Loading...
Morrista Qa�tr(v CM IRORNIA HOME OCCUPATION OF A BUSINESS PERMIT# 10 cL0 01O— OC is INSPECTION DATE;,,-49.0%,0 TIME_1: OD CqW! 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 re u ons. NEW APPLICATION $105.00 (" LOCATION CHANGE $55.00 Applicant Names: i } Yn � I�vQ c� . ���- u.► Address: j`� v V 5 ., r �} r 1 ►� etl I (O,LCA� 1)�i Y I L c,, i Phone: - K Email: WrnbG6Jd-eyS. SM Ljqmal[,� Type of residence: Square Footage Type of Business: G) -eAo 0'ro +V1 cfz-')Yl Brief Descrintion of the Business aeration: Location and Square Footage of Business in Home: (Ex. Bedroom 120 SF) f�w I k� Lp-• Number of Persons Involved in Business: 21 Description of Machinery, Equipment, and Supplies Being Used: A&M i n (rj 0� t o I HAVE READ, UNDERSTAND, AND AGREE WITH THE ATTACHED CONDITIONS BY WHICH A " HOME OCCUPATION PERMIT IS ALLOWED. WVW - - � r v-/a I nn d'ao PL SIG NATURE DATE 78495 CALLE TAMPICO — LA QUINTA, CA 92253 — 760-777-7000 ors 6rY� WWW.LAQUINTACA.GOV 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 760.777.7063. 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 a 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 are: Carrier: ,A Policy Number: Number: 611 "J 1 0 — l 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. Pwl-" 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. SIGNATURE(/ 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. 78495 CALLE TAMPICO — LA QUINTA, CA 92253 — 760-777-7000 W W W. LAQU I NTACA.G OV ----1 WILLMOR-06 CERTIFICATE OF LIABILITY INSURANCE DATE,MYY) 1/22/202Y2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER "`'c "' � v r w r IV HUB International Insurance Services Inc. 75030 Gerald Ford Drive, Suite 201 Palm Desert, CA 92211 INSURED William Moms Development, Inc. DBA: W. M. Builders 78605 Avenida La Jarita La Quinta, CA 92253 COVERAGES CERTIFICATE NUMBER: Diane Nielsen rt): (760) 360-4700 4742 INSURER B : INSURER F : State Comaensation Insurance Fund of California REVISION NUMBER: 200-9706 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOC INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AODL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR TO RENTED MED EXP tAny ones 22020 PERSONAL d ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JEC LOC OTHER: GENERAL AGGREGATE PROLWCTS - COMPIOP AGG $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AA�UUTµ�OSyyyy EE AUTOS ONLY AUTOONN COhdBIN eD SINGLE LIMIT & BODILY INJURY (Per rsan S BODILY tN.IURY Per accident '. W.nf?A A E S — UMBRELLA LIAR HOCCUR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED RETENTION $ A WORKERSCOMPENSATION AND BUM MY 1'R0!'31Ut:'r0glpMTNMFUE0KEG1J71YC Y / N %710EFUMJMBER EXCLUDED? ( aR ) DESCAiFFWN OF OPERATIONS N / A 9157107-19 4/16/2019 4/16/2020 X PTR DTH- ATUTE ER E.L. EACH ACCIDENT 1,000.000 E.L DISEASE - EMPLOYEE 1.000,000 E.L DISEASE - POLICY LIAiR PO 1 000.000 r DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD HOME OCCUPATION CONDITIONS ADDRESS 78605 Avenida Lo Jarita 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 SS G]NING THIS DOCUMENT I AGREE THAT I HAVE READ, UNDERSTAND AND WILL COMPLY WITH ALL•CONDITIONS. PRI ME AOFFICER SIGNATURE DATE Conditions Per La Quinta Municipal Codes: 9.60.110, 9.160, 9.210.060 CONSENT TO INSPECT PRIVATE PROPERTY Name:Telephone No: Property �-- Address: 6c�(�� a` PLEASE INDICATE IF YOU ARE: _ TENANT _PROPERTY OWNER _PROPERTY MANAGER The undersigned herein consents to the City of La Quinta, Code Compliance Division Inspector(s) right of entry to inspect all Yard Areas, building exterior(s), and/or interior(s), Including audio and video recording as needed to determine whether said property complies with local and state codes. The undersigned herein states that he/she is in lawful possession or control of the property designated or has th a �thority to act in the owner(s), tenant(s). and/or occupants(s) behalf a and in their Rsence l Signature: +f Amm, All" * Date: Z,'tq � 2v Nombre: Direccion: PERMISO PARA INSPECCIONAR PROPIEDAD PRIVADA Telefono: FAVOR DE INDICAR: INQUILINO PROPIETARIO Por este medio usted da permiso a (el) O a (los) inspector(es) de Division de Cumpliminetos del Codigo de la Ciudad de La Quinta para entrar a esta propiedad para inspeccionar todas las areas de la propiedad incluyendo los exteriores de todos los edificios, y/o interiores. Tambien incluyendo la grabacion de audio y video como se requiere para determinar si dicha propiedad esta en acuerdo con las leyes del codigo local y estatales. Por este medio de este documento usted declara que tiene posesion legal, o tiene la autoridad o consentimiento del propietario(s), y/o ocupante(s) en su ausencia. Firma: Fecha: