MUP 2015-0001City of La Quinta
78-495 Calle Tampico
La Quinta, California 92253
PHONE. -760.777.7125 FAX: 760.777.1233
Office Use Only
_
Case Number Accepted Assigned 3G-i�ay
By To Deadline
C- Doo 11
hn C
1
15 zc� i S
Notes:
MINOR USE PERMIT
APPLICATION
RECEIVED
MAR 13 2015
CITY OF LA QUINTA
COMML11lNF fflVVMPMENT
MIR .11 201 -
CITY OF LA OUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
Finance Stamp
Sections A, B and C are to be completed by the applicant in their entirety and shall be
accompanied by all listed plans, studies, reports and exhibits listed in Section D unless
specifically waived by the appropriate City staff member and noted thereon.
SECTION A — PROJECT INFORMATION
Project Name: `4 l l JV\ nn VV \1J L a\C P l Y P o� x,_N
Project
Description: C Ck\4( Q
APN #(s): r� a C t
Site Address/
Location:
General Plan: Zoning:
Specific Plan: Proposed Use:
Proposed Phases: Related Cases:
Minor Use Permit Application Page 1 of s
City of La Quinta - Planning Department - 760.777.7125 05.20.13
PAApplication Submittal Forms\Applications\MUP\MUP Application - 05.20.13.doc
SECTION B - STATEMENT OF OPERATIONS
The purpose of this form is to provide a detailed statement outlining the day-to-day operation of the
proposed project. Any approval related to this application will be based on the information provided
and will therefore be subject to the continued operation of the proposed project consistent with the
information provided. Please be aware that any activities beyond those described here may result
in the need to amend your use permit in the future, thus it is encouraged that the information
provided be based on the ultimate operation level of the proposed use.
Description of proposed use:
Hours of operation -
Number of employees:
List any other local, state or federal licenses or permits required:
Types of equipment and processes used:
Describe any hazardous materials used, stored, or produced on-site. � N
Describe any other special characteristics specific to the proposed use:
Minor Use Permit Application Page 2 of 8
City of La Quinta • Planning Department ■ 760.777.7125 05.20.13
PAApplication Submittal Forms\Applications\MUP\MUP Application - 05.20.13.doc
J
•
SECTION C - APPLICANT/OWNER INFORMATION
Applicant: NI &I' -0A �,� "P do, - C)\, r '1 ( C) I - H e'er
(Name) (Phone)
(Mailing Address)
/�� (Email) C C^A
Owner(s): '5 RS
(Name) (Phone)
Architect:
(Mailing Address) (Email)
(Name) (Phone)
(Mailing Address)
(California State License #)
Applicant Certification
(Email)
I certify that I have read this application packet in its entirety and understand the City's
submittal and review process and the requirements for this application. I further certify
that each application item submitted as part of this application is consistent with the
minimum required contents for that item as described in Section D of this application. I
understand and agree that if during the processing of the application, it is determined the
information does not strictly meet such standards or contains errors or omissions,
clarification and/or supplemental information may be required and the preparation of such
information may be considered, in the Planning Director's judgment, an unreasonable
delay and will result in a suspension of processing time limits in accordance with the
California Code of Regulations, Title 14, Section 15109.
Applicant's Signatu
Print Name: \rN k
Owner Certification
Date -'3 "
I certify under the penalty of the laws of the State of California that I am the property owner
of the property that is the subject matter of this application and I am authorizing and
hereby do consent to the filing of this application and acknowledge that the final approval
by the City of La Quinta, if any, may result in restrictions, limitations and construction
obligations being imposed on this real property.
Owner/Authorized Agent Signature*:�-�, . Date-
Print Name(s): Mt C VJQ WQ— VN''�J2AM�
'An authorized agent for the owner must attach a notarized letter of authorization from the legal property
owner. Any off-site work identified on the plans must be accompanied by a statement of authorization with a
notarized signature of the subject property owner.
