HOP1996-00083
FOR OFFICE USE ONLY: Permit No. I-/D P96 00.4s
Tax Map: a!9 /I
JrA Lot No.: 3s1/7v-) Zone: ~~•~'G~D
Business Tax Receipt No.: Ur AqI 149
Approved By: Date Approved:' - l - 9c
Filing Fee Rec'd:$ Receipt Number:
Check when com~ OREGON
Entered into Log i` Copy To Applicant Original Filed
Home Occupation Permit - Type I
Filing Fee - $10.00
Business Name: cc{' Application Date.- V12-,l ,r
Property Address: t ~,5 In S~~ ~Cyl - Apt.# j-\ a
City I-, c, c" Zipcode G a 1 `i Bus. Ph.:
Property Owner*: 1 L ra L+c r ar nnkS
Nature of Business: t--- * ca
Name of Applicant*: Ti ;tee
Applicant Address: 1 l-3r,9 0 , LO Apt.# n
City T T ; A Zipcode Cl 1 Lt Home Ph.: Cr 2L! - 13 2,L!
Conditions: The Home Occupation Permit - Type I is subject to the following:
1.) Home occupations may be undertaken only by the principal occupant(s) of a residential property;
2.) There shall be no more than three deliveries per week to the resident by suppliers;
3.) There shall be no offensive noise, vibration. smoke, dust, odors, heat or glare noticeable at or beyond
the property line resulting from the operation. Home occupations shall observe the provisions of TDC
Chapter 18.090 (Environment Performance Standards);
4.) The home occupation shall be operated entirely within the dwelling unit and a conforming accessory
structure. The total area which may be used in the accessory building for either material product
storage and/or the business activity shall not exceed 528 square feet. Otherwise. the home
occupation and associated storage of material and products shall not occupy more than 25 percent
of the combined residence and accessory structure gross floor area. The indoor storage of materials
or products shall not exceed the limitations imposed by the prevision of the building, fire, health and
housing codes;
5.) A home occupation shall not make necessary a change in the Uniform Building Code use
classification of a dwelling unit. Any accessory building that is used must meet Uniform Building
Code requirements and be in conformance with TDC Chapter 18.144 of this title;
o.) More than one business activity constituting two or more home occupations shall be allowed on one
property only if the combined floor space of the business activities does not exceed 25 percent of the
combined gross floor area of the residence and accessory structure. Each home occupation shall
apply for a separate home occupation permit, if required per this chapter, and each shall also have
separate Business Tax Certificates:
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13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772
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7.) There shall be no storage and/or distribution of toxic or flammable material, and spray painting or
spray finishing operations that involve toxic or flammable material which in the judgement of the Fire
Marshall pose a dangerous risk to the residence, its occupants, and/or surrounding properties. Those
individuals which are engaged in home occupation shall make available to the Fire Marshall for review
that Material Safety Data Sheets which pertain to all potentially toxic and/or flammable materials
associate with the use;
8.) No home occupation shall require any on or off-street parking other than that normally required for
a residence;
9.) The following uses are not allowed as home occupations:
a.) Auto-body repair and painting
b.) On-going mechanical repair conducted outside of an entirely enclosed building
c.) Junk and salvage operations
d.) Storage and/or sale of fireworks
10.) There shall be no exterior storage of vehicles of any kind used for the business except that one
commercially licensed vehicle of not more than three-quarters ten GVw may be parked outside of
a structure or screened area.
Standards: According to Tigard Development Code Chapter 18.142.050, a Home
Occupation Permit - Type I shall exhibit no evidence that a business is being conducted
from the premises. Home Occupation Permits - Type I shall not permit:
1.) Outside volunteers or employees to be engaged in the business activity other than the persons
principally residing on the premises;
2.) Exterior signage which identifies the property as a business location;
3.) Clients or customers to visit the premises for any reason;
4.) Exterior storage of materials.
I hereby certify that I have read and understand the above conditions and standards for
the operation of a home occupation. I acknowledge that this home occupation approval
may be revoked if the above conditions and standards have not been complied with
and/or the home occupation is otherwise being conducted in a manner contrary to the
Tigard Community Development Code (18.142). Revocation due to a violation of the
home occupation requirement(s) cannot be renewed for a minimum period of one year
(18.142.090).
Ap cant Sigq~, re Date
Owner Signature cif different than Applicant) Date
Owner Signature (if different than Applicant) Date
X~en :re owner 3ra the aaPhcanl are different peon:e the ac06can1 must Ce ire purc-aser of reccrc cr es See n Bcssess•on The ownerisl or agent of tria cwrer
must sign this aDOilcanon or su'cm-t a writer autror.nt;on w :m this acpllcatzn
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REGISTRA"ON CERM7CA7'E
This c etti#ies that the person named hereon t f
is. registered as provided by law as a ; ~ f ~ tft r ~ ~ i
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`m YY-9 Request for Taxpayer
Give form to the
(Rev March 19941 Identification Number and Certification requester. So tt'';-;
:),-Pftment of U,.. ;r:A send to th !Rj.
