MichelPao�
APR 15 2022
.ca, Qaiaz,
CITY OF LAQUINTA
DESIGN & DEVELOPMENT DEPARTMENT
HOME OCCUPATION OF A BUSINESS
I'L.iti SIT ROW INSPECTION DATE qj-Z V 12ZTLME_
U& - 770125 4o\
;'! ase read each condition fisted on the attachment in this packet to see if the
Pi-QPUsk'd Dome business complies with the City's Home Occupation regulations.
NEW APPLICATION $109,00 LOCATION CHANGE $57.00
Applicant Names;
F
Address*
Phone:
I
rType of residence:
1j f
Email:
Square Footage:
Type of Business:
t
Brief Description of the Business Operation:
Pa C'_�I
Location and Square Footage of Business in Home: tEx. Bedroom 170SF)
Number of Persons Involved in Business:
Description of Machinery, Equipment, and Supplies Being Used:
I, HAVE READ, UNDERSTAND, AND AGREE WITH THE ATTACHED CONDITIONS WHICH A HOME*
OCCUPATION PERMIT IS ALLOWED,
APPLICANT SIGNATURE
JCj ! ZZ
DATE
Ii- APPLICANT IS OTHER THAN THE PROPERTY OWNER, A SIGNED AUTHORIZATION FROM
OWNER OR RENTAL/LEASING AGENT IS REQUIRED.
OWNER/AGENT SIGNATURE DATE
AGENT COMPANY NAME CONTACT PHONE
PLEASE CONTACT YOUR HOMEOWNER'S ASSOCIATION PRIOR TO PAYING FOR YOUR HOME
OCCUPA-,gON 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 THIS
STATEMENT,
SIGNATURE
CODE COMPLIANCE USE ONLY
APPROVED � DENIED,
v �•
OFFICER
SPECIAL CONDITIONS
qh:-ol Z-L-
DATE
WORKER'S COMPENSATION
;i voor <.omp;,ny l-"Js -zmployees, a copy of the Workman's Compensation Policy must
i: ; ny the C usii oss License application, indicating dates of coverage and dollar
Proof of coverage must be received before the Business License can be
ii you do not have employees, please check the last section on this page: "I certify that
it your business is being operated from your home in La Quinta, a Home Occupation
Nr,"tw, 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
iss�ied pursuant to Section 37101 of the government code or Section 7784 of the
Revenue and Taxation Code, shall e to nd n a declaration that states the
f9ilowing:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury, one of the following declarations:
0 I havee 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.
Policy Number: I 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
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
t�,.11(10j days of the change in requirements,
r
APPLICANT 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. IR 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.
HOME OCCUPATION CONDITIONS
c-J C.
ALL HOME OCCUPATIONS SHALL COMPLY WITH THE FOLLOWING CONDITIONS:
1.. Ii, establishment and conduct of a home occupation shall bean incidental and accessory use and
:,hall :),at change the principal character or use of the dwelling unit involved.
Only residents of the dwelling unit may be engaged in the home occupation.
3. A hcrne 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
occupadon shall not occupy more than twenty-five percent of the combined floor area of the house and
gGroge.
4, A home occupation shall not be conducted within a detached accessory structure, although materials
may be stored in such a structure.
5, Thera 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 sates. 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 some 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 Conditi
BY SIGNING THIS DOCUMENT AGREE THAT) HAVE READ, UNDERSTAND AND WILL PLY WITH ALL CONDITIONS.
�4'� ''ti�tiLylt i -
PRINT N6ME,A OFFICER SIGNAT RE
"'f r
SIGNATURE BATE
Conditions Per La Quinto Municipal Codes: 5.6o.11o, 9.160, 5,210.060