ORourkea
CALIFORNIA
HOME OCCUPATION OF A BUSINESS
PERMIT# ^ Gp 81, INSPECTION DATE 2G TIME , 70' "
Please read each condition listed on the attachment in this packet to see if the proposed home business complies
with the City's'Home Occupation regulations.
NEW APPLICATION $75.00
Applicant Names: ^ ,_ '�fig-a m y
(76
Property Address:
Mailing Address:
Property Owners Name:
Phone�n r_ 6l
Type of residence:
Type of Business:
kol�
Brief Description of the BusipessiO
Location and
LOCATION CHANGE $40.00
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Email: an6 re,& `
m
Square Footage:
-a
ss in Home: (E Bedroom t20 SF)
Y\Ac _� "mil "'
Number of Perso4Hllvolved ' usi ss:
I
Description of Machinery, Equipment, and Supplies Being UseA:
41 le
HAVE READ, UNDERSTAND, AND AGREE WITH THE ATTACHED CONDITIONS BY WHICH A HOME
OCCUPATION PERMIT IS ALLOWED.
APPLICANT'S SIG DATE
78495 CALLE TAMPICO — LA QUINTA, CA 92253 — 760-777-7000
WWW.LAQUINTACA.GOV
IF APPLICANT IS 0 T H E R ITH THE PROPERTY OWNER, A SIGNED AUTHORIZATION FROM OWNER OR
RENTAUI.EASfNG AGENT IS REQUIRED.
PROPERTY OWNER/AGENT SIGNATUREC�o I CRE�-
PROPERTY OWNER/AGENT PRINT NAME
9^7-(0
DATE
�o - yo9-s-8oC?
CONTACT PHONE
PLEASE CONTACT YOUR HOMEOWNER'S ASSOCIATION PRIOR TO PAYING FOR YOUR HOME OCCUPATION
PERMIT. YOUR HOA MAY RESTRICT OR PROHIBIT A HOME -BASED BUSINESS.
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING YOUR
APPLICATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE ATTACHED PAGE SHALL BE
GROUNDS FOR REVOCATION OF THIS PERMIT
I HAVE READ AND UNDERSTAND THI3'STATEMENT.
-SIGNATURE
CODE COMPLIANCE USE ONLY
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APPROVED DENIED SPECIAL CONDITIONS
OFFICER DATE
78495 CALLE TAMPICO - LA QUINTA, CA 92253 - 760-777-7000
WWW.LA UINTACA.COV
ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS:
I. The establishment and conduct of a home occupation shall bean incidental and accessory use and shall not change the
principal character or use of the dwelling unit involved.
2. Only residents of the dwelling unit may be engaged in the home occupation.
I A home occupation shall be conducted only within the enclosed living area of the principal dwelling unit or within the
garage provided no garage space required for off-street parking is used. The home occupation shall not occupy more than
twenty-five percent of the combined floor area of the house and garage.
4. A home occupation shall not be conducted within a detached accessory structure, although materials may be stored in
such a structure.
5. There shall be no signs, outdoor storage, parked vehicles or other exterior evidence of the conduct of the home
occupation. Neither the dwelling nor the lot shall be altered in appearance so that it appears other than a residence, either
by color, materials, construction, lighting, sounds, vibrations or other characteristics.
6. Electrical or mechanical equipment which creates interference in radio, television or telephone receivers or causes
fluctuations in line voltage outside the dwelling unit shall be prohibited.
7. The home occupation shall not create dust, noise or odors more than that normally associated with residential use.
8. No sates activity shall be conducted from the dwelling except for mail order sales. The dwelling unit shall not be the
point of customer pickup or delivery of products or services, nor shall a home occupation create greater vehicular or
pedestrian traffic than normal for the district in which it is located. Exception: Musical instruction and academic tutoring
where not more than two students are present at the residence at the same time shall be permitted.
9. Medical, dental or similar occupations in which patients are seen in the home are prohibited.
10. All conditions attached to the Home Occupation permit shall be fully complied with always.
Revocation or suspension of a permit. The director of Code Compliance may revoke or suspend any permit for a Home
Occupation if the director determines that any of the performance and development standards listed in subsection C of this
section have been or are being violated, that the occupation authorized by the permit is or has been conducted in violation
of any state statute or city Iaw, or that the Dome occupation has changed or is different from that authorized when the
permit was issued.
Conditions Per La Quinta Municipal Codes: 9.60.110, 9.160, 9.210.60
78495 CALLE TAMPICO — LA QUINTA, CA 92253 — 760-777-7000
WWW.LA UINTACA.GOV
WORKER'S COMPENSATION
If your company has employees, a copy of the Workman's Compensation Insurance Policy must accompany the Business License
application, indicating dates of coverage and dollar amount. The 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 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 Code Compliance Division at (760) 777-7063.
Every employer who applies for any license or a 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 a declaration that states the following:
WORKMAN'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
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 this lice3nse 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
ce tc copy within ten s of the change in requirements.
APPLIC T SI AT[T 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 accessed to you as provided in Section 3706 of the Labor Code.