Irlt F.f Hall rteV Cn UC SP.NIfn
'Jame (fit Icn,! 1. a . r •i. n f"1 iinstructions on paq: 2 It ynar narn° r,..----
Business name (Sole proprietors see instn,ct ons on page ) J
o
CL Please check appropriate box: ❑ Individual/Sole propn etor Corporation I__ I'~,^,nerstun r
H Address (number, street. and apt or suite nn.) Requester's nanoend address (nre n..:
co
G City of Tigard
1 C5, Q A)
City. state, and ZIP code 13125 SW Hall Blvd.
T t e-Ci f"~ 12 Cl,) Tigard, Or 97223
I:FWI axpayer Identification Number (Tlf\l; -
Enter your TIN in the appropriate bcx. For _
individuals, this is your social security number social security number
(SSN). For sole proprietors, see the instructions
on page 2. For other entities, it is your employer ~L
identification number (EIN). If you do not have a OR For Payees Exempt From Backup
number, see How To Get a TIN below. Withholding (See Part II
Note. If the account is in more than one name, Employer identification number instructions i
see the chart on page 2 for guidelines on whose q 13} ~1~~ 5
number to enter.
LEM_ Certification - - -
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the !
Revenue Service that I am subject to backup withholding as a result of a failure to report all owcrest or dividends, or (e) the IRS has noon,
me that I am no longer subject to backup. withholding.
Cartification Instructions.-You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because of underreporting interest or dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, the acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement
(IRA), and generally payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct
TIN. (Also see Part III instructions on page 2.)
Sign
Here Signature ► ` - Date ► (r,
Section references are to the Internal payments under certain conditions. This is interest and dividend accounts opetled
Revenue Code. called "backup withholding.' Payments after 1983 only), or
Purpose of Form.-A person who is that could be subject to backup 5. You do not certify your TIN. See the
required to file an information return with withholding include interest, dividends, Part III instructions for exceptions
the IRS must get your correct TIN to report broker and barter exchange transactions,
income paid to you, real estate rents. royalties, nonemployee pay. and Certain payees and payments are
transactions, mortgage interest you paid, certain payments from fishing boat exempt from backup withholding and
the acquisition or abandonment of secured operators. Real estate transactions are not information reporting. See the Part II
property, cancellation of debt, or subject to backup withholding. instructions and the separate Instructions
contributions you made to an IRA. Use If you give the requester your correct for the Requester of Form W-9.
-orm W-9 to give your correct TIN to the TIN, make the proper certifications, and How To Get a TIN.-If you do not ha t
requester (the person requesting your TIN) report all your taxable interest and TIN, apply for one immediately. To appl,.
and, when applicable. (1) to certify the TIN dividends on your tax return, your get Form SS-5, Application for a Social
you are giving is correct (or you are waiting payments will not be subject to backup Security Number Card (for individuals?
for a number to be issued), (2) to certify withholding. Payments you receive will be f'om your local office of the Social
you are not subject to backup withholding, subject to backup withholding if: Administration, or Form SS-4, ApF>
or (3) to claim exemption from backup for Employer Identification Number ,1of
withholding if you are an exempt payee. 1. You do not furnish your TIN to the requester, or businesses and all other entities), frorn
Giving your correct TIN and making the your local IRS office.
appropriate certifications will prevent 2. The IRS tells the requester that you If you do not have a TIN, write "App ied
certain payments from being subject to furnished an incorrect TIN, or For" in the space for the TIN in Part I,
backup withholding. 3. The IRS tells you that you are subject and date the form, and give it to the
Note: If a requester gives you a form ether to backup withholding because you did not requester. Generally, you will then ha.,n
than a W-9 to request your TIN, you must report all your interest and dividends on days to get a TIN and give it to the
use the requester's form if it is substantially your tax return (for reportable interest and requester. If the requester does not receive
similar to this Form W-9, dividends only), or your TIN within 60 days, backup
What Is Backup Withholding?-Persons 4. You do not certify to the requester withholding, if applicable, will begin and
making certain payments to you must that you are not subject to backup continue until you furnish your TIN
withhold and pay to the IRS 31 % of such withholding under 3 above (for reportable
Cat. No. 10231X Form W-9 (Rev. 3-94)
F agt- 2
Note: Writing "Applied For" e-. If you are exempi front backup TIN whether or not you are required to fill
means that you have alread, <vithhofdrng. you should still complete th s a tax return Pavers must generally
DN OR that vot,, intent; to atTc_ farm to avoid passibi- erroneous hacnu.. :v thhoid 31 of taxable interest.:: v i-
lnholding. Enter er*airi other p3o-dints to i F
As soon as you receive yju I, write "Exempt- u, I'art II, and sign ;ind who does not give a TIN to a i;av„r
date the form. If you are a nonresident Certain penalties ma
complete another Form W-9. ,nc!u:)-' your y also apt>Iv
TIN, sign and date the form, and owe if to alien or a foreign entity riot subject to
the requester backup withholding, give the requester a What Name and Number To
completed Form W-8, Certificate of Give the Requester
Penalties Foreign Stahl'-,.
