CAVEFEE $35.00
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59
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504,
HOME OCCUPATION PERMIT
i
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 C R✓� �N,�IS�S PHONE<G/?) 77�
PROPERTY OWNERF_ A- A RE PHONE S�1 M E
PROPERTY ADDRESS S5- o/ 6 -go A6o ' L I a u r4C 4 F
MAILING ADDRESS o
TYPE OF RESIDENCE (single, multipAAJ
mobil
TYPE OF BUSINESS VAC A 7-1.0,;,J FA5
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL t
1-0 AA),D 56�56Nf1 L
NUMBER OF PERSONS INVOLVED IN BUSINESS Q_
LIST NAME OF PERSONS EMPLOYED p 4-79ke
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE ( EXCLUDE GARAGE) 02 /OD 5. =-
V10 I .4 F
A),f -6,E MPEN I
LATE
G AJ r A S
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME 3s1-2,e019M -
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION
N Q O f f/ G G _5y yD L/6 S
I HAVE. MADOIUNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME QdCt_PAT N AL WED (CONDITIONS ATTACHED).
LICANT SIGNATURE-
IF APPLICANT IS OTHER TITAN FROPEPCd`i OWNER, AU711CORIeZAT� I:N Cr-F� 0,W- ER
OR AGENT IS RtOUIREP. FT:
0"'N� n%AGENT,*UGNATURE ,�f,;.,E.;. DAT
IMPORTANT: `.;pFALSE OR MISLEADING Ii�;OR ►T1 D SHALL BE, CsROifF�`lOS FOR
DENYING YOUR FIOME: OCCx�ATION; . FAI itPZ ' TO" COMPLY f�I a►'n1�ITIONS
_,. LISTED OIC. THI ATTACHED PAVE SF.AL.�3. BE GROUNDS FOR'' REVCIC, T'IOF" OF
PERMIT.
Buil durnq ani Safety_.epartmen�;;.
AVrROVED DENIED ' )E ONDI.TION,3�ATTAC�iED
F.9s
T4t�t 4 4a Qaloa `
78-495 CALLE 'TAMPICO — LA QU1NTA, 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.
XI"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 shoulbjpcome subject to
the worker's compensation provisions of Sec o 700
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
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MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 ���.
PGA WEST,H RESIDENTIAL ASSOCIATION, INC.
P.O. Box 1282 • La Quinta, CA 92253
August '28, 1995
Mr. & Mrs. Robert Cave
55 405 Winged Foot, } -
La Quinta,.CA 92253
RE: PGA West II Residential Homeowners Association
Home Operated Business
• Dear Mr. & Mrs. Cave:
This letter will serve to give notice of approval of your request
to run a bookkeeping business and prepare seasonal leases from your
home in PGA West II Residential Homeowners Association.
If you have any questions or comments for us, please call our
management company', The Monarch Group, at (619) 360-4161.
Sincerely
Ted Martens, Treasurer
c: Board of Directors
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