78495 CALLE TAMPICO — LA QUINTA, CA 92253 — 760-777-7000
WWW.LAQUINTACA.GOV
Aw
PETER ALDANA
COUNTY OF RIVERSIDE Mail fo., P.O. Box 751, Riverside, CA 92502-0751 -- (951) 486-7000
ASSESSOR -COUNTY CLERK -RECORDER
OFFICE OF THE COUNTY CLERK
FICTITIOUS BUSINESS NAME STATEMENT COUNTY CLERK'S FILING STAMP
SEE REVERSE SIDE FOR FEES AND INSTRUCTIONS F I L E D
CLERK'S USE ONLY County of Riverside
USE BLACK INK ONLY - Peter Aldana
MUST BE TYPED OR PRINTED S # _1-8301523 Assessor -County Clerk -Recorder
INITIAL CROSS OUTS er Itrerir R-201814000
NO WHITE OUT ALLOWED Cananeat,: 10/05/2018 02:37 PM Fee: $58.00
THE FOLLOWING PERSONS} IS (ARE) DOING BUSINESS AS: Page 1 of 1
la. Fictitious Business Name (if more than one business name at some address - Attach Supplemental Sheet)
ANDREA M O'ROURKE
lb. List COMPLET113 Physical Business Address (No P.O. Boxes or Postal PkelUtles) le. Name of County (where businessitllMiled)
5310155 AVENIDA MENDOZA , LA QUINTA CA 92253 RIVERSIDE
Mailing Address (If different than husine::s address — optional)
2a. Registrant Information (Individual, Corp., LLC, Gen. Partner, etc.) 2b. Registrant Information (individual, Corp., LLC, Gen. Partner, etc.)
ANDREA MAY O'ROURKE
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)
53885 AVENIDA MENDOZA
cst nc ress 1 .arp, tit r at er a plryslc�ir asdress n t e. alit. I C) Residence Address (if Corp. or LLC enter the physical address of the Corp./LLC)
LA,QUINTA CA 92253
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 Califomia
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 ifrm 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 ofCorp./LLC. Must be registered in California List State of Corp./LLC. Must be registered in California
3. This business is conducted by: (If More Than 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 Associallon - other than a artnershi ❑ Sl�la or Local R island Domestic Parinershi
4. KI 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 registrunt who declares nS true any malrrial matterpursuatil to Section 17913 oflhe
Businem and Prafessians Code, that the registrant knows In he f>,ixe, is guilty of a tnisrlumeunnr punkhahle by a nine not to exceed one thousand dollars (.S7,000).)
5. Signalure(s)l
(Only one Is required)
Typed or Printed Name(s) ANDREA MAY O'ROURKE
If Limited Liability Company/Corporation, Title OC'D BY:
THIS STATEMENT WAS FILED WITH THE COUNTY CLERK OF RIVERSIDE COUNTY ON DATE INDICATED BY FILE STAMP ABOVE
NOTICE -IN ACCORDANCE WITH SUBONISION (a) OF SECTION 17920, A FICTITIOUS 8USINESS 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 (bi OF SECTION 1792O, WHERE IT EXPIRES 40 DAYS AFTER ANY CHANGE IN THE PETER ALDANA
FACTS SET FORTH IN THIS STATEMENT PURSUANT TO SECTION 17913 OTHER THAN A
CHANCE 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
BUSINESS NAME IN VIOLATION OF THE RIGHTS OF ANOTHER FEDERAL, STATE OR COMMON BY—
LAW� - Deputy
(SEE SECTION 14411 ET SEQ., BUSINESS AND PROFESSIONAL CODE),
Arft 500 (Re .'1112017) Avallablc-I. Afterna to Formats
HOME OCCUPATION CONDITIONS
ADDRESS 53885 Avenida Mendoza. H.0.2018-0082
ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS:
1. The establishment and conduct of a home occupation shall be an incidental and accessory use and
shall not change the principal character or use of the dwelling unit involved.
2. Only residents of the dwelling unit may be engaged in the home occupation.
3. A home occupation shall be conducted only within the enclosed living area of the principal dwelling
unit or within the garage provided no garage space required for off-street parking is used. The home
occupation shall not occupy more than twenty-five percent of the combined floor area of the house and
garage.
4. A home occupation shall not be conducted within a detached accessory structure, although materials
may be stored in such a structure.
5. There shall be no signs, outdoor storage, parked vehicles or other exterior evidence of the conduct of
the home occupation. Neither the dwelling nor the lot shall be altered in appearance so that it appears
other than a residence, either by color, materials, construction, lighting, sounds, vibrations or other
characteristics.
6. Electrical or mechanical equipment which creates interference in radio, television or telephone
receivers or causes fluctuations in line voltage outside the dwelling unit shall be prohibited.
7. The home occupation shall not create dust, noise or odors in excess of that normally associated with
residential use.
8. No sales activity shall be conducted from the dwelling except for mail order sales. The dwelling unit
shall not be the point of customer pickup or delivery of products or services, nor shall a home occupation
create greater vehicular or pedestrian traffic than normal for the district in which it is located. Exception:
Musical instruction and academic tutoring where not more than two students are present at the
residence at the same time shall be permitted.
9. Medical, dental or similar occupations in which patients are seen in the home are prohibited.
10. All conditions attached to the home occupation permit shall be fully complied with at all times.
Revocation or Suspension of Permit. The director of building and safety may revoke or suspend any permit for a
home occupation if the director determines that any of the performance and development standards listed in
subsection C of this section have been or are being violated, that the occupation authorized by the permit is or has
been conducted in violation of any state statute or city law, or that the home occupation has changed or is different
from that authorized when the permit was issued.
Special Conditions:
BY SIGNING THIS DOCUMENT I AGREE THAT I HAVE READ, UNDERSTAND AND WILL COMPLY WITH ALL CONDITIONS.
61
OFFICER SIGNATURE
/y-9-1b
DATE
Conditions Per La Quinta Municipal Codes: 9.60.110, 9.160, 9.210.060