Minor Use Permit Application Page 3 of 8
City of La Quinta - Planning Department - 760.777.7125 05.20.13
P:1Application Submittal Forms\ApplicationsWUMMUP Application - 05.20.13.doc
Date Paid: Friday, March 13, 2015"
Paid By: MICHELLE MENDOZA
Cashier: MFA
Pay Method: DEBIT
Printed: Tuesday, March 17, 2015 5:36 PM 1 of 1' ^
_.. . , -CT.II C
April 30, 2015
0 0
Ms. Michelle Mendoza
FILE
copy
54125 Avenida Obregon
La Quinta, CA 92253
SUBJECT: MINOR USE PERMIT 2015-0001 - YUMMY CAKE CREATIONS
COTTAGE FOOD OPERATION AT 54125 AVENIDA OBREGON
Dear Ms. Mendoza:
The Community Development Department has reviewed your request for a
Cottage Food Operation (CFO) in a residence at 54125 Avenida Obregon. This
letter is to notify you that your request has been approved and is subject to the
following Conditions of Approval:
1 . The cottage food operation shall be registered or permitted as a "Class A"
or "Class B" operation by the Riverside County Department of
Environmental Health, in accordance with Riverside County Ordinance
916 and Section 114365 of the California Health and Safety Code.
Evidence of said registration or permit issuance by the County shall be
provided to the Community Development Department prior to issuance of
a City of La Quinta business license. All cottage food operations require a
City of La Quinta business license to be procured subsequent to, and in
compliance with, approval of the minor use permit application and
associated conditions of approval.
2. The cottage food operation shall be clearly incidental to the use of the
structure as a dwelling unit, and shall not create dust, noise or odors in
excess of that normally associated with residential use.
3. The cottage food operation shall not generate pedestrian or vehicular
traffic in excess of that normally associated with residential use.
4. No direct sales or service from the residence or property on which the
residence is located is permitted. The cottage food operation shall not be
the point of customer pickup or delivery of products or services, nor shall
a cottage food operation create greater vehicular or pedestrian traffic than
normal for the residential zoning district in which it is located.
5. The cottage food operation shall be conducted solely within the primary
residence.
6. Sign(s) identifying the cottage food operation are not permitted to be
posted or displayed on the premises, nor on or within anything located on
the premises, except as may be required by any federal, state, and/or
local permitting agency. Neither the dwelling nor the property shall be
78-495 Calle Tampico I La Quinta I California 92253 1 760.777.7000 1 www.La-Quinta.org
altered to appear other than a residence, either by color, materials,
construction, lighting, sounds, vibrations or other characteristics.
7. No more than one (1) cottage food employee, as defined by California
Health and Safety Code Section 113758(b)(1), shall be employed by the
cottage food operation, not including any residing family or household
member.
This minor use permit may be revoked for any violation of LQMC Section
9.60.115 or of Section 114365 et seq. of the California Health and Safety
Code. The city may, for inspection purposes, access the permitted area of a
private home where a cottage food operation is located if the city has, on the
basis of any complaint(s), reason to suspect that the cottage food operation has
violated the provisions of this Section and/or California Health and Safety Code
Section 114365 et seq: Furthermore, the City may also conduct routine periodic
inspections to ensure compliance with the provisions and conditions of the
cottage food operation's minor use permit and City business license.
This approval is final, but may be appealed by any interested party to the
Planning Commission, provided the required application forms and fee of
$1,595.00 are filed with this office within fifteen (15) days of the date of this
letter.
Should you have any questions, please call me at (760) 777-7125.
