Madison Commercial Real Estate, Inc71 DD zk 0
JUN 1 1 2020
CITYOFLAQUINTA 0
HOME OCCUPATION OF A BUSINESg51 3NDEVELOPMENT DEPARTMENT
PERMIT# H02020-0031INSPECTION DATE
_ TIM
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 regul42tions,
NEW APPLICATION $105.00 LOCATION CHANGE $55.00
App i ant fVame :I
A d r��,f
Phone: Email:
A I - - /7
jo ,;P /
'T o- 15- /Z
T of reside ce: Square Footage:
P� 74,
Type of B iness•
Bt•ief D�scriptian of the Bus nes oeratii
Location an Squarennta of Business in Home: (Ex. Bedroom
�� Np 00 D A _ ka
Number of Perso Involved in Business:
Description of achinery, E uipment, and Supplies Being Used:
wr,
I HAVE READ, UNDERSTAND, AND AGREE WITH THE ATTACHED CONDITIONS VlWICH A HOME
OCCUPATION PERMIT IS ALLOWED.
APPLICANT SIGNATURE DATE
WORKER'S COMPENSATION
If your company has employees, a copy of the Workman's Compensatior Policy must
accompany the Business License application, indicating dates of coverage and dollar
amount. This proof of coverage must be received before the Business Li ense can be
processed.
If you do not have employees, please check the last section on this pagel: "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 t
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 0mlAtte andiqn a decl!aralion
that statgs
f0mina-
I hereby affirm under penalty of perjury, one of the following declaration:
I have and will maintain a certificate of consent to self-insui
Compensation, as provided by Section 3700 for the dL
business activities conducted for which this license is issued
I have and will maintain Worker's Compensation Insurance,
by Section 3700 for the duration of any business activities ci
which this license is issued.
My Worker's Compensation Insurance carrier and policy
number are: Carrier:
Policy Number:
Expires:
A COPY OF SAID POLICY OR CERTIFICATE OF CONSENT SHOW
AMOUNT OF COVERAGE AND EXPIRATION DATE FOR WORKER
COMPENSATION IS REQUIRED TO PROCESS THIS APPLICATIO
for Worker's
ation of any
is required
nducted for
NG THE
iJ 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. I
APPLICANT SIGN101JRL
DATE
WARNING: Failure to secure Worker's Compensation coverage is unlawfu and shall
subject an employer to criminal penalties and civil fines up to $100,000. 1 n addition to
the cost of compensation, damages, interest, and attorney's fees may be aissessed to
you as provided in Section 3706 of the Labor Code.
IF APPLICANT IS OTHER THAN THE PROPERTY OWNER, A SIGNED AUTHORIZ
OWNER OR RENTAL/LEASING AGENT IS REQUIRED.
OWNER/AGENT SIGNATURE
AGENT COMPANY NAME
DATE
CONTACT PHONE
aTION FROM
PLEASE CONTACT YOUR HOMEOWNER'S ASSOCIATION PRIOR TO PAYING FOR YOUR HOME
OCCUPATION PERMIT. YOUR HOA MAY RESTRICT OR PROHIBIT A HOME-BAS D 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
APPROVED
I HAVE READ AND UNDERSTAND THIS
STATEMENT.
r Ali-
�IGNATU-RE
f`
CODE COMPLIANCE USE ONLY
DENIED
OFFICER DATE
SPECIAL CONDi,rIONS
N
ALL HOME OCCUPATIONS SHALL COMPLY WITH HE
FOLLOWING CONDITIONS:
1. The establishment and conduct of a home occupation shall be an i
cidental
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 livi
g 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 acces
ory
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 chz
racteristics.
6. Electrical or mechanical equipment which creates interference in ra
io,
television or telephone receivers or causes fluctuations in line voltage
nutside
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 form
it order
sales. The dwelling unit shall not be the point of customer pickup or d
livery 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. Ex
eption:
Musical instruction and academic tutoring where not more than two sk
dents 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 de
ermines
that any of the performance and development standards listed in subsection
C of
this section have been or are being violated, that the occupation auth
rized 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
hen the
permit was issued.
Conditions Per La Quinta Municipal Codes: 9.60.110, 9.160, 99.210.060