McphersonP.O_ Boz 1509
78-995 Cnu.e TAmreco (760) 777-7000
QNINTA, CALIFORNIA 92253 FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
FEE 570.00 INSPECTION DATE:
Please read each condition luted on the attadonat in this packet to see iF the proposed
activity complies with the City's Home Occupation Regulations.
APPWCANTNAMES-. (list all 0w=, Pte. upftc OwPwAtiM moos -
PROPERTY A,,RFSS: 51 Z3G �`� ea t 4 PHOW I n i 1 �� - 4 q CD - 9 U 2
MAILING ADDRESS: S A""T D IFDIPFPRFNTFROMABOVE)
PROPERTY OWNER: ,-„ S CL! i j �4 LCL 3_ CS T� •�� ��I
TYPE OF RESIDFNCI, (SINGLE, MULTIPLE; MOBILE HOMO, ETC): S l n CI L- E
TYPE OF BUSINESS: l i S �—Z►V rJ G -P,4 T 0414&1 C L -C7 H�-NC� S -TI �1 U ST
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: • G
Y} ::5>4 O f- Sck rn � l i -Q. o S
NUMBFROFPFRS0NSINVOLVm INBU9IESS:
SQUARE FOOTAGE OF USABLE FLOM AREA IN ROUSE (EXCLUDE GARAGE:
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (PTC BEDROOM
125 SQ FP.):
DESCRIPTION OF MACIIINERY, EQUMMENT. AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION:
CoanPL i
I HAVE BEAD, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCLUFATWN IS ALLOWED. (CONDITIONS ATTACHED).
APPLICANT'S SIGNATURE DATE
IF APPLICANT IS 07IIIER THAN THE PROPERTY OWNER, AUITiORTZATION OF OWNER OR
RENTALa EASING AGENT IS REQUIRED -
OWNWAGINTSIGNATURE
n \ r::)
AEMIT COMPANY NAME
DATE T
CONTACTPR # DATE
DYEPORTANT: FALSE OR MISLEADING MMI[tMATION SHALL BE GROUNDS FOR D&NYING
YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON TIE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OFPERMTI:
tttlipfMlpiltpt/ppptNlitpililfitpe^"_—.��iitptt�ItNptiitii#i+tiiHMipifiipitf!
BUBDINO AND SAFETY DEPARTMENT/CODE COMPLIANCE Dr.FM RAF
APPROVE DENIED SPE4%LCONDTITONS
OFF[CL•R LD. # 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.
n / I HAVE READ AND UNDERSTAND THIS
STATEMENT.
Signature
WORD SCOWENSATION
If yam wmpaoy bss eMPloye % a mpg Gibe WOdc 'S Cao Policy mm accompany me
ticmee application, icing dates of coverage and MIT asioam. This proafofooverage mast be received
before the boamrs license coo be processed.
Hym do am have employees, plcase check the hast aertion on this par- `1 Certify teal_..._`
Iyam bo.divra ha being operemd fig your basis as L Qaouta, a Home Oocoquabon Permit is arloued bdive a
temm license is ierard
Ifyou have my questions, please contact the Code Comphanc a Dlvls;on at 777-7070.
Every employer who applies for any baase or renewd of my license fm a boomers issued pntanent to Section
37101 ot'the gova>aent Code or Semon 7284 of the Reve ne and Taxation code shall mmRhftA2dijzu
dectomban that states [be follavrins,
I hereby afttD under penalty of perjury, one of the following declarations:
I have and willnu mhain a certifirse of misam to self-imme far Wodw's
Coon, as provided by Semon 3700 for the dam ion of any baainag aetivitics
conducted for which this license is issued
I have and will mamma', Worker's Compensation Insurance, m required by Section
3700 fm the d,oti,a ofany bruins activities coveted for which this license is
issued
My Worker's Compensation carrier and policy o®bar.
Pohn Ntmtda len
A COPY OF SAID POLICY OR CERTIFICATE OF CONSENT SHOWING THE AMOUNT OF
COVERAGE AND EXPIRATION DATE FOR WORKER'S COMPENSATION S REQUIRED TO
PROCESS THIS APPLICATION.