Sincerely,
Wallace Nesbit
Principal Planner
c: Riverside County Fire Department
Code Compliance Division
78-495 Calle Tampico I La Quinta I California 92253 1 760.777.7000 1 www.La-Quinta.or�
L4
tit N1.I11
DISTRICT ENVIRONMENTAL SERVICES DIVISION
Date: April 01, 2015
Name: Michelle M Mendoza
Mailing Address: 54125 Avenida Obregon
La Quinta, CA 92253
Facility Name: YuMmMy Cake Creations
Site address: 54125 Avenida Obregon
La Quinta, CA 92253
RECEIPT FOR PAYMENT
of
Annual Registration
RE: CoitAgEfoQd Operation - Class A
PR#: PR0067002 Facility ID: FA0044190 Account ID: AR0091450
Type of foods approved
Food Type: Baked Goods, .
PAYMENT RECEIVED - THANK YOU:
Total Amount Received: $ 162.00
Registration Expiration Date: 03/31/2016
County of Riverside
Department of Environmental Health
P. O. Box 7909
Riverside, CA 92513-7909
Please feel free to call our office if you have any questions.
(888) 722-4234 or www.rivcoeh.org
RECEIVED
APR 2 3 2015
CITY OF LA QUINTA
PLANNING DEPARTMENT
You may reach us at
RI StYEI ID TY/INDIO FACILITY
DEPT OF ENVIRONMENTAL HEALTH
47950 ARABIA ST. STE# A
)3/ 17/2015 000001
1538 8:48AM SERV.0050005
COUNTY OF RIVERSIDE
EPARTMENT OF ENVIRONMENTAL HEALTH
CALIFORNIA HOMEMADE FOOD ACT AB 1616
COTTAGE FOOD OPERATION (CFO)
REGISTRATION /PERMITTING FORM
4600 $162.04 ----------- — ------ - — ----- -- -- - -
ID. CARD $162-00 :tions
000001 APPr (ode: 04M s: l CFO City
d: Online gon La Quinta
c '`°"`r Copy
Owner Phone:
THANK YOU! a 760-702-4607
j Mailing Aaaress lU aifferent):
Email Address:
chelles 16ChotmaiLcom
Website:
www. face book.com/yumnvnycake
Date:
01/23/2015
-- ---�------------
CFO ZIP:
92253
Owner Cell:
760-702-4607
Mailing City:
1. Cate ones:
99 CClass A" (Direct Sales Only) ❑ "Class B" (Direct & Indirect Salesj —
41102�
2. Prohibited Items: Initial if you agree to abide by the following:
I understand that foods containing cream, custard, or meat fillings are potentially hazardous and are NOT.:;
ALLOWED. Only foods that are defined as "non -potentially hazardous" are approved for preparation by a Cottage—
Food Operation (CFO). These are food items that do not require refrigeration to keep them safe from bacter01,grrawth _
that could be a cause of food -borne illness. - - -
3. "Class A" Self Certification Checklist:
Checklist completed (Required for' Class A" CFOs Only)
4. Products:
Please checIcALL ofihe items Voll will he nrPnnrinQnnd1ni- c.,11i)io
Baked Goods
Dried Pasta
Honey
Popcorn
Ground Chocolate
Dry Baking Mixes
Mustard
Vinegar
Churros
Waffle Cones
Tortillas
Fruit Butter **
Dried Mole Paste
Herb/Spice Blends
Pizelles
lams/Jellies**
Trail Mix
Fruit Tamales/Pies
Nuts/N. ut Mixes
Dried Fruit
Fruit Empanadas
Nut Butters
Dried Tea
Roasted Coffee
~couNTvoi RIVERSIDE"
DEPARTMENT OF ENVIRONMENTAL HEALTH
CALIFORNIA HOMEMADE FOOD ACT AB 1616
COTTAGE FOOD OPERATION (CFO)
REGISTRATION /PERMITTING FORM
CFO Business Name:
YuMmMy Cake Creations
i CFO Physical Address:
54125 Avenida Obregon
Owner Name:
Michelle M. Mendoza
Owner Phone:
760-702-4607
CFO City:
La Qumita
Date:
01/23/2015
CFO ZIP:
92253
Owner CcIL-
760-702-4607
Mailing Address (if different):
?Mailing City: Mailing ZIP:
Email Address:
chelles 16@hotmail-com
-- ------- ---
Website:
www.facebook.com/yummmycake
1. Categories:,
Z"Class A" (Direct Sales Only) ❑ "Class B" (Direct & Indirect Salesj
`:7 7 A:--'-.'.4
2. Prohibited Ite ms: Initial if you agree to abide by the follo-Aing:
I understand that foods containing cream, custard, or meat fillings are potentially hazardous and are NOT.:
ALLOWED. Only foods that are defined as "non -potentially hazardous" are approved for preparation by a Cottage-_'
Food Operation (CFO). These are food items that do not require refrigeration to keep them safe from bac j� � : - . ;:
p.qTig :gr.pwth ;
that could be a cause of food -borne illness.
