KarpowiczPermit Details
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Permit Details PERMIT NUMBER
.� City of La Quinta H02014-1027
�;.
Description:
Type: HOME OCCUPATION
Subtype: STND
Status: SUBMITTED
Applied: 9/18/2014 ARDS
Approved:
Parcel No: 774212019 Site Address: 54175 AVENIDA VALLEJO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 284
Lot: 8
Issued:
UNIT 26
Lot Sci Ft:0
Building Sci Ft:0
Zoning:
Finaled:
Valuation:$0.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings:0
No. Stories:0
No. Unites:0
Details:
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE NAME
ADDRESSI CITY
STATE ZIP
PHONE
FAX
EMAIL
OWNER DARLEEN KARPOWICZ
7 AVENIDA VISTA SANTA FE
GRANDE B7
NM 92253
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY
AMOUNT PAID PAIDDATE RECEIPT# CHECK# METHOD PAID BY CLTD
BY
HOME OCCUPATION 101-0000-42447 1 0 1 $70.00 1 $70.00 1 9/18/14 1 R1277 DEBIT DARLEEN KARPOWICZ ARDS
El Total Paid for HOME OCCUPATION: $70.00 $70.00
TOTALS: $70.00 $70.00
INSPECTIONS
SEQID
INSPECTION TYPE
INSPECTOR
SCHEDULED
DATE
COMPLETED
DATE
RESULT
REMARKS
NOTES
FINAL"
MRO
9/23/2014
HOME OCCUPATION
MRO
9/23/2014
PARENT PROJECTS
REVIEWS
REVIEW TYPE
REVIEWER
SENT DATE
DUE DATE RETURNED DATE STATUS
REMARKS
NOTES
BOND INFORMATION
ATTACHMENTS �y
Printed: Thursday, September 18, 201411:15:34 AM 1 of 1�1rfi
http://laquinta.crw.comltrakit9lDocumentViewer. aspx?&report=/Documents/PERMITS/Pe... 9/ 18/2014
FEE $70.00
lulls
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P.O. 'Box 1504
78-495 CALLS TAMPIco (760) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
APPLICATION FOR HOME OCCUPATION OF A BUSINESS
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 , W-Leeyo
PROPERTY ADDRESS
- (� " 1 f,�4-z�k�i-, PHONE: �0 i
MAILING ADDRESS: 3
(ll: D>FFL"I2.ENT FROM ABOVE)
PROPERTYOWNER: ��+ . �i-� �fl fr, 9�e't� f1.s, ■� f �_ .. d. 1
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.):
TYPE OF BUSINESS:
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE:'
NUMBER OFPERSONS INVOLVED IN BUSINESS:
SQUARE FOOTAGE OF USABLE .FLOOR AREA IN HOUSE (EXCLUDE GARAGE): % t� 00 .A 44 -
--
LOCATION AND SQUARE W, 'PAGE OF AREA OF BUSINESS 125 ACTIVITY IN HOME (EX. BEDROOM -
DESCRIPTION OF MA
CiflNERY, EQUIPMENT, AND SUPPLIES BEING USED IN TIP jBjJSINE
OPERATION:Md-
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I HAVE READ, U DERST. D, AND AGREE WITH THE CONDITIONS B�HiC
HOME OCCUPATION IS ALLOWED. (CONDITIONS ATTACHED).
APPLICANT'S SICIA"-
, DATE
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTALA.EASING AGENT IS REQUIRED.
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LOW,
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OWNER/AGENT SI NATURE
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AGENT COMPANY NAME CONTACT PH. #
DATE
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 SPECIAL Ca nIT1(JNS r F
OFFICER) DATE F.
Please contact your Homeow
Occupation Permit. Your H
home based businesses.
's Association prior to paying for your Home
Downer's Association may restrict or prohibit
I HAVE READ AND UNDERSTAND THIS
STATEM"T.
Signature
01K
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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 thelast 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
37I0I of the government Code or Section 7284 of the Revenue and Taxation code shall complete and signa
declaration (}lai states the fo11ow4ng-
1;�; 1► ► M1 1 ;1
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 AN XPIRATION DATE FOR WORKER'S COMPENSATION IS REQUIRED TO
PROCESS THI APPLICATION.
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.
APPLICANT SIGNATUI& 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.