrz MAILING ADDRESS Sq,Ic TYPE OF RESIDENCE (single, multiple, mobil home, etc.) SING-�t� TYPE OF BUSINESS tbf)Okln(&- G1AfCE.2r5- 15eAVic� 451MEsy BRIEF DESCRIPTION OF HOW THE BUSIN SS WILL OPERATE NUMBER OF PERSONS INVOLVED IN BUSINESS rrJlr"E LIST NAME OF PERSONS EMPLOYED • SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE) LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EXAMPLE, "BEDROOM -125 S.F.") .DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS OPERATION IJ0Nt; I HAVE READ, UNDERSTAND, AND AGREE WITH.THE CONDITIONS BY WHICH A HOMEJVgCUPATI90 IS ALLOWED (CONDITIONS ATTACHED). , 10 zq APPLICANT AGNATURE IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT IS REQUIRED. .OWNER/AGENT SIGNATURE DATE IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE. GROUNDS FOR DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH CONDITIONS LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT. • Buildi and Safety Department APPR VED DENIED CONDITIONS ATTACHED-Zja-- S' 3©/9/% ff'3©-7&/ • T4ty,, 4 4a Q" 78-495 CALLE TAMPICO — LA OUINTA; CALIFORNIA 92253 (619) 777-7000 FAX (619) 777-7101 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 declaration: 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 THE POLICY SHOWING THE AMOUNT OF COVERAGE AND EXPIRATION DATE FOR WORKMEN'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 37�. Date: 1}I ag1�i�- Applicant: 1zho WARNING: Failure to secure workman's compensation coverage is unlawful, and shall subject an employer to criminal penalties and civic fines up to $100,000. In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. bus.fac ~l MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 November 16, 1994 Mr. Martin Langer 49994 El Circulo La Quinta, CA 92253 Dear Martin Per our telephone conversation today regarding the request to conduct business out of your residence at 49994 E1 Circulo, La Quinta, CA. I offer the following response. Your request to establish a business at 49994 E1 Circulo, La Quinta, CA 92253 is acceptable by management pending final approval by the Board of Directors of The Santa Rosa Cove Homeowners Association. Sincerely, 'D�- a �--tz:) Dan Barnett, Property Manager, SRC HOA • L, '�t r, ;LaY "ACKARD WASSOGIATES ,A S 0 1 *:;S�at�Matiagemen+s�sr« Dan Barnett Propety Manages kyr �, s 1.4 i,�3.5663 •: 'moiA.- ,019) 'n `t ate• f :, o`y Boardwalk, Shite X-3 -,, z -vjr Palm De ert California 92260 ��♦1 • 1. 2. 3. 5. 6. Tay q 4a BUS. LIC. N0. �7 199.4 BUSINESS LICENSE APPLICATION FORM ************** *** ******* *APPROVED BY L DATE .....PROOF OF WORKERS COMPENSATION INSURANCE IS REQUIRED........ IS THIS BUSINESS LOCATED AT YOUR HOME: YES—,— NO Business Name: C0 _�,� ,�,�, ; , T •� C.i��I OnlCL R - -r _ Business Address : ggqg4 -L Ci 2ntl o 4. Mailing Address:'. S./j AA c= LA Q[oIr4, Q Z?5.3 Business Phone : ( (� ( ) ; j �, 4 Z, j I Owned By: CORPORATION PARTNERSHIP C�INDIVIDUAL z 7. If Corporation or Partnership: Tax I.D.# 8. If Individual Owner: Social Security # 2. 14 9. Name of Owner A R A t� CIG k, Title: j Z u->-.7,0_, - Or Officers 10. Type of- : S C -fl V is l= SSS ` .Business , ,�C C/Q)T'S 11. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A ; COUNTY HEALTH, PES'! ZaNO YES r 12. SBE Resale Number: 13. BUSINESS.LOCATED WITHIN THE CITY OF LA QUINTA Building (Does No� APPTo 1Y Contractors): A. Estimated Gross Business Receipts for New Businesses Only.. $ o - Ari® B. Previous Year Gross Receipts For Established Businesses :l',��ll U ********GOOD ONLY FOR JANUARY 111994 THRU DECEMBER 31 1994 ******* I HEREBY CERTIFY that all the information supplied by me is correct and any licenses required by the County, State.or Federal Government have been issued to me and are in full force and effect. nat C SiLQ g ure Title Date Submit Form To: CITY OF LA QUINTA BUSINESS LICENSE DIVISION 78-495 Calle Tampico