Foster,•`�� ' �/ IIIII'lllllllllll'11
� II 35
• �W — - -
D
• FEE $35.00 APR 11 1995
CITY OF LA QUINTA BY
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 2253
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.
EUS:NESS NAME S"r. '�*d A tijIs PHONE.
(p &Iff
PROPERTY OWNE$9,1'"D (— PHONE 3 6-
o 3 SG
PROPERTY ADDRESS �JW-2 A.1 T�o.4 44 Qv,.)-rA-
MAILING ADDRESS '? D C3A , c 69d, g 1 4y .,, •7�/,7-"q
TYPE OF RESIDENCE (single'. multiple, mobil home, ctc.)
TYPE OF BUSINESS
BRIEF DESCRInPTION OF HOW THE BUSINESS WILL OPERATE
11DMF �-^�.L!' f a� R� /,�dfn—G ArLl.GK5-- ---
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED
•SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE)
1
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
( EXAMPLE , "BEDROOM -12 5 S. F. 040 M r, C44-''c-�- 1 Z o 5. F.
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING
USED IN THE
BUSINESS OPERATION„1.� r A eP� ” -
67
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS
BY-WHICH'A
HOME—QCCUPAT-JON ;S ALJ4WED (CONDITIONS ATTACHED) .
,
AP P L I CANT--S'rGMA
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
0 T IS REQU RED.
• 3
OWNER/AGENT SIGNATURE DA
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.,
.•.Bu---inx and Safety Department__________________________________
-'APPROVED DENIED CONDITIONS ATTACHED
cA
•
VILLA LA QUINTA
HOMEOWNERS ASSOCIATION
P. O. BOX 10, LA QUINTA, CA.
APRIL 11, 1995
CITY OF LA QUINTA
LA QUINTA, CALIFORNIA
GENTLEMEN:
THIS LETTER IS TO ADVISE YOU THAT OUR ASSOCIATION IS AWARE OF
THE FACT THAT JOAN FOSTER AND JOAN LIZZA D.B.A. ST. JOAN ARE
USING THEIR BUSINESS LICENSE OUT OF 78-234 HACIENDA LA QUINTA,
WHICH IS WITHIN OUR HOMEOWNERS ASSOCIATION. THIS IS ACCEPTIBLE
• AT THIS TIlVIE WITH OUR ASSOCIATION.
IF YOU HAVE ANY QUESTIONS, PLEASE CALL ME AT #564-2372 OR ANNE
TUTTLE AT #564-2177.
YOUR TRULY
P CK C. ROSS
PRESIDENT
0
T4'it'4 4a Qaba
78495 CALLE . TAMPICO — LA QUINTA, 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..'
V I certify that in the performance of any business activities
for which.thi.s 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.
Date: .31� Applicant:
WARNING:, Failure to secure workman' Vcompensation 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
MAILING ADDRESS P.O. BOX 1504 LA OUINTA, CALIFORNIA 92253 \4fl(;