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DEC2 7 2016 pEC 2?
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016
CITY OF LA OUINTA I cc 014
'�� ! CITY Q� au4� TIENT
Nk1V DE vELUPMENT DEPARTMENT C���lSN1T� pElf
P.O. Box 1504
78-495 CALLe TAMPICO (7 60) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
FEE $70.00 INSPECTION DATE: Z
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 IV- CL ' " 1 a I n es , s V -16j
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PROPERTY ADDRESS: 43373 6 Vk1J(Aq E5planadr_ Omom,: X o- 77q -8 6q 8
MAILING ADDRESS: (IF DIFFERENT FROM ABOVE)
PROPERTY OWNER: �nl k�} ZA Uva Y► qod -Pe+ i 52QIGsg n
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC_): J i nq le ^
TYPE OF BUSINESS:X51 n! and rJ' 6hb baiton tw0io icc s C �,oi umC5
BRIEF DESCRIPTION OF HOW THF: BUSINESS WILL OPERATE: _Ghc(jTy rune � fAz(nos Sl-lt
belca Clai+ n(s)r n�s). (%tjmny pre s�wp and em[�c�(f W b�e Cj .,
Self*d date'.
NUMBER OF PEINVOLVED INBUSINESS:_ INVOL2
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): JT 260
LOCATION ANDS U FOO G.E OF AREA OF BUSINESS ACTIVI'T'Y IN HOME (EX. PCDROOM -
125 SQ FT.): ' x cd ma V"A
&hAC <3 120 S�
DESCRIPTION OF MACHINERY, LQ ]IPMENT, AND 5> TPPLIES BEING U ED STHE BUSINESS
OPERATION: S�WI(� mac frz t"sl,_ 5ffaacr, iron , r Ines ne. hea, P(ess r '
drecv� rna�h�nc ,-�'�br►c , CrWAal rhinos+once
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUP 'I ION IS ALLOWED. (CONDITIONS ATTACHED).
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APPLICANT'S JVNATURE A1T
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.
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OWNEIVAGEN' GNATURE
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AGENT CJ MWANt--&AME
760.77 - g6q g
CONTACT PH. #
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DATE
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DATE
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT.
BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION:
APPROVED DENIED j SPECIAL COND . I.ONS
OFFICE I.D. # • !� DATE % Z Z /�
WORKER'S COMPENSATION
If your company has employees, a 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 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 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,
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
Tar t q t_ljtat stmt's llte_fQ11010im
WORKER'S COMPENSATION DECLARA IIQN -
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 TH- E AMOUNT OF
COVERAGE AND EXPMATION DATE FOR WORKER'S COMPENSATION IS REQUIRED TO
PROCESS THIS�PPLICATION.
�%f 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, 1 will provide the City with a
policy or certificate copy within ten (10) days of the change in requirements.
i212
APPLICANT Si URE DATE
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 be assessed to you as provided in Section 3706 of the Labor Code.
GROSS RECEIPTS RANGE:
CLASS 1
CLASS 2
CLASS 3
0 -25,000
$ 15.00
$ 18.00
S 21.00
25,001 - 50,000
25.00
30.00
36.00
50,001 - 100,000
30.00
36.00
43.00
100,001 - 250,000
46.00
55.00
66.00
250,001 - 500,000
76.00
90.00
108.00
500,001 - 750,000
114.00
135.00
162.00
750,001 - 1,000,000
150.00
180.00
216.00
1,000,001 - 2,000,000
400.00
500.00
600.00
2,000,001 - 3,000,000
500.00
625.00
750.00
3,000,001 - 4,000,000
600.00
750.00
900.00
4,000,001 - 5,000,000
700.00
875.00
1,050.00
5,000,001 - 10,000,000
1,000.00
1,250.00
1,500.00
10,000,001 - and up
1,500.00
1,875.00
2,250.00
CLASS 1 Automobile Repair and Services; Laundry, Dry Cleaning anrl(�arment ServiceManufacturing; Retail
and Wholesale Trade.
CLASS 2 Amusement and Recreation Services, including Motion Pictures; Architectural Services; Automotive
Sales; Barbers & Hairstylists; Beauty Shops; Engineering Services; Landscape & Horticultural
Services; Operators, Renters & Lessors of Commercial Property; Services to Buildings, and all other
persons engaged in business not specifically listed elsewhere.
CLASS 3 Accounting, Auditing & Bookkeeping Services; Financial Services; Insurance Brokers & Services;
Legal Services; Management & Public Relations Services, Medical & Health Services; Real Estate
Agents, Brokers, Managers & Services.
* On September 19, 2012 Governor Brown signed into law SB -1186 which adds a state fee of $1 on any applicant for
a local business license, permit, or renewal. The purpose is to comply with construction -related accessibility
requirements for businesses in order to facilitate compliance with federal and state disability law, as specified.
r- _
W.3!_._41M t _ .` 1
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
ADDRESS: 43373 Parkway Esplande W H02016-0064
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 not 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 there the maintenance of an office
opened 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 O COMPLY WITH ALL OF THESE
CONDITIONS.
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PRINT NAME Of R SIGNATURE OF APPROVAL
- [ . _�
Ci(;AI-AT IRF DATE -
** OFFICERS SIGNATURE INDICATES HOME OCCUPATION APPROVAL