RamosFE�.0 0
P.O. Box 1504
78-495 CALLS TAMPICO (760) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
:
INSPECTION DATE: `yy//l 7.i itle d 1"1y1_ d :) 0jbpLI
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 all owners, partners, and/or corporation officers
r
y� �Y
PROPERTY ADDRESS: V - Q
MAILING ADDRESS: S V,.� e- _ (TF DIFFERENT FROM ABOVE)
PROPERTY OWNER - 'r VO�
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.).-
TYPE
TC.):
TYPE OF BUSINESS:
Yck 0 -) 1
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE:
1 �
NUMBER OF PERSONS INVOLVED IN BUSINESS:
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE):
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EX. BEDROOM -
125SQ FT.): % 5
DESCRIPTION OF MACHINERY, EQUIPMET, AND SUPPLIES BE1N USED IN THE
OPERATION: 1 ,j
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCT7PA N OWED_ (CONDITIONS ATTACHED).
APPLIC I NATURE DATE
IF APPL ANTIS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTTAL/LEASING AGENT IS REQUIRED_
1e_
SIM
OWNEEII ENT SIGNATURE
AGENT COMPANY NAME
DATE
CONTACT PH. # DATE
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION; FAILURE TO COMPLY wrm THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT.
BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION:
APPROVED _ - DENIED.-- SPECIAL CONDITIONS
OFFICER - I.D. # _ DATE
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..
Signatu
WORKER'S COMPENSATION
If your company has employees; 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 cane processed_
If you do not have employees, please check the last section on this page: "I Certify tbIA .....
If your business is being operated from your home in La Quinta, a Home OccuIO Permit is required before a
business license is issued.
If you have any questions, -please contact the Code Compliance Division x 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 sign a
declaration that states the follo«1inR:
WORKER'S COMPENSATIQX—DECLARATION
I hereby affirm under penalty of perjury, one of 111e following declarations:
I have and will maintain a �cate of consent to s61f=insure for Worker's
Compensation, as prov d by Section 3700 for the duration of any business activities
conducted for which iCmse is issued_
I have and -will.ruaint;�n Worker's Compensation Insurance, ,required by Section
3700 for the duratio /of any business activities conducted for or
this license is
issued.
My Worker's
Carrier
Policy Numb<
A COPY OF SAID POLICY OR
COVERAGE AND EXPIRAM.
PROCESS THIS APPLICATIM
insurance carrier and policy number:
I Expires:
TIFICATE OF CONSENT SHOWING THE AMOUNTO
TE FOR WORKER'S COMPENSATION IS REQUIRED
_ I that in the performance of any business activities for which this license is
issu I shall not employ any person in any manner so as to become subject to the
wor ees compensation laws of California, and agree that if I should become subject to
th worker's compensation provisions of Section 3700, 1 will provide the City with a
licy or certificate copy within ten (10) days of the change in requirements.
DATE
WARM 14 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 be assessed toyou as provided in Section 3706 of the Labor Code.
HOM , OCCUPATION CONDITIONS AND CRITERIA
L 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 shall 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 Home Occupation only when it does
not interfere with the use of such space for the off-street parldng or vehicles required by Chapter 4.160 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. poot chlorine, paint
thinner, etc.), unless the ba=dous materials are stored in a manner approved by the State Fire Marshal 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.
$_ 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.
I L 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 recogniwd 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
inay be deemed necessary to carry out the intent of this section_
CITY OF LA QUINTA MUNICIPAL CODES: 9.60.110,9-160, and 9.210.060
HOME OCCOPATION CONDITIONS
ADDRESS: 53545 Avenida Velasco
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 no 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 9.60 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 orders 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 by 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 devised 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 reasonable 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, UNDERTAND AND AGREE TO COMPLY WITH ALL OF THESE
CONDITIONS.
PRINT NAME c OFFICE SIGNATURE OF APPROVAL
SIGNATURE DATE
** OFFICERS SIGNATURE INDICATES HOME OCCUPATION APPROVAL