Simmons•
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92247
.�L�'«G�ra l
COMMUNITY
SAFETY DIVISION
HOME OCCUPATION PERMIT
Permit Number: 11-00005437
(760)777-7050
FAX (760) 777-7011
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) SIMMONS S ELAINE
Property address: 78960 SONESTA WY
Mailing address: 78960 SONESTA WAY
Property owner: SIMMONS S ELAINE
Type of business: JEWELRY MAKING
Phone: (760) 360-6981
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Brief description of how the business will operate: CITY.u•.A iN� rq
Square footage of usable floor area in house (exclude garage) 2000 SQUARE FT
Location and square footage of area of business activity in home (Example: Bedroom — 125 sq ft.) BEDROOM,
100 SQUARE FOOT
Description of machinery, equipment, and supplies being used in the business operation:
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED. (Conditions Attached)
APPLICANT- SIGNATURE 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 . Your inspector will be Philip
Juarez. 11
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� PPROVED
❑ DENIED
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------INSPECTOR US
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Inspector Signature
-----------------------------------
7-11
Date
10/05/2011 WED
9:12 PAX 760 777 7105 City of La Quint& 0001/005
P -0 -'Box 1504
78-495 CALLS TANpico (760) 777-70A0
LA QUINT -A, CALIFORNIA 92253 FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
FEE $70.00 INSPECTION DATE:
Please read each condition listed on the attachment'in this packet to see if the proposed
activity complies with the City's Rome Occupation Regulations.
APPLICANT NAMES: (List all ownus, putners, and/or corporation olDeas .
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I HAVE READ, U"ERSTAND, AND AGREE WITH THE CONDITIONS BY Ww
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ATE
IF APPLICANT IS Q7iIF,R THAN -IIB PROPERTY OWNER.
WAL/LEASING AGENT IS.REQUUtED.
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10/05/2011 WED 9:12 PAX 760 777 7105 City of La Quinta 0002/005
0 GENT SI
DATE .
NAME cgfqTAcTr PH. # DATE
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION;- FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALT. BE GROUNDS FOR REVOCATION OF PERMIT.
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BUILDING AND SAFETY DEPAR'IMNT/CODE COMPLIANCE DPASION: .
APPROVED DEN>FD SPECIAL CONDITIONS
OFFICER DATE
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10/.05/2011 WED 9:12 PAX 760 777 7105 City of La Quinta &D004/005
WORM'S COMPENSATION
Ifyour 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.....
.Ifyour 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, plane 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 Qolete and sib a
awl -IN �1'06WXT
I hereby affirrn under penalty ofperjury, 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 boniness activities conducted for which this license is
issued
My Worker's Compensation insurance carrier and policy number:.
Carrier:
Policy Number: Expires:
A COPY OF SAID POLICY OR CERTIFICATE OF CONSENT SHOWQi6 THE AMOUNT OF
COVERAGE AND EXPWATION DATE FOR WORKER'S COMPENSATION IS REQUIRED TO
PROCESS. APPLICATION.
1 certify that in the performance of any business activiges. 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 agme that if I should become subject to
the worker's compensation provisions of Section 3700,1 will provide the City with a.
policy or certificate dopy within ten (10) days of the -change in requirements.
S1 ATURE DATE
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subtect an employer
to cttminal penalties and civil fines up to.SIOO,000. Irl addition to the cost of compensation, damages,
interest, and attorney's tea may be assessed to you as provided. in Section 3706 of the Labor Code.
10/05/2011 WED 9:12 FAX 760 777 7105 City of La Quinta 0003/005
PLEASE R ADf
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 UNDERSTAND THIS
STATEMENT.
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Signa
HOME OCCUPATION CONDITIONS
• ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS:
•
1. No one, other than the resident of the dwelling shall be employed on the premises in the conduct of the Home
Occupation.
2. The Home Occupation shall be conducted entirely within the enclosed area of the main building and shall not occupy
more than 25 percent of the total area of the structure.
3. A Home Occupation shall not be conducted within an accessory structure. There may be storage of equipment or
supplies in an accessory structure. Garage space may be used for the conduct of a Home Occupation only when it
does not interfere with the use of such space for the off-street parking of vehicles required by Chapter 9.160 of the
Zoning Ordinance.
4. There shall be no outdoor storage of equipment, machinery, supplies, materials, or merchandise.
5. There shall be no sales activity, either wholesale or retail, except mail order sales, nor shall there be the maintenance
of an office open to the general public.
6. There shall be no supply of hazardous materials stored on the premises at any given time (i.e. pool, chlorine, paint
thinner, etc.), unless the hazardous materials are stored in a manner approved the State Fire Marshall or any other
regulating agency.
7. There shall be no dispatching of persons or equipment to or from the subject property, including the use of vehicles
which operate to and from the premises.
8. No vehicles or trailers, except those normally incidental to residential use, shall be parked at the residence at any
time.
9. There shall be no use of any mechanical equipment, appliance, or motor outside of the enclosed building or which
generated noise detectable from outside the building in which it is located that is related to the business.
10. There shall be no signs or other devices identifying or advertising the home occupation.
11. In no way shall the appearance of the building or lot be so altered, or the home occupation be so conducted, that the
lot or building may be reasonably recognized as serving a non-residential use (either by color, materials, construction,
lighting, sounds, vibrations, etc.)
12. No Home Occupation shall create a nuisance by reason of noise, odor, dust, vibration, fumes, smoke, electrical
interference, traffic, or other causes.
13. The use shall meet reasonable special conditions as established and made of record in the Home Occupation Permit,
as may be deemed necessary to carry out the intent of this section.
14. Listed below are special conditions which shall be considered a part of the conditions directly related to this
application and this permit:
MY SIGNATURE BELOW INDICATES THAT I HAVE READ, UNDERSTAND AND AGREE TO COMPLY
WITH ALL OF THESE CONDITIONS:
DATE
Office Copy -White Customer Copy - Yellow