3. "Class A" Self Certification Checklist:
15CChecklist completed (Required for "Class A" CFOs Only)
4. Products:
Please check AL of 1he items vou will be DreDari . n LY andloi- selling.
Baked Goods
Dried Pasta
Honey
Popcorn
Ground Chocolate
Dry Baking Mixes
Mustard
Vinegar
Churros
Waffle Cones
Tortillas
Fruit Butter
Dried Mole Paste
Herb/Splce'B tends
P ize He s
Jams/JeUies**
Trail Mix
Fruit Tamales/PiesNuts/Nut
Mixes
Dried Fruit
Fruit Empanadas
Nut Butters
Dried Tea
Roasted Coffee
Rev. 122013
Food descriptions:
5. Product Labeling: Initial if you agree to abide by the following: �✓lf4'A
For a detailed description, see the CDPH document "Labeling Requirements for Cottage Food Products." I understand
that all cottage food products must be properly labeled in compliance with the Federal, Food, Drug, and Cosmetic Act
(21 U.S.C. Sec. 343 et seq.) The label must include:
• The words "Made in a Home Kitchen" in 12 -point type. 0 The name commonly used to describe the food
product.
• The CFO business name, city, state and zip code of the cottage food operation which produced the cottage food
product. if the firm is not listed in the current telephone directory then a street address must also be declared
(A contact phone number or email address is optional but may be helpful for consumers to contact your
business.)
• The registration or permit number of the cottage food operation which produced the cottage food product and
in the case of "Class B" CFOs, the name of the county where the permit was issued.
• The ingredients of the food product, in descending order of predominance by weight, if the product contains
two or more ingredients.
• The nct quantity (count, weight, or volume) of the food product. It must be statedin both English units (pounds)
and metric units (grants).
• A declaration on the label in plain. language if the food contains. any of the eight major food allergens such as
milk; eggs, fish, shellfish, tree nuts, wheat, peanuts, and soybeans. There are two approved methods prescribed
by federal law for declaring the food sources of allergens in packaged foods: 1) in a separate summary statement
immediately following or adjacent to the ingredient list, or 2) within the ingredient list.
• If the label makes approved nutrient content claims or health claims, the label must contain a '`Nutrition Facts"
statement on the information panel o The use of the following eleven terms are considered nutrient content
claims (nutritional value of a food): free, low, reduced, fewer, high, less, more, lean, extra lean, good source,
and light. Specific requirements have been established for the use of these terms. Please refer to the Cottaize
Food. Labeline Giudelite for more.details.
o A health claim is a statement or message on the label that describes the relationship between a
food component and. a disease or health-related condition (e.g., sodium and hypertension,
calcium and osteoporosis). Please refertothe Cottage Food Labeling Guideline for more details.
