MortensonW �
CALIFORNIA
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MAR 10 2020
CITY OF LAQ1 VI(A
DESIGN & DEVE ��PMENT DEPARTMEN CnY OF LA QUINTA
HOME OCCUPATION OF A BUSINESg)ESM AND DEVE-OPMEjUDEPARTMENT
PERMIT# LD2o —cc Zi, INSPECTION DATE.
TIME '
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 $105.00 LOCATION CHANGE $55.00
Applicant Names:
Kurt Mortenson
Address:
51221 Via Sorrento
Phone: Email:
760-861-9664 oofda@aol.com
Type of residence: Square Footage:
Single Family
Type of Business:
Financial advice
Brief Description of the Business Operation:
Phone calls and emails with clients
Location and Square Footage of Business in Home: (Ex. Bedroom 120 SF)
Number of Persons Involved in Business:
1
Description of Machinery, Equipment, and Supplies Being Used:
Computer & cell phone
I HAVE READ, UNDERSTAND, AND AGREE WITH THE ATTACHED CONDITIONS BY WHICH A
HOME OCCUPATION PERMIT IS ALLOWED.
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DATE
78495 CALLE TAMPICO — LA QUINTA, CA 92253 — 760-777-7000
WWW.LAQLJ-I '-.' CA.€ OV
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 fallowing:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury, one of the following declarations:
1 have and will maintain a certificate of consent to self -insure for Workers Compensation, as
provided by Section 3700 for the duration of any business activities conducted for which this
license is issued.
I� I have and will maintain Workers Compensation Insurance; as required by Section 3700 for
the duration of any business activities conducted for which this license is issued.
My Workers Compensation insurance carrier and policy number are:
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 APPUCATiON.
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 workers compensation
laws of California, and agree that if I should become subject to the workers 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.
DATE
WARNING: Failure to secure Workers 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 attorneys fees
may be assessed to you as provided in Section 3706 of the Labor Code.
78495 CALIF TAMPICO — LA QUINTA, CA 92253 — 760-777-7000
W W W.LAQU11VTACA. V
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MAR 2020
CITY OF LAWIN IA
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MAR 16 2020
DESIGN & DEAR- o 'll.-.N 1 lir.rAn 1 MCITY OF LA QUWA
HOME OCCUPATION OF A BUSINESSESIM AND DCf,1 °Pr y' DEpAMff
PERMIT#-�(6 WO _00 Lj INSPECTION DATE TIMI -
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 $105.00 LOCATION CHANGE $55.00
Applicant Names:
Carol E York
Address:
78343 Scarlet Court,
La Quinta, CA 92253
Phone:
Email:
530.798.6066
carol-york@sbcglobal.net
Type of residence:
Square Footage:
condo
763
Type of Business:
Financial
Brief Description of the Business Operation:
Financial Advising and Planning
Location and Square Footage of Business in Home: (Ex. Bedroom 120 SF)
Dining Room at 100 sq feet
Number of Persons Involved in Business:
1
Description of Machinery, Equipment, and Supplies Being Used:
Cell phone
I HAVE READ, UNDERSTAND, AND AGREE WITH THE ATTACHED CONDITIONS BY WHICH A
HOME OCCUPATION PERMIT IS ALLOWED.
0
PISS
'P Ll rM73 f G ATURE' , DATE
78495 CALLE TAMPICO — LA QUINTA, CA 92253 - 760-777-7000
WWW.LAQUINTACA.GOV