Wear-' jt..:•�..�;'-r,`� P_O_ Box 1504 (7GOj 777-7Q00
cCF7�� 78-495 CALLE TAMPIcO
LA QUINTA, CALIFORIA 92253 FAX ('760) 7'77-7101
N
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
�
FEE 570.00
INSPECTION DATE: 2' 1 — Zn f loll ; ' 2,e)_
10 ,o
Please read each condition Iisted on the attachment in this packet to see if the proposed
activity complies with the City's Home Occupation Regulations.
APPLICANT NAMES: (List all owners, partners, and/or corporation officer's
6.,4t2IGL-j( (NF,,a
F,
PROPERTY ADDRESS: J� !{.r/ PHONE:
MAILING ADDRESS:
t' l n'1 /i (li- DIFFERENT FROM ABOVE)
PROPERTY OWNER:
F,
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.):
TYPE OF BUSINESS:
F
z
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: ~ T
NUMBER OF PERSONS INVOLVED IN BUSINESS:
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): _a4300 SO f
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EX_ BEDROOM -
125 SQ FT_): L� S -
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED 114 THE BUSINESS -
OPERATION: /`7 0620 tY2 I
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATION IS ALLOWED_ (CONDITIONS ATTACHED).
APPLIC 'S SIGNATURE D
7r,
IF APPLICANT -IS OTBER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
EB (! *RECD
REN-FAL)LEASING AGENT IS REQUIRED_ u F
OWNEWAGSIGNATURE
AGENT COMPANY NAME CBN<,C7 PH- # DATE
IMPORTANT: FALSE OR FADING INFORMATIO BE GROUNDS FOR DENYING
YOUR HOME O CC ON; FAILURE TO COMPLY wrm NDl'ITONS LISTED ON THE
ATTACHED E SHALL BE GROUNDS FOR REVOCATION OF P -
BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION:
APPROVED DENIED. � ., �. SPECIAL CONDITIONS
OFFICER Imo_ # DAA
PLEASE RLR AD!
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
WORK ,R' S COMPENSATION
if your company has eniployecs, a copy of the Workman's Compensation Pol icy must accom�the-businesst be
m
license application, indicating dates of coverage and dollar aouint_ This proof of coverage
before the business license can be processed_
If you do not have employees, please check the last section on this page: "1 Certify that ........
If your business 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, -please contact the Code Compliance Division at 777-7050.
t to• Section
Every empiayex who applies for any license or renewal of any license for a business issued pulses rid i
37101 of the gurvenunent Cade or Section 7284 of the Revmme and Taxation code shall. camp $n
declaration that states the followin .
WaRKER'S COMPENSAECLAxATIorr
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 lnsurance, 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:
Caries_
Policy Numb -=x-_ L�Pires:
NT OF
A COPY OF AN POLICY OR
DATE FOR WORKER' COMPENSATION ON IS REQUUMED TO
COVERAGE_
PROCESS TMS 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 should become subject to
the worker's compensation provisions of Section 3700, l will provide the City with a
policy or certificate copy within ten (10) days of the change in requirements_
LTC T GNATURE TE
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer
to criminal penalties'and civil fines up to $100,000. In addition to the cost of compensation, damages,
interest, and attorney's fees may he assessed to.you as provided in Section 3706 of the Labor Code_
I30ME OCCUPATION CONDITIONS AND CIUTKIUA
I-jEOMOCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS AND REQUIREMENTS:
No one, oilier that the resident of the dwelling shall be employed ori the premises in the conduct of the Home
Occupation"
The Home occupation shall be conducted entirely within the enclosed area of the main building and shall not. occupy
more than 25% 6f the total area of the structure -
A Home Occupation shall not be conducted within an accessory strxzctu n There Ho be Storage of equipment of
supplies in an accessory structure. Garage space may be used for Elie conduct of a Home occuepra9 I6a afthh�rt ng
docs
not interfere with the use of such space for the off-street parking or vehicles required by Chap
Ordinance.
There shall be no outdoor storage of equipment, machinery, supplies, materials, or merchandise.
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 gePeral public_
blo
There shall be no supply of hazardous materials stored on the Pr m ses POOL cal ri any otherl
thinner, etc.}, unless the hazardous ma#erials are stored m approved by the State Fire
regulating agency.
ment to or from the subject properly, including the use ofrvehicles
There shall be no dispatching of persons or equip
which operate to and from the premises.
use, shall be parked at the residence at any time_
No vehicles or trailers, except those normally incidental to residential
There shall be no use of any mexhanicalmen. appliance, or motor outside of the enclosed building or which
equip
de the building in which it is located that is related to the business-
generated noise detectable from outsi
p_ There shall be no signs or other devices identifying or advertising the home occupation.
1 _ In no way shall the appearance of-tln-ed ae budding Ilot be so altered, 101- the house occupation be so conduce�u� the lot
or budding may be reasonably reco
as serving a 111011 -residential use (either by color, maUx aI.s, 'o',
_
"lighting, sounds, vibrations, etc).
- reason of noise, odor, dust, vibrations, fumes, smoke, electrical
No Home Occupation shall create a nuisance by
interference, traffic, or other causes -
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.
TY OF LA QUINTA MUNICIPAL CODES: 9.60-110,9-160, and 9.210.060