Fisher• 02
FEE $35.00
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CITY OF LA QUINTA
8-495 Callp Tampico, P. P.B x 1504, La Q
HOME OCCUPATION PERMIT
p�°D
AUG 2 9 1995 D
9y_
uint CA 92253
Read each condition listed on the attachment to this form to see if
the proposed activity can comply with the City's Home Occupation
Regulations.
• • ./��., cam/ -i.: � •,� � U .a, i
TYPE OF RESIDENCE (single, multiple, mobi
TYPE OF BUSINESS //Im<I
, etc.)
�•r
IN HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOMEDRwti
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY,
BUSINESS OPERATION Ii
:PMENT, AND SUPPLIES BEING USED IN THE
I HAVE -RF�NFrLLOWED
D, AND AGREE WITH THE CONDITIONS BY
WHICH A
HOME 0 A
(CONDITIONS ATTACHED).
Y-
AP ZC
GNATURE
DATE
IF APPLICANT
IS OTHER THAN
PROPERTY OWNER, AUTHORIZATION
OF OWNER
OR AG�E`N�T% IS.
REQUIRED.
/f
AGENT
DATE
IMPORTANT: FALSE OR MISLWING INFORMATION SHALL „$E GROUNDS,, FOR
DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLYCONDITIONS
LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOIR--kEVOCATION OF
PERMIT
Build' and Safety De artme�rt x.. -
APPROVED "'DENIED CONDITIONS ATTACHED
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T4t�t 4 4a Quioa
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
or 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 II/hnµecome subject to
the worker's compensa)ion provisions of a 3700.
Date: K - 1A `[/Q Applicant:
WARNING: Failure to secure workman'd cdmpsation 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
M/ING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 �a�.
LA QUINTA PALMS HOMEOWNERS ASSOCIATION
C/O J & W MANAGEMENT
P. O. BOX 1398
PALM DESERT,.CA 92261
August 28, 1995
To Whom It May Concern
The Board of Directors are aware that Robert & Bernice Fisher are receiving calls for and
handling the dispatching of Airport' Taxi business from their rental residence at 79-263
Horizon Palms Circle, La Quinta, CA. 92253..
The Board of Directors have been aware of this activity for a considerable period of time
and have noted that the only traffic in and out of the property ( other than the coming and
going of Mr: & Mrs. Fisher). is via telephone:
• Written by,
r
Bob Miller, Board Member and Treasurer
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