An establishment whose principal business activity is the practice of one or more of the following: (1) the placing of designs, letters, figures, symbols, or other marks upon or under the skin of any person, using ink or other substances that result in the permanent coloration of the skin by means of the use of needles or other instruments designed to contact or puncture the skin; (2) the creation of an opening in the body of a person for the purpose of inserting jewelry or other decoration.