Page 2 of 5
Dried or Dehydrated V s
Ve et—a—b-IM1975tato Chips
Dried Vegetarian -based Soup Mixes
Buttercream Frosting with Non-PHF Ingredients
Sweet Sorghum Syrup
Granola/Cereals
Chocolate Covered Nonperishable Food
Confections Containing:
Salted Caramel Fudge UMarshmallow Bars Hard Candy HNuts
e t.
trrt
❑
Candy (i.e. Cotton Candy, Candied Apples, other candies provide descriptions/recipes):
"These items must comply with standards described in Part 150 of Title 21 of the Code of Federal Regulations
http.lwww.accessdata.fda.gov/scripts/cdrhic fdocs/c fCFRrCFRSearch.cfm?CFRPart= 150
Rev. 122013
Food descriptions:
5. Product Labeling: Initial if you agree to abide by the following: �✓lf4'A
For a detailed description, see the CDPH document "Labeling Requirements for Cottage Food Products." I understand
that all cottage food products must be properly labeled in compliance with the Federal, Food, Drug, and Cosmetic Act
(21 U.S.C. Sec. 343 et seq.) The label must include:
• The words "Made in a Home Kitchen" in 12 -point type. 0 The name commonly used to describe the food
product.
• The CFO business name, city, state and zip code of the cottage food operation which produced the cottage food
product. if the firm is not listed in the current telephone directory then a street address must also be declared
(A contact phone number or email address is optional but may be helpful for consumers to contact your
business.)
• The registration or permit number of the cottage food operation which produced the cottage food product and
in the case of "Class B" CFOs, the name of the county where the permit was issued.
• The ingredients of the food product, in descending order of predominance by weight, if the product contains
two or more ingredients.
• The nct quantity (count, weight, or volume) of the food product. It must be statedin both English units (pounds)
and metric units (grants).
• A declaration on the label in plain. language if the food contains. any of the eight major food allergens such as
milk; eggs, fish, shellfish, tree nuts, wheat, peanuts, and soybeans. There are two approved methods prescribed
by federal law for declaring the food sources of allergens in packaged foods: 1) in a separate summary statement
immediately following or adjacent to the ingredient list, or 2) within the ingredient list.
• If the label makes approved nutrient content claims or health claims, the label must contain a '`Nutrition Facts"
statement on the information panel o The use of the following eleven terms are considered nutrient content
claims (nutritional value of a food): free, low, reduced, fewer, high, less, more, lean, extra lean, good source,
and light. Specific requirements have been established for the use of these terms. Please refer to the Cottaize
Food. Labeline Giudelite for more.details.
o A health claim is a statement or message on the label that describes the relationship between a
food component and. a disease or health-related condition (e.g., sodium and hypertension,
calcium and osteoporosis). Please refertothe Cottage Food Labeling Guideline for more details.
Page 2 of 5
• Labels must be legibl4wEnglish (accurately translated informat"nother language may accompany
• Labels, wrappers, inks, adhesives, paper, and packaging materials that come into contact with the cottage food
product by touching the product or penetrating the packaging must be food -grade (safe for food contact) and
not contaminate the food.
• Sample of label must be submitted prior to final approval.
Example:
MADE IN A HOME [UTCHEN Permit #: 12345 Issued in county: County name
Chocolate Chip Cookies With Walnuts
Sally's Treats
Anywhere, CA 925XX*
Ingredients: Enriched flour (Wheat flour, niacin, reduced iron, thiamine,
mononitrate, nboflavin and folic acid), butter (mile, salt), chocolate chips
(sugar, chocolate liquor, cocoa butter, butterfat (mills)), walnuts, sugar, eggs, sah,
artificial vanilla extract, baking soda.
Contains: Wheat, eggs, mile, soy, walnuts
Net Wt. 3 oz. (85.049g)
* Full address required for cottage food operations not currently fisted in the local telephone directory
6. Water Source:
Please identify the watersource to be used in Cottage Food Facility (Check one box only)
LIQ Name of Public Water System or Community Services Di trict:
C()CkCV)q 1 �a -, a,Ni4P Lj (AX�.
