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FEE $35.00
CITY OF LA QUINTA
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FEB 2 2 1996
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78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
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 DL-SY.70'P 9L�S}}11�(, ��EJ2V14iONE S(oq- 393,17
PROPERTY OWNERPHONE -1!76q- (4(, 19
PROPERTY ADDRESS �l q - n G.c -T()� O C_T. L_p� CI U.
C (4 c) a a S 3
MAILING ADDRESS S.p�rr, e
TYPE OF RESIDENCE ( single, multiple, mobil home, etc.)
TYPE OF BUSINESS `T Y 9 :: S ETT i l\� �, S F; tR_V i CF
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE 0�-
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED S I Dt� F Y H • S c v 7 T r -
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE ( EXCLUDE GARAGE) O a a .1
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME I as S, F. - z4fDo,,.
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION
c
I HAVE READ, UNDE. , AN AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUP��,,14 A�OWED ONDI S ATTACHED) .
DATE
IF A,`WPLICANT IS • 0-THER TE�,,_N PROP yRTY OWNER, AUTHORIZATION OF OWNER
OR AENT IS REQUIRED.
OWNER/AGENT S IGNATURE `"`s A� _ DATE
IMPORTANT: MtE ORA415LKAI)ING, -.,_,NFORMK"i:(0Sa 2'1ALL BE GROUNDS FOR
DENYING YWRR' _ BORE OCCUPATION; FAILURE:- TO COMPLY WITH CONDITIONS
LISTED -.0N' 1�1% ATTACHED , PAGE,- _- 11,LL BE.'= GROUNI'DS FOR REVOCATION Or
PERMIT. -1�ra� afety Departn2�at o
ATTACHgD
N.
78-495 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.
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 shoul ome ject to
the worker's compensation provisions of S o 37 0.
Date: a - -°1 G 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
ALMAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 �;�.
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PARC LA QUINTA HOMEOWNERS ASSOCIATION
AVAIL PROPERTY MANAGEMENT
P. 0. BOX 1032
PALM DESERT, CA 92261
(619) 568-2717
February 16, 1996
Mr. Sid Scotten
49-095 Tango Court
La Quinta, CA 92253
RE: Business Permit
Dear Mr. Scotten:
• Your request for permission to operate a business from your
residence within Parc La Qunita Homeowners Association was
reviewed by the Board at their meeting on April 18, 1995.
It was unanimously agreed that approval would be given for your
in home business with the conditions that this business will not
adversely affect your neighbors. It is understood that you will
have no 'walk-in' business clients come to your home. There
will not be an unusual number of deliveries to your home on
behalf of the business; there will be no commercial vehicles
used in the commission if this business which will be visible,
and; you will be licensed by the City of La Qui nta for this type
of business only from this residence.
Should the conditions of these arrangements not be met, of if
complaints are levied and found to be valid regarding this
business, the Association has the right to withdraw this
approval at any time.
Sincerely,
Cam Anderson
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