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LamrosW P.O. Box 1504 78-495 CALLE TAMPICO (760) 777-7000 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. I ��1(� APPLICANT NAMES: (List all owners, partners, and/or corporation officers N `' c rn VJ PROPERTY ADDRESS D D I S�.VG' �Go �) EJI� PHONE: NE:. D Z " 23 MAILING MAILING ADDRESS: PROPERTY OWNER: TYPE OF RESIDENCE, (SINGLE, MULTIPLE, MOBILE HOME, ETC.): S i r) le - TYPE OF BUSINESS: L a, v, d S C a n C BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE: ' ' J CC- w, &,il e�l - el &t— NUMBER OF PERSONS INVOLVED IN BUSINESS: SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE): LOCATION AND U FOOTAGE OF AREA OF 1 125 SQ FT.): e� J' t'o M L L4 6 DESCRIPTION OF CHINERY, EQUIPMENT AND OPERATION: Eo Ut) P /Y) i] Ll.' ."" , I't aa00 IN HOME (EX. BEDROOM - IN I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME OCCUPATION IS ALLOWED. (CONDITIONS ATTACHED). 5wll�f APPLICA T'S SIGNATURE DATE IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, AUTHORIZATION OF OWNER OR RENTAL/LEASING AGENT IS REQUIRED-Jipk,'.��` I iCfrL�E C` CUP/j 1C)F4 141 C)V[-:D INITIAL C� ce OWNER/AGENT SIGNATURE DATE AGENT COMPANY NAME 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 SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION: APPROVED DENIED SPECIAL CONDITIONS OFFICER I.D. # DATE 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 complete and sign as 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 APPLICATION. �L 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, I will provide the City with a policy or certificate copy within ten (10) days of the change in requirements. tAvv"30-7 . PA4- v%- V APPLICANT AIGNATURE S--- t,:?, - / Ll 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. 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 STATEMENT. Signature LARRY W. WARD COUNTY OF RIVERSIDE P.O. Box 751, Riverside, CA 92502-0751 -- (951) 486-7000 ASSESSOR -COUNTY CLERK -RECORDER 38-686 El Cerrito Road, Palm Desert, CA 92211 -- (760) 863-8732 OFFICE OF THE COUNTY CLERK FICTITIOUS BUSINESS NAME STATEMENT ID I TY LE D SEE REVERSE SIDE FOR FEES AND INSTRUCTIONS RIVERSIDE COUNTY CLERK'S OFFICE S? CLERK'S USE ONLY LARRY W. WARD - USE BLACK INK ONLY - I-2014-02671 •'� # 405 `q BE TYPED OR PRINTED $�{ MUST you Receipt INITIAL CROSS OUTS NO WHITE OUT ALLOWED Co„ rents: v- zap 1@/2@12@14 Fee ; 58 @@ Page I of I T. Brimmer THE FOLLOWING PERSON(S) IS (ARE) DOING BUSINESS AS: Is. Firlitionii Business Name more than one business name at same address -Attach Supplemental Sheet) e((If v) J o_ e, I h, List COMPLE'i'F. Physical,Business Address (No P.O. Boxes oorrPoistal Facilities) � rLEjNama of County (where business is Imutd) �%J �� ' �tcx-itd, � � .1,(.R Q�It i� . �I. ■ �GL �'I �-� J i'� 1 V �.I'�J I � 2� Mailing Address (If different than business address— optional) T� 2a. Regstranl In ot3melian Individual orp., LLC, Gen. Partner, etc.) 2b. Registrant Information (Individual, Corp., LLC, Gen. Partner, etc.) If individual -spell out first, middle and last names (use dash if no middle name) If�vidu a� out first, middle and last names (use dash if no middle name) " 61 ile , n L_M b V-D 5 RVs-i-denCOAciaresKijcorp.orentorineppysicaiacares.,;aiinoC-o-rp—.7LTC) Residence Address (if Corp- or LLC enter the physical address of the Corp./LLC) -It)`$15W D -COC Ciry 1�1-� ,-state2.)Z3 i city State Zip List State of Corp./LLC. Must be registered in California List State of Corp./LLC. Must be registered in California 2c. Registrant Information (Individual, Corp., LLC, Gen. Partner, etc.) 