DIETRICK11111111111111111111
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CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504,
W
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La QuiA-42253-
HOMEOCCUPATION 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.
BUSINESS NAME Double D Construction PHONE 619-771-1561
PROPERTY OWNER Michael Dietrick PHONE 619-771-1163
PROPERTY ADDRESS 51-960 Ave. Herrera La Ouinta Ca 92253
MAILING ADDRESS Same as above
TYPE OF RESIDENCE (single, multiple, mobil home, etc.) Single
TYPE OF BUSINESS General Contractor
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
Correspondence through the office
NUMBER OF PERSONS INVOLVED IN BUSINESS One
LIST NAME OF PERSONS EMPLOYED None
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) 1600 sq. ft.
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
( EXAMPLE, "BEDROOM -125 S.F.") Bedroom - 144 sq. ft.
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION Computer, Fax Machine, Typeixitter, Office supplies
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCgUPAT�N' Mf ALLOWED ( CONDITIONS ATTACHED) . I _ 9"I A /1 .. A M _ l' -P I
APPLICANT 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.
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Building nd Safety Department
P ROVED DENIED CONDITIONS ATTACHED
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