Garciar � _
m= P_O. Box 1504
c 78-495 CALLS TAMPIco (760) 777-7000
FAX 760 777-7101
LA Q,UINTA, CALIFORNIA 92253 ( )
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
FE70.0� INSPECTION DATE: P
L) L) 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 officers
PROPERTY ADDRESS: S7$-0 An NV,0400 PHONE:
MAIL NG ADDRESS: �l 1 S��I�} zi D (IF DIFFERENT FROM ABOVE)
- PROPERTY OWNER-
TYPE
WNER TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.):
TYPE OF BUSK MSS: 1A'h10g('-7AV1rA4
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE:
NUMBER OF PERSONS INVOLVED IN BUSINESS:
SQUARE FOOTAGE OF USABLE R AREA IN HOUSE (EXCLUDE GARAGE): 17100
IN HOME X_ BEDROOM -
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY (E
125 SQ FT.): - *7aF� _
DESCRIPTION OF MAC IUNERY, EWTMENT, AND SUPPLIES BEING USED IN THE BUS_ INESS
OPERATION:
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
I3[O A AL VE D. (CONDITIONS ATTACHED).
APPLICANT'S SIGNATURE DATE
IF APPLICANT IS OTHER THAN THE PROPERTYOWNER, AUTHORIZATION OF OWNER OR
REN7AL/LEASING AGENT IS REQUIRED-
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
STA`I'ENIENT.
Signature
ovaGN 4DqER/
Q AGENT COMPANY NAME CO ACT PH. # DATE
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR ROME 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_ SPECIAL CONDITIONS
I_D_ W DATE
A - `
WORKER'S COMTENSATION
If your company has employees, a copy of the Workman's Compensation PO] icy 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 op,'�rat: r from your home in La Quinta, a Home Occupation Permit's required before a
business Iicense is issued.
if you have any questions, -please contact the Code Compliance Division at 777-7050.
t to Section
Every employer who applies for any license or renewal of any license for a business issued pt Tss ud s� a
37101 of the government Code or Suction 7284 of the Revenue and Taxation code shall comp �--
deriaration that states the foll
woR R'S D %NS AT N J EC�ARA oN
I hereby affirm under penalty of perjury, one of the following declarations:
I have and wi11 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
activities conducted for which this license is
3700 for -the duration of any business
issued.
My Worker's Compensation insurance carrier and policy number:
Carrier:
Policy Number- Expixes:�
AMOUNT OF
A COPY OF SAID POLICY OR CERTIFICATE OF CONSENT SHO IItRA):ATION DATE FOR WORKER' COMPENSAT
COVERAGE AND EXPON IE�
S REQED TO
PROCESS THIS PLICATION.
I certify'that in the performance of any business activities for which this EOMSe is
issued, I shall not employ any person in any mariner so as to become subject to the
worker's compensation Iatvs of California, and agree that if I should become subject to
the workees compensation provisions of Section 3700, I will provide the City with a
policy or certificate copy within ten (10) days of the change in requirements.
APPLICANT SIGNATURE DATE
WARNIN G: Failure to secure Worker's Compensation coverage is unlawful, and shall subject au employer
fo criminal penalties"and r-ivil f n.6 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_
HOII1E OCCUPATION GOND T ONS AND IERIA
ROMEOCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS AND REQUIREMENTS:
No one, other that the resident of the dwelling shall be employed oii the premises in the conduct of the Home
Occupation.
Within the enclosed area of the main building and shall not. occupy
The Home Occupation shall be conducted entirely
more than 25% of the total area of the struct re-
A Home Occupation shall riot 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
Off-street
parking or vehicles required by Chapter9.1t30 Dong
not interfere with the use of such space for the O
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
2n Office open to the general public_
There shall be no supply of hazardous materials stored on the premises at any given time (i.e_ pool, chlarine, paint
thinner, etc), unless the hazardous materials are stored in a manner approved by the State Fire Marshal or any other
regulating agency.
There shall be no dispatching of persons or equipment to or from the subject property, including the use ofrvehicles
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_
There shall be no use of any znechanicai egvipn=e appliance, or motor outside of the enclosed building or which
generated noise detectable from outside the bmlding in which it is located that is related to the business.
D. There shall be no signs or other devices identifying or advertising the home occupation.
I. In no way shall theappearance 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 se� a non residential use (either by color, lnatUials, consbmc ion,
jigliong, sounds, vibrations, etc).
Z. No Home Occupation shall create a nuisance by reason of noise, odor, dust, vibrations, fumes, smoke, electrical
interference, traffic, or other causes_
The use shall meet reasonable special conditions as established and made of record in the Horne 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 9210.060
HOME 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 equippent, appliance, or motoroutside 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.
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
W ITH ALL OF THESE CONDITIONS:
PItI1 ;'IE
SI NATUR DATE
Office Copy — White Customer Copy — Yellow