Steiner & Barter•
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P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92247
- 38
COMMUNITY SAFETY DIVISION
(760) 7 77-705 0
FAX (760) 777-7011
HOME OCCUPATION PERMIT
Permit Number: 09-00003061
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) ARMIN & PEGGY
STEINER/C.BARTER
Property address: 51753 ELDORADO DR Phone: (760) 771-1913
Mailing address: 51753 EL DORADO DRIVE D n n
Property owner: ARMIN AND PEGGY STEINER ='�1 , I )j
rt
1Type of business: Music Scoring ' 2009
rief description of how the business will operate: G�c � .M L,� r' J
Square footage of usable floor area in house (exclude garage) 3600 square feet
Location and square footage of area of business activity in home (Example: Bedroom - 125 sq ft.) casia, 250
square feet
Description of machinery, equipment, and supplies being used in the business operation:
;EAD, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
TION fSALLOWED. (Conditions Attached)
APPLIQANTSSI
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 9:30-10:00 p.m. on 05-14-09.
Your inspector will be Michael Morris.
. ------------------------------------------INSPECTOR USE ONLY ----------------------------------------------------
JS APPROVED Ay -®9
CE HP
❑ DENIED Inspector Signature .Date
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FEE $70.00
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P.O. Box 1504
78-495 CALLS TAMPICO (7 60) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
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.
IT NAMES: (List all owners, partners, d/or Jrcporation 0 rslal7l)IIII
PHONE:
MAILING ADDRESS:
PROPERTY OWNER:
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.):
TYPE OF BUSINESS:
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATF.-
DIFFERENT FROM ABOVE)
NUMBER OF PERSONS INVOLVED IN BUSINESS:
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE):
, ��t,0,0
LOCATION AND ARE FOOTAGEA
OF OF BUSINESS ACTIVITY IN HOME- (EX. BEDROOM -
125 SQ FT.): A OZ J�;
DESCRIPTION OFMAC
/ / ' AND ) IES BEIN USED IN BUSINESS
OPERATION: h f" ��2-t IJV J// 1/J/2?1
VE READ, U E AND, AND AGREE WITH THE CONDITIONS BY WHICH A
UP ALL (CONDITIONS ATTACHED).
T'S SIGNIA76RE DATE
IF APPLICANT ISP.`I'HER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
REN -FAL/LEASI G AGENT IS REQUIRED.
IV
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OWNER/AGENT SIGNATURE
DATE
AGENT COMPANY NAME CONTACTW. # / DATE
IMPORTANT: FALSE OR MISLEADING INFO TIO L BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION; FAILURE COMPLY WIT E CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GRO S FOR REVOCATION O ERMIT.
BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION
APPROVED DENIED
OFFICER I.D. #
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do
SPECIAL CONDITIONS
DATE
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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.
I HAVE READ AND UNDERSTA7 THIS
STATEMENT.
Signature
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0 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.
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 7284 of the Revenue and Taxation code shall complete and sin 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' Comnsation i r nce carrier
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 laws of California, and agree that if I should become subject to
therker's compensation provisions of Section 3700, I will provide the City with a
\ polikor certificate copy within ten (10) days of the change in requirements.
r
ATURE DATE
WARNIN"ailure to secure Worker's Compensation coverage is unlawful, and shall subject an employer
to crimindf 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. .
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TRAVELERS
INSURER: FARMINGTON CASUALTY COMPANY
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
TYPE V INFORMATION PAGE WC 00 00 01 ( A)
POLICY NUMBER: (IFUB-7660M29-9-08)
NEW -08
1 NCCI CO CODE: 22640
INSURED: PRODUCER:
MUSICMASTER, INC. DESERT CORNERSTONE INS
DBA INDEPENDENT BOOKKEEPING .81-557 DR CARREON BLVD STE B8
51753 ELDORADO DRIVE INDIO CA 92201
LA QUINTA CA 92253
Insured is A CORPORATION
Other work places and identification numbers are shown in the schedule(s) attached.
2. The policy period is from 12-04-08 to 12-04-09 12:01 A.M. at the insured's mailing address.
3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers
Compensation Law of the state(s) listed here:
CA
B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work In each state listed in
item 3.A. The limits of our liability under Part Two are:
Bodily Injury by Accident: $ 1000000 Each Accident
Bodily Injury by Disease: $ 1000000 Policy Limit
Bodily Injury by Disease: $ 1000000Each Employee
C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here:
AL AR AZ CO C4 DC DE FL GA HMA ID IL IN KS KY LA MA MD ME MI MN
MO MS MT NC NE NH NJ NM NV NY OK OR PA RI SC SD TN TX UT VA VT WI
D. This policy includes these endorsements and schedules:
SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE
4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating
Plans. All required Information is subject to verification and change by audit to be made ANNUALLY.
DATE OF ISSUE: 11-21-08 DE
OFFICE: DIAMOND BAR 189 DIRECT BILL
PRODUCER: DESERT CORNERSTONE INS CJB05