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P.O. Box 1504
78-4955 CALLE TAMPICo
LA QWNTA, CALIFORNIA 9225$
(760) 777-7000
FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
FEE $70.00 INSPECTION DATE:
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 empoistion officers f LJt,�7
PROPERTY ADDRESS:
-MA1L1NG ADDRESS:
PROPERTY OWNER:
TYPE OF RESIDENCE, (SINGLE,
TYPE OF BUSINESS:
ems.. D �p
PHONE:
DIFFERENT FROM ABOVE)
W
MOBILE HOME, ETC.): t4 <- ... _..
BRIEF DESCRIPTION F HOW THE BUSINESS WILL OPERATE: I
C
n s
NUMBER OF PERSONS INVOLVED IN BUSINESS: J.-
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): — �r_ uo
LOCATION AND FOOTAGE OF ARBA OF BUSINESS INH {{E� BEDROOM -
125 SQ FT.): _ C - �� �v. i
DESCREMON OF kY AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION: �l d -
Vi, RRAD, UNDE AND, AND AGREZ WITH THE CONDITIONS BY WHICH A
HO ATION IS D. (CONDITIONS ATTACHED)._
to ( 5
APFUCANT'S SIGNATURE DATE
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENI'ALILEASING AGENT IS REQUIRED. -
OWNER/AGENT SIGNATURE
DATE
AGENT COMPANY NAME CONTACTmL.# DATE
EWPORTANT: FALSE OR MISLEADING INFORMATION SEL4U BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION; FAELURX TO COMPLY WITH THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PIiRMPr.
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BUILDING AND SAFETY.DEPAR'YMENTICODE COMPLIANCE DIVISION:
APPROVED DENIED SPECIAL CONDM NS
OFFICER !V I.D. # �� ^ DATE 15
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
STATE NT.
Signature
WORKER'S COMPENSATION
Hyour oempsmy has employees, a copy of the Workman's Compensation Policy must accompany the'businass
license application, indicating dates of coverage and dollar amount. This proof of coverage must be received
before -the business lioaase can be processed.
'If yon do not have employees, pkasc check the WE section On 111is page: ' I Certify that......"
If your business is being operated fionn your hank in La Quinti, a Home Occupation Permit is required before a
business license is issued.
If you have any questions,'please. contact the Code Complianee 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 gplete and�ga`a
declaration that dates the Ulm"
I hereby affirm under penalty of perjury, one of the following declarations:
I have and will maintain a certificate of conserrt to self-insme for Wodwr'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 19 RZOUIRED TO
PROC APPLIC.A,TION.
�-- 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 s*cx to the
worker's compensation laws of CaTdornia, and agree that ig I should become subject to
the worker's eamrpeasation provisions of Section 3700, I will provide the City with a
policy or certificate copy within ten (10) days of the change in requirements.
APX' ANT SIGNATURE DATE
WARNING: Failure to secure Worker's Compensation coverage is rmlawfal, and shay subject an employer
to criminal penaides-and civil fines up to S100,000. In addition to the cost of compensation, daumsges,
interest, and attorney's feces may be assessed to you as provided in Section 3706 of the Labor Code.
HOME OCCUPATION CONDITIONS AND CRITERIA
ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS AND REQUMEMENTS:
1. No one, other that the resident of the dwelling shrill be eirployed on the premises in the conduct of the Home ,r
Occupation.
2, The Rome Occupation shall be conducted entirely within the enclosed area of the. main building and shall not occupy ✓
more than 2-5% 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 four the conduct of a Home Occupation only when it does
not interfere with the use of such space for the off-street parking or vehicles required by Chapter 9.160 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 shallbe xw supply of hazardous materials stored on the premises at any given time (i.e. pool, chlorine, paint /
thinner, etc.), unless the bazardam 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 flora 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 detecmble 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 the building or lot be so altered, or the 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 inoise, odor, dust, vibrations, fumes, smoke, electrical
interference, traf&, or other causes.
13. The use shall meet reasonable special conditions as established and rade of record in the Nome Occupation Permit, as
may be deemed necessary to carry out the intent of this section
CITY OF LA QUR rrA MUNICIPAL CODES: 9.60.110, 9.160, and 9.210.060