Barton & Robidouxfi�Daw r � 1 000 r
Nei
P.O. Box 1504
78-495 CALLS TAMPIco (764) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
FEE $70.00
INSPECTION DAI
TE: �WA
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 NAMES: (List aH own= partes M and/or
Id
n
ion officers
PROPERTY ADDRESS: ?6 5 � e 5 , J r PHONE: b ;L�OQ /
MAILING ADDRESS: OF DIFFERENT FROM ABOVE)
PROPERTY OWNERc=' r; -5 ,. I
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC_): ` �� ►''4 ' I
TYPE OF BUSINESS: _ -1n 446 Iz-^
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE:
—Apple :ire
NUMBER OF PERSONS INVOLVED IN BUSINESS:
ti :"N
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE):
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EX. BEDROOM -
125 SQ FT.): /0.
DESCRIPTION OF MACHINERY,
OPERATION:
AND SUPPLIES BEING USED IN THE BUSINESS
cr �- r -t A - -
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HWPLIe'S'41GN�ATURE
ATION IS ALLOWED_ (CONDITIONS ATTACHED).
-f: I /
ATE
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
REN-TAL/LEASING AGENT IS REQUIRED.
N
WORKER'S COMPENSATION
If your company has employees, a copy of the Workman's Cc ml ensauon 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....."
If your business is being operated from your home in La Qiiinta, a Home Occupation Permit is required before a
business license is issued.
If you have any questions,'please 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 complete and '
declaration that StatcS the f 11QwiR_L'
WORKER'S COMPENSATION DE RADON
I hereby affirm under penalty of perjury, 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 business 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 SHOWING THE AMOUNT OF
COVERAGE AND EXPIRATION DATE FOR WORKER'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 compensations laws of California. and agree that if I should become subject to
the worker's compensation provisions of Section 3700, I will provide the City with a
policy or certificate copy within ten (10) days of the change in regnir�ents_
APPLICANT SIGNATURE
DATE
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer
to criminal penalties'and civil fines up to 5100,000. In addition to the cost of compensation, damages,
interest, and attorney's fees may be assessed to you as provided in Section 3706 of the Labor Code.
OWNER/AGENT SIGNA
AGENT COMPANY NAME
IWORTANT: FALSE OR MIS
YOUR HOME OCCUPATION;
ATTACHED PAGE SHALL BE
DATE
CONTACT PH. #
INFORMATION SHALLA GROUNDS FOR DENYING
TO COMPLY WITH CONDITIONS LISTED ON THE
S FOR REVOCATIU OF PERMIT.
BUILDING AND SAFETY-DEPARTMENT/CODE
APPROVED DENIED
OFFICER I.D. #
DIVISION:
SPECIAL CONDITIONS
PLEASE READ!
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.
Signature
HOME OCCUPATION CONDITIONS AND CRITERLk
ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS AND REQUIREMENTS:
1. No one, other that 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% of the total area of the structure.
3. A Home Occupation sha$ not be conducted within an accessory structure. There may be storage of equipment of
supplies in an accessory structure. Garage space may be used for the conduct of a dome Occupation only when it does
not interfere with the use of such space for the off-street parkin or vehicles required by Chapter 9.160 ofthe 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 shah be no supply of hazardous materials stored on tiro premises at any given time (i.e. pool, chlorine, paint
tb rL=, etc.), unless the hazardous materials are stored in a manner approved by the State Fire Marshal or any other
regulating agency_
7. There shall he 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 tete building or lot be so altered, or Lhe 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, vibrations, 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.
I
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CITY OF LA QUINTA MUNICIPAL CODES: 9.60.110, 9.160, and 9.210.060