PAULr �
• FEE $35.00
CITY OF LA QUINTA
•
11111111111111111111
7,
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
HOME OCCUPATION PERMIT
Read each condition listed on the attachment to this form to see if
the proposed activity can comply with the City's Home Occupation
Regulations.
--------------------------------
800-821-7122
BUSINESS 'riAi�SE Quality Computer Supplies giiv 771-0040
PROPERTY OWNER aures R. Paul PHONE ""ii=moi
PROPERTY ADDRESS - ang ewoo , EaQuinta, CA
92253
MAILING ADDRESS same
TYPE OF RESIDENCE (single, multiple, mobil home, etc.) condo
TYPE OF BUSINESS telephone marketing computer supplie
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE P o e .
Product ships from manufacturer to end user. We invotue.
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED James R. Paul, Snart Paut, Daryt U. Paul
SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) 200 sq ft O
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED
BUSINESS OPERATION telenhnnPR_ fax, laser printer. photocoi
I RAVE READ, UNDERSTAND, AND AGREE WITH -THE CONDITIONS BY "WHICH A
OME 0 UTI D (CONDITIONS ATTACHED).
ANT SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS REQUIRED. -
OWNER/AGENT SIGNATURE DATE
IMPORTANT: FALSE: OR:.MISLEADING INFORMATION SHALL BE GROUNDS FOR
DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH"CONDITIONS
LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF
PERMIT.
• Building and Safety Department
APPROVED DENIED CONDITIONS ATTACHED
,995
a f
w
ZATION FORM
*APPROVED BY
* DATE
****************************
PROOF OF WORKERS COMPENSATION INSURANC E IS REO IRFD PRIOR TO ISSUANCE
1. IS THIS BUSINESS LOCATED AT YOUR HOME: YES X NO
2. Business Name: Quality Computer Supplies'
3. Business Address: 54-967 Tanglewood 4. Mailing Address: same
LaQuinta, CA 92253
5. Business Phone: (800 821-7122 or (619) 771-0040
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership: TAX I.D.# 95=3985049
8. If Individual Owner: Social Security # 290-38-0919
9. Name of Owner' James R. Paul
Title: president
Or Officers
BUS. LI NO.
0-0. Type of Business• telephone market/computer supplies
11. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNTY HEALTH PERMIT:
YES NO n/a
12. SBEResale Number: SR EHC 18-701255•
13. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To Building
Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
s
B. Previous Year Gross Receipts for Established Businesses,
$_795,000
***********GOOD ONLY FOR JANUARY 1, 1995 THRU DECEMBER 31, 1995**�*/*******
I HEREBY CERTIFY that all the information supplied by me is correct and any
licenses required by the County, State or Federal Government have been issued
to me and in ful�forq'e and effect.
"a"uj.0 Title . Date
• Send Completed Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
78-495 Calle Tampico
P. 0. Box 1504
La Quinta, CA 92253