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2020 Application BL4/8/2021 La Quinta > Administration > Business Form > Edit Business Center A=n Admin Details Audit Log (1) Dashboard L218382] Casa De Las PlumasY 7Businesses �e oFS II�TNTCityLimits(RENEWAL) 515 Avenida Montezuma Business La Quinta, CA Workflows 9092892965 Tasks Due: 07/01/2020 Date Submitted: 11/23/2020 Forms Fees NEW BUSINESS LICENSE APPLICATION Documents Approvals 1 0 Licenses Transactions Batch Processing Reconciliations Admin Tools Notifications Media Library Groups Users Reports Accrual Based Reports My Reports Menu Business Audits Audits Events Audit Log Log Out Advanced Menus open Site Configuration Support Business Name * ,Casa De Las Plumas TYPE OF OWNERSHIP: Sole Proprietorship Partnership Corporation LLC Trust LLP Non -Profit DESCRIPTION OF BUSINESS: short term rental PHONE * 909 289 2965 EMAIL ADDRESS * ceciledahlquist@icloud.com Physical Address (i.e. Location of Short Term Vacation Rental, if applicable) ADDRESS: * UNIT 51-715 Avenida Montezun Mailing Address Street * PO Box 1294 Country United States State/Province OWNER/OFFICER INFORMATION NAME * Cecile Dahlquist Driver's License Number N8923843 PLEASE ANSWER QUESTIONS BELOW Unit CITY * La Quinta Postal * 92352 TITLE * Owner Expiration Date 10/10/2021 1. Food Vendor? A COPY of a current Riverside County HEALTH PERMIT is required Yes No 2. Corporation or Partnership? Yes No STATE * POSTAL* California v 92253 City * Lake Arrowhead If Yes, A FEDERAL TAX ID NUMBER is required. 3. Retail business or selling product within the City? A COPY of a California Sellers Permit is required. Yes No 4. NON-PROFIT Business- 501(c)(3)? You are exempt from paying fees - a COPY of 501(c)(3) status is required. * https://Iaquinta.munirevs.com/admin/business-form/edit/?businesstaskid=100980&uniqueid=071 c24116a49516adebO4a583e103edf 1/2 4/8/2021 La Quinta > Administration > Business Form > Edit Yes No 5. Is your business name the same as your legal name? A copy of your Fictitious Business License is required. Yes No 6. Selling or serving alcohol? A copy of your ABC License is required. * Yes No 7. Massage Therapist? A copy of State License or Reciprocal License is required. Yes No 8. Do you have Employees? * If Yes, Worker's Compensation Worker's Compensation Policy If No, are you a beauty/barber Yes No Policy No. Expiration Date shop, nail salon, massage Date establishment or other business with independent contractors? Yes No 9. Is your business located in a RESIDENTIAL area within La Quinta City limits? * Yes No SIC Code: This can be looked up at https://www.osha.gov/pis/imis/sicsearch.htmi if you do not know the SIC code. Please indicate SIC Code: * OTHER - Enter your SIC Code 7021 Rooming and Boarding Houses 6531 Real Estate Agents and Managers 6514 Operators of Dwellings Other Than Apartment Buildings If you selected OTHER, please type your SIC code here. PLEASE NOTE: THE OWNER / OFFICER APPLYING FOR THE BUSINESS LICENSE MUST PROVIDE A COPY OF A VALID GOVERNMENT ISSUED ID OR DRIVER'S LICENSE WITH THE APPLICATION. By signing this application, Owner certifies under penalty of perjury under the laws of the State of California that it has reviewed the relevant Federal, State, County and local laws, and that Owner has provided all information to the City in this application as required by those authorities. Owner further certifies that all information supplied by Owner on the application is true and correct and any license required by the County, State or Federal Government have been issued to Owner and are in full force and effect. Owner further certifies that it has conducted the requisite analysis required under Government Code section 16000.3(a) and (b), and that it has provided all necessary information as required by that statute. Owner further understands and agrees that it is Owner's responsibility to check with BOTH the Building Department and Planning Department to determine if any permits are required for this type of business and its location. By signing this application, Owner agrees to indemnify, hold harmless and defend the City and any and all of its officers, employees, agents, and volunteers from any and all claims, obligations, suits, judgments, penalties, causes of action, losses, liabilities, or costs that may arise out of the issuance of the business license, including, but not limited to, claims that may arise under Government Code section 16000.3(b), and brought pursuant to Code of Civil Procedure sections 1085 and/or 1094.5. Name (as electronic signature) * Title (Owner, Manager, Etc) * Date Cecile Dahlquist Owner 08/18/2020 https://Iaquinta.munirevs.com/admin/business-form/edit/?businesstaskid=100980&uniqueid=071 c2411 6a4951 6ad eb04a583e 1 03edf 2/2