If you use a Private Water Supply*, identify the source (well, spring, surface, etc.):
Private Water Supply: Water Quality Results
Check boxes below if initial water testing has been completed. All testing must be done at a State Certified Laboratory.
Attach a copy of the lab results and list the results in the space provided next to type of test.
Page 3 of 5
❑ $acteriological Test( (y):
❑ Nitrate Test (yearlv):
❑ Arsenic
ME]
(yearly,
v,
Fluoride (once):'
*Additional information may be required if food is
your local area office for details.
F11 I1
L.Aboi
if
applicable*):
prepared from a home with a private water supply – Check with
7. Disposal of Waste:
Please check what type of treatment is used to dispose of waste
XPublic Sewer Service
❑ Private Septic System
In the event of septic system failure or plumbing problem, you are required to notify Riverside County Department of
Environmental Health immediately and discontinue all cottage food operations until repairs are completed and approval
to operate is issued
8. Food Processor Course: - Initial if you agree to abide by the following: d 4VLI
Within 3 months of being approved to operate by the Environmental Health Department, please provide proof of
completion of the required California Department of Public Health (CDPH) food processor course*. Proof of
completion may be faxed to our Department at (951) 358-5017 (if possible please include area office and/or name of
inspector you have corresponded with).
* Riverside County Food Handler Course will meet this requirement: www.rivcoeh.org
9. Emplovee: Initial if you agree to abide by the following:
I understand that I may not have more than one full -tone equivalent cottage food employee, not including a fanuly
member or household member of the cottage food operator, working within the registered or permitted area of a private
home where the cottage food operator resides and where cottage food products are prepared or packaged for direct,
indirect, or direct and indirect sale to consumers.
10. Gross Annual Sales: Initial if you agree to abide by the following: �ky-A/-
I understand that I will lose my CFO status and will need to become permitted in a commercial facility if my CFO
business exceeds the following gross annual sales figures for the calendar years in the following table:
Calendar Year
In2013 .......................................:.
In2014 .........................................
In 2015 and in subsequent years ..
Gross Annual Sales
.............................. $35,000
.............................. $45,000
............................. $50,000
11. Delivery Limitations: Initial if you agree to abide by the following: _�— I understand that I may
accept orders andpayments via the internet, mail or phone. However, all "Class A" & "Class B" CFO products must be
delivered direct (in person) to the customer. The CFO products may not be delivered via US Mail, UPS. FedEx or
using any other indirect delivery method as this is regulated/subject to CDPH registration and state and federal
requirements.
Page 4 of 5
12. Zoning nts: Initis ryou agree ) g
Re uiremeree to abide b y the followin :
4
I understand that I must comply with all applicable zoning requirements for the jurisdiction in which I live. I
have attached documentation from the Planning office (if required).
13. Owner's Statement:
agree to grant access to the local health department to conduct an
ins ection of my cottage food operation (mark one):
"Class A": In the event of a consumer complaint or,reported food -borne illness.
❑ "Class B": For regular annual facility inspections and in the event of a consumer complaint or reported foodborne
illness.
0
to notify Riverside County Department of Environmental Health
prior to modifying my food list, type of operation, and/or method of selling, distributing, or otherwise providing my
CFO products to the consumer or retailers, regardless of whether the product is sold, consigned, or given away.
Owner's azure Print 1Vame Date
OFFICE USE ONLY
AMT RECD: DATE RECD: _ -1 _ t S 1 N VOICE.:
PAYMENT TYPE.-
CASHDIT/D
CHECK
CHECK#:
DRIVERS LICENSE#: —,eir -.i-r EXPIRATION DA TE:
SAMPLE LABEL RECEIVED BY.
COPY OF PLANNING APPROVAL R=EIVED BY. -
ONSITE CFO INPECTION COMPLETED BY.
DATE:
CFO APPROVED BY:
DATE: Zj-177_1<
FA #.- P g—,5f: SR#: PE#: District:
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