DAVISF
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• FEE $35.00
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92 53 /0,441
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 PHONE /-�) 77/ O U
PROPERTY OWNER M A2 `r Z:) +4-U S PHONE '-7-7/ — y o c n,
PROPERTY ADDRESS 4"_ 7 / ,P S" n� .ic rz� C S
MAILING ADDRESS
TYPE OF RESIDENCE (single, multiple, mobil home, etc.).0 o
TYPE OF BUSINESS Pu -D 4-_� S i (_,-/t1 .
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE MC s-rz y
NUMBER OF PERSONS INVOLVED IN BUSINESS /
LIST NAME OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE ( EXCLUDE GARAGE) 2 966
LOCATION AND SQUARE FOOTAGE OF AREA r i^
OF BUSINESS ACTIVITY IN HOME D EB 1 /a'19
( EXAMPLE , "BEDROOM -125 S.F.") aff 14
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BIIj �—I_N E
BUSINESS OPERATION f=A X Gu
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HO OCCUPATION
SALLOWED (CONDITIONS ATTACHED). /
APPLI SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, -AUTHORIZATION OF OWNER
ORAGENT IS REQUIRED.
C
SIGNATURE
.,DATE
a
OR'i FALSE OR MISLEAD?IdG.>�,INFORMATION SHAD BE GROUNDS FOR
Hn-PIE OCCUPATION-;. FAILURE TO COMPLY;Tdf�,T�i CONDITIONS
STEIr-ON 'ice `ATTACHED PAGE SHALL HE GROUNDS FOR REVOCATION OF
FAIT
Buiih 'wand Sa'fI% s rtment 6 M
_. _ APPROVED - ~="" ' ' DENIED CONDITIONSATTACHED
•
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4 4-a Qu&M
78-495 CALLE TAMPIC , - LA DUINTA, 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 hich 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.
�� ��
.Date: Applicant:
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
MAILING ADDRESS - P.O. BOX 1504 - LA DUINTA, CALIFORNIA 92253 �40�.
PGA WEST RESIDENTIAL ASSOCIATION, INC.
February 8, 1996
Ms. Mary Davis
54-718 Inverness
La Quinta, CA 92253
Re: 54-718 Inverness.
PGA West
Dear Ms. Davis:
Thank you for your letter requesting permission to operate a
business from your home at PGA West.
• Please be advised that at the Board of Directors meeting on
January 25, 1996 you were granted permission to conduct your
business from your home located at 54-718 Inverness.
0-
It is understood that there will be no visual or audio signs of
this business being operated from your home as well as no
additional foot or vehicular traffic. There will be no on site
solicitation or on site storage as well.
The Board of Directors reserves the right to revoke this decision.
Sincerely,
�•
Michael L. Walker AMS
General Manager,
PGA West Residential Association, I'nc.
P.O.
Box"1060, L.a Quints, California 92253, Telephone 619-771-1234 Fax 619-771-5125