I oertidy thm m mo pto#rmmmc ofany buzi =wits for which tint limrRR
issued I Nall sera emptor arty pcmwa m M roamer so n 10 became sd*M to the
wader's comWrmanon laws of California, wd og x Thai If I shonid become subject to
The woclmr's etriprasuiva piOb omc ui5avan 3700. I will provide the City with
policy or catd iiia,^ copy madam ton (10) days d the change in m+pdremevla
APPLICAAT SMIfA7UR£ DATE
WARNING: Pare in secure Worker's Cempmealive —craw is ®mwfal, sod shall subject so employer
to criminal penalties and dvd Roes 0p to SIOU,BBO. In addition to the cost of mnqNmntiaq damars,
interest; said sft rney's fees may be asseued in you as provided in Section 3706 of the Labor Code
HOME OCCUPATION CONDITIONS AND CRrrRALA
ALL HOMB OOQIPATIONS SHAT l COMPLY WTM TRE FOLLOWING CONDITIONS AND REQUUUMOM:
1. No oro, odw mat the resident ofthe dweWmg shall be employed on the pronim in the coact oftbe Rome
2 The Home Occup bm aba0 be conducted entirely with® the mdmed am of the mem bmMmmg and shall not occupy
mote than 25% of the bond —of the struc —
3. A Home Occupation shaD cut bo conducted wG6m maccamarystrtMme. Tbamybeeoaageofeq I of
aytplimmmaaramorysuact— OznkW spaco my be osed for me conduct ofs Home Oaapubm only ,bm ddect
not' wifh the me of sarh:pane forme off-street pa idng m vahida mpomd by lbapl x9.160 of the Za®g
Otdlmooe.
4. Thme Wag be no outdoor stege of e*npmme, marLmey, supplies, cube nls, m mothandne.
5. Iba shall be no sum activity, time wholWe or mb ai4 csoep[ mil order sale, nor shall that be The manamox of
ao oTm opm to the genal pnblie
6. Tbm shall bo err kippiy of -Ad owmml-. A—d on the presses at any given cone (Le. poo4 chbr®q paw
thea , city, oaken the Radom oamaiah aro slued in a onus approved by the Shue Fire Marial or my omen
replows+0--7•
7. Thea sWl be no dimpucYn of peons ar ogaipmmtto or from the subject property, including the: use of vehv3n
which opab to and from me pa®fn.
g. No vehicle or miles, -0 those normally mcideml to mmdmtW me, shall be peed at the midence u any t®e.
9. Tba shall be m me of my marhomul egaaipmmf, ppliaoce, ar ®Our -Iside of me cwJowd building ar which
Smaled cone detectable from outside the bolding in which it is located mat is related to me busies
ID_ Tba shall be no signs n outer device idmbfymg ar sdvcrbmg the home omapaGm.
11. In m way sball the appnnooe of the balding or lot be so eland, or the hum occupation be so omdmmd, mm me tel
or bldg my be --.I* —p—d as —4 a non -m A-bd me (ad -by color, mmak c omlmation,
lighting, somdti vaastiom, ete).
12 No Home Occupation also gran a ®moi by reason ofnoisq odor, dont, vabstrom, fine, a nohn, ebcmaal
mkdamR traffic, ar othe none.
13. ibe mac shall meetimomble apecsl cbmdi bm as ernWnhed and made of record m the Hum Occupabun Pernod, as
may be deemed moesey te arty out the cote of this section
QTY OF LA QUINCA MUNICIPAL CODE4 9.60.1lo, 9.160, and 9110.060
HOINIE OCCUPATION CONDITIONS
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 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. pool, chlorine, paint
thinner, etc.), unless the hazardous materials are stored in a manner approved 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 equipnent. appliance, or motor outside of the enclosed building or which
uilding in which it is located that is related to the business.
generated noise detectable from outside the b
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 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, UNDERSTAND AND AGREE TO COMPLY
WITH ALL OF THESE CONDITIONS:
P E til " --I r'1 CS 4£RSQ "
Z7
NAME
SIGNATUR
ol-o&—IC..Q
DATE
Office Copy — White Customer Copy — Yellow