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Community Development
Department
78-495 CALLE TAMPICO (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
HOME OCCUPATION PERMIT
Permit Number: 14-00000101
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 namee(s):+ (List all owners, partners, and/or corporation officers) PAM DORSEY r_ f
v I L�a �QC WL a- i a t [t` I"Lz
Property address: 52425 EISENHOWER DR Phone: (760) 702-0832
Mailing address: 52425 EISENHOWER DR.
Property owner: REDEVELOPMENT AGENCY CITY OF L
Type of business: CAREGIVER
Brief description of how the business will operate:
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Square footage of usable floor area in house (exclude garage) 1394 SQ. FT.
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Location and square footage of area of business activity in home (Example: Bedroom — 125 sq ft.) DINING
ROOM, 75 SQ. FT.
Description of machinery, equipment, and supplies being used in the business operation:
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I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPXTION IS ALLOWED. (Conditions Attached)
APP
2. 1 ,r
DATE
If applicant is othef1l"ari the property owner, authorization of owner or rental/leasing agent is required.
our in �7'�Y6m twcen 7�-'10fI- . .M: O UT -i
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will be Wayne Campbell. 1
------"----------------------------..-I SPECTOR E ONLY----------------------------------------------------
®'APPROVED
❑ DENIED Inspect r Signature Date
CL I-IP
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Y
P.O. Box 1504
78-495 CALLS TAMPICO (760) 77 7 -7 000
LA QUINTA, CALIFORNIA' 92253 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 corporation officers P71'.1 1 SQ CI
i pf, Qv -
.PROPERTY ADDRESS: �, . - - e -7 P1IONE:
MAII.ING ADDRESS: _(fF DUTEREW FROM ABOVE)
PROPERTY OWNER: I l u i 1 T 1f14 1 i -ter u r�rt r
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.):.
TYPE OF BUSINESS:
BRIEF DESCRIIMON OF HOW TIE BUSINESS WILL OPERATE- 4d12,
- C_cam. & it
NUMBER OF PERSONS INVOLVED IN BUSINESS:.
SQUARE FOOTAGE OF USABLE KOOR AREA 1N HOUSE (EXCLUDE GARAGE): ! ��
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVI.17 TN HOME (F..3I~ BEDROOM -
125 SQ FT.): "a ,r 2- o c-/o 1 c y
DESCRIPTION ON MACHINERY, EQUIPMENT, AND SUPPLrflS BEING USED IN THE BUS HT, SS
OPERATION: .- -- +
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDMONS BY WHICH A
HO1jG0, OC A�'ION L5 ALLOWED. (CONDITIONS ATTACHED).
Ai'1'LICA "SIGNATURE A
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.
7
WtrTCF1A S TM DATE
F�l 6f tA 0) ) Fk
COMPANY N CONTACT PH. #f DATE
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PdPORTANT�LSE OR MI &ADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH THE CONDMONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT.
BUILDING AND SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION:
APPROVED DENIED SPECIAL CONDITIONS
OmCER I.D. # DATE
1 '
PLEASE READ.
Please contact your IIj eowner's Association prior to paying or your Home
Occupation Permit. Youi Iomeowner's Association may r trict or prohibit
home based businesses.
I HAVE RE ND UNDERSTAND THIS
STATE
Signature
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 co=lete and sign a
declaration that states the following_
W op, Eu, c (O MPENS A TION DECLARATION
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:
Policy Number: Expires:
A COPY OF SAID POLICY OR CERTIFICATE OF CONSENT SHOWING THE AMOUNT OF
COVERAGE AND EXPIRATION DATE FOR WORKER'S COMPENSATION IS REQUIRED TO
PROCESS THIS APPLICATION.
I certify that in the performance of any business activities for which € his 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 1 should become subject to
the worker's compensation provisions of Section 3700, I ,%vill provide the City with a
policy or certificate copy within ten (10) days of the change in requirements.
APPL S GNA_
WARNING: Faila to secure Worker's Compensation coverage is unlawful, and shall subject an employer
to criminal penalfies-and civil fines up to $100,000. In addition to the cost of compensation, damages,
interest, and at[orncy's fees may be assessed to you as provided in Section 3706 of the Labor Code.
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 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.
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:
P171 NAME
SIGNATURE
r-
DATE
Office Copy — White Customer Copy — Yellow