2d. Registrant Information (Individual, Corp., LLC, Gen. Partner, etc.) If individual -spell out first, middle and last names (use dash if no middle name) If individual -spell out first, middle and last names (use dash if no middle name) Residence Address (if Corp- or LLC enter the physical address of the Corp./LLC) Residence Address (if Corp. or LLC enter the physical address of the Corp./LLC) City State Zip City State Zip List State of Corp./LLC Must be registered in California List State of Corp./LLC. Must be registered in California F 3. This business is conducted by: (If More Then four Registrants -Attach Additional Sheet Showing Owner Information) Individual ❑ Married Couple ❑ Trust ❑ Corporation ❑ General Partnership ❑ A Limited Partnership ❑ Co-partners ❑ Joint Venture ❑ Limited Liability Company ❑ Limited Liability Partnership ❑ An Unincorporated Association - other than a partnership ❑ State or Local Registered Domestic Partnership 4.`V Registrant has not yet begun to transact business under the fictitious name(s) listed above. ❑ Registrant commenced to transact business under the fictitious business name(s) listed above on I declare that all the information in this statement is true and correct. (A registrant who declares as true any material matter pursuant to Section 17913 of the Business and ProfessionsCode, that the registrant knows to be false, is guilty of n misdemeanor punishable by a fine not to exceed one thousand dollars (S1,000).) 5. Signature(s), .tJA l,.fiA-L.?S _ (Only one is regUlred) S Typed or Printed Name(s) ^ /Lv If Limited Liability Company/Corporation, Title QC'D BY: THIS STATEMENT WAS FILED WITH THE COUNTY CLERK OF RIVERSIDE COUNTY ON DATE INDICATED BY FILE STAMP ABOVE NOTICE -IN ACCORDANCE WITH SUBDIVISION (a) OF SECTION 17920, A FICTITIOUS BUSINESS I HEREBY CERTIFY THAT THIS COPY IS A CORRECT COPY NAME STATEMENT GENERALLY EXPIRES AT THE END OF FIVE YEARS FROM THE DATE ON OF THE ORIGINAL STATEMENT ON FILE IN MY OFFICE. WHICH IT WAS FILED IN THE OFFICE OF THE COUNTY CLERK, EXCEPT, AS PROVIDED IN SUBDIVISION (b) OF SECTION 17920, WHERE IT EXPIRES 40 DAYS AFTER ANY CHANGE IN THE LARRY W. WARD FACTS SET FORTH IN THIS STATEMENT PURSUANT TO SECTION 17913 OTHER THAN A CHANGE IN THE RESIDENCE ADDRESS OF A REGISTERED OWNER. A NEW FICTITIOUS RIVERSIDE COUNTY CLERK BUSINESS NAME STATEMENT MUST BE FILED BEFORE THE EXPIRATION. THE FILING OF THIS STATEMENT DOES NOT OF ITSELF AUTHORIZE THE USE IN THIS STATE OF A FICTITIOUS ' r BYi2^- -`" Deputy BUSINESS NAME IN VIOLATION OF THE RIGHTS OF ANOTHER FEDERAL, STATE OR COMMON LAW (SEE SECTION 14411 ET SEQ., BUSINESS AND PROFESSIONAL CODE). ACR 500 1RCW.321213331 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 W I ALL OF THESE CEi DITIONS: (�] byv-s SIGNATURE DATE Office Copy — White Customer Copy — Yellow Permit Inspections Page I of 1 Enter Permit Number H02014-1036 !i 4 1 or.l 1000% T Find I Next Wit Y �`. Permit Inspections City of La Quinta Permit Number: H02014-1036 Applied:10/20/2014 Approved: Issued: Finaled: Status: SUBMITTED Parent Permit: Parent Project: Details: HOME OCC INSPECTION 10/21/14 AT 11:00-11:30A.M Description: LANDSCAPE MAINTENANCE Site Address: 78815 W HARLAND DR City, State Zip Code: LA QUINTA, CA 92253 Applicant: DANNY LAMBROS Owner: CHARLES HOUSEHOLDER Contractor: <NONE> LIST OF INSPECTIONS SEQ SCHEDULED DATE COMPLETED DATE TYPE INSPECTOR RESULT REMARKS ID 10/21/2014 HOME ELIZABETH OCCUPATION ESCATEL Notes: Printed: Monday, 20 October, 2014 1 of 1 http://laquinta. crw.comltrakit9lDocumentViewer.aspx?&report=/Documents/PERMITSIP... 10/20/2014