§ 115.49 ORIGINAL MASSAGE THERAPIST PERMIT APPLICATION.
   (A)   If an applicant does not hold a current massage therapist permit issued by another jurisdiction that has adopted the Coachella Valley Model Massage Ordinance, application for issuance of a massage therapist permit by the city shall be made, under oath, on the form set out by the Permit Administrator. The following information, documents and other requirements shall be included with the submission of all such applications:
      (1)   The applicant's legal name, any aliases and date of birth;
      (2)   A certified letter of intent to employ from the operator of a massage therapy establishment lawfully operating within the city. Each such letter shall verify that the operator of the massage therapy establishment has reviewed the applicant's qualifications and that the applicant has met the requirements necessary to perform massage therapy at that facility;
      (3)   The applicant's home and business addresses, corresponding telephone numbers, and permanent address and telephone number, if different;
      (4)   Written evidence that the applicant is at least 18 years of age;
      (5)   The previous home addresses of applicant for the ten years prior to the filing date of the application and the dates of residency at each such address;
      (6)   The names, addresses and descriptions of all current and former businesses owned, operated or managed by applicant for the ten years prior to the filing date of the application and the dates applicant owned, operated or managed each such business;
      (7)   Employment history for the ten years prior to the date of application, and all massage or similar business history and experience;
      (8)   Two front-face portrait photographs taken within 30 days of the date of application, at least two inches by two inches in size;
      (9)   Applicant's weight, height, color of hair and eyes, and gender;
      (10)   The applicant's driver's license number or identification number;
      (11)   The applicant's fingerprints taken within the previous 60 days by an agency approved by the Permit Administrator;
      (12)   The applicant's social security number and/or state or federally issued tax identification number;
      (13)   Proof, in the form specified here, that applicant is:
         (a)   A graduate of a recognized school of massage; or
             (b)   Certified by the National Certification Board for Therapeutic Massage and Bodywork. Proof of certification by the National Certification Board for Therapeutic Massage and Bodywork shall be in the form of a certified copy of the therapeutic massage and bodywork credential issued by said Board. Proof of graduation from a recognized school of massage shall require both of the following:
            1.   Certified copy of the applicant's diploma or certificate of graduation, or equivalent documentation, establishing that applicant has successfully completed the course of study for competency as a massage therapist offered by the recognized school of massage; and
            2.   Certified transcript from a recognized school of massage verifying applicant has successfully completed a course of study requiring at least 700 hours of massage therapy training. If the application is submitted concurrently with an application for an off-premises endorsement, the minimum hours of training shall be as set out below for an off-premises endorsement application;
      (14)   A certified statement from a physician licensed to practice medicine in the United States that provides that the applicant has, within 60 days prior to the filing date of the application, been examined by said physician and it has been determined that the applicant is free of any communicable disease as defined in this chapter;
      (15)   A list of all of applicant's convictions of crimes, excluding traffic violations;
      (16)   Whether or not the applicant has ever been convicted of any disqualifying conduct;
      (17)   Whether or not the applicant is required to register as a sex offender pursuant to the Cal. Penal Code § 290;
      (18)   Whether or not applicant has had a previous permit, license or other authority for massage services denied, suspended or revoked by any entity. If so, the date, location and reasons for the denial, suspension or revocation;
      (19)   Whether or not the applicant has been a sole proprietor, general partner, officer, director, member or employee of any massage therapy business that has had a permit, license or authority to operate a massage business denied, suspended or revoked by any entity. If so, the applicant shall provide the name and location of the massage therapy establishment or business for which the permit was denied, suspended or revoked, the date of the denial, suspension or revocation, and the reason(s) for the denial, suspension or revocation; and
      (20)   The applicant shall provide the Permit Administrator with the authorization to conduct the necessary background investigations to determine the truthfulness and correctness of the information provided by applicant and whether the applicant is qualified pursuant to this chapter to receive the requested massage therapist permit.
   (B)   The applicant shall date and sign the application and declare under penalty of perjury that the information contained in the application is true and correct.
   (C)   The applicant shall pay a non-refundable application fee of $150 at the time of filing an application to defray the costs of administering this chapter.
(Ord. 1453, passed 12-7-05)