Foulds & FeldmannPermit Details 4 {-__- Page 1 of 1
Enter Permit Number HO2014-1032L;.•'-?h-�
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e Permit Details PERMIT NUMBER
City of La Quinta H02014-1032
Description:
Type: HOME OCCUPATION
Subtype: STND
Status: SUBMITTED
Applied: 10/9/2014 ARDS
Approved:
Parcel No:604321003 Site Address: 79350 DESERT STREAM DR LA QUINTA,CA 92253
Subdivision: TR 23935-5
Block:
Lot:3
Issued:
Lot Sq Ft: 0
Building Sq 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
NAMETYPE
NAME
ADDRESSI
CITY
STATE
ZIP
I PHONE
FAX
EMAIL
OWNER
I MAUREEN FELDMAN
LA QUINTA
92253
1 (760(625-6488
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT# CHECK # METHOD PAID BY CLTD
BY
HOME OCCUPATION 101-0000-42447 O $70.00 $70.00 10/9/14 R1911 2119 CHECK MAUREEN FELDMAN ARDS
G7
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
10/15/2014
HOME OCCUPATION
MRO
10/15/2014
PARENT PROJECTS
REVIEWS
REVIEW TYPE
REVIEWER
SENT DATE
DUE DATE
RETURNED
DATE
STATUS
REMARKS
NOTES
BOND INFORMATION
L�
ATTACHMENTS
Printed: Thursday, October 09, 2014 1:49:48 PM 1 of 1 "y , ,,, , ,
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FEE $70.00
P.O. Box 1504
78-495 CALLS TAMFICo
LA QUINTA, CALIFORNIA 92253
(760) 777-7000
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 offiicexs
PROPERTY ADDRESS: 1�� S erkiN, �c.s - PHONE: —
MAILING ADDRESS�rr�� )b GPI i I I C ! v 0 L, -(II DIFFERENT FROM ABOVE)
PROPERTn fI f'. { _ _ i�� r'
TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.): 1 ,
TYPE OF BUSINESS:
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: _ .o1'vji-081
NUMBER OF PERSONS INVOLVED IN BUSINESS:
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE):
LOCATION AND SQUARE
125 SQ FT.): arc'_:: 4
AGE OF AREA OF IT SS ACTIVITY IN BIOME (EX. BEDROOM -
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION: CLsn is Lv s .:F�d,6,v ,
I HAtEREAD, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
OCC110 IS ALLOWED. (CONDITIONS ATTACHED).
{,T;t-fcAjt SIGNATURE DATE
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.'
r
O RI ENT SIGNATURE
AGENT COMPANY NAME
/) ) S 141
DATE
CONTACT PH. # 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 S DEPARTMENT/CODE COMPLIANCE DIVISION:
APPROVED DENIED SPECIAL CONDM ONS
OFFICEIWl I.D. # `�=-F DATE /I 5--h q
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
STATEMENT.
r
Si iature
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,'piease 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 complete and sigiaa
declaration that states the following:,
,WORKER'S COMPENSATION 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:
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 IS REQUIRED TO
`PROCESS THIS LIGATION. '
I certify that in the performance of any business activities for which this noose, is
issued,l shall not employ arty person in any manr so as to become subtext to the ne
worker's compensation laws of California, and agree that if I should become subject to
the worker's 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.
7 '
LICA!N-1 SIGNATIJRE
i 0� nl DATt
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.