Part III-Certification For this type of account: Give name and SSN of
Failure To Furnish TIN--If you ;,i t.,
furnish your correct TIN to a reou9 ,t-r • i For a joint account, only 'he person whose 1. Mdw,duaI The individual
are subject to a penalty of S50 f0, --TIN is shown in Part I Should sign. z a m-e ?he actual owner M
Such failure unless your failur? ineiwduals (joint account or.
1. Interest, Dividend, and Barter =0UnII t.,nds, th., firs
reasonable cause and not to Exchange Accounts Opened Before 1984
Civil Penalty for False Information it ith and Broker Accounts Considered Active Custodian account of
a minor (Uniform Girl
Respect to Withholding.-If you make a During 1983. You must give your correct to Minors Act)
false statement with no reasonable basis TIN, but you do not have to sign the 4. a The usual I n.•
that results in no backup wfthhOl;ii^q. you certification. revocable savings
are subject to a 5500 penalty rust ,grantors i
2. Interest, Dividend, Broker, and assn trustee)
Criminal Penalty for Falsifying Barter Exchange Accounts Opened After u Su .aue" trust The actur,
Information.- Willfully falsifyine: 1983 and Broker Accounts Considered account that is not
a ieyat or valid trust
certifications or affirmations rnas ; r,l.•,: Inactive During 1983- You must Sinn the under state ta.a
you to criminal penalties incluclimj certification or backup w thholding will s. Soie propneiorsh,p t he. own.;,
and/or imprisonment apply. If you are subject to backup
Misuse of TII If the requester withholding and you are merely providing For this type of account: Give name and EIN of
discloses or uses TINS in violation of your correct TIN to the requester, you must 6. Sole proprietorship The owner
Federal law, the requester may be subject cross out item 2 in the certification before 7. A valid trust, estate, or Legal entrr,
to civil and criminal penalties. signing the form. pension trust
3. Real Estate Transactions. You must 8. Corporate the corpr,r,r-.,•
9. ASSOCration, club, ihn prq n,--z•
Specific Instructions sign the certification. You may cross out religious. charitable,
item 2 of the certificatior. educational. or other
Name.-If you are an individual, you must tax-exempt
4. Other Payments. You must give your organization
generally enter the name shown on your correct TIN, but you do not have to sign 10. Partnership
social security card. However, if you have the certification unless you have been 11. A broker or registered The broker or r-,n,n-
changed your last name, for instance, due notified of an incorrect TIN. Other nominee
to marriage, without informing the Social payments include payments made in the 12. Account with the The PUI enlrt,
Security Administration of the name Department of
course of the requester's trade or business Agriculture in the name
change, please enter your first name, the for rents, royalties, goods (other than bills of a public entity (such
gs or
last name shown on your social security for merchandise), medical and health care goa state t. local
card, and your new last name. government, stn) t
services, payments to a nonemployee for district, or prison) that '
Sole Proprietor.-You must enter your services (including attorney and accounting receives agricultural
individual name. (Enter either your SSN or fees), and payments to certain fishing boat program payments
EIN in Part I.) You may also enter your crew members.
List lust anti circle the name of n:. person wnp52
business name or "doing business as" 5. Mortgage Interest Paid by You, number you furnish
name on the business name line. Enter Acquis?tion or Abandonment of Secured circle the minor s name and furnish the minor's SSN
your name as shown on your social Property, Cancellation of Debt, or IRA 'You must show our individual name, but you may .,'sr,
security card and business name as it was Contributions. You must give your correct enter your business or ''doing business as" name
used to apply for your EIN on Form SS-4. TIN, but you do not have to sign the may use either your SSN or EIN
Part I- Certification. 'I_-st'irst ano title the,~~ame of the lagai trust, is! r.Taxpayer Identification Number or pension trust. ,Do not furnish the TIN of the Der:_
(TIN) P(IVBCy Act Notice representative or trustee un ess the legal entity rts,•:t ,
not designated in the account title.)
You must enter your TIN in the appropriate Section 6109 requires you to give your Note: If no name is circled whet, -Wore than
box. If you are a sole proprietor, you may correct TIN to persons who must file name rs listed. the number v.,W h- tort-;...le.-~ ;r r ~
enter your SSN or EIN. Also see :•,a crmahon .;;tn the IRS to repo
on this page for further clarification of interest, dividends, and certain other
name and TIN combinations. If you do not income paid to you, mortgage interest you
have a TIN, follow the instructions under paid, the acquisition or abandonment of
How To Get a TIN on page 1. secured property, cancellation of debt, or
Part 11-For Payees Exempt From contributions you made to an IRA. The IRS
Backup Withholding uses the numbers for identification
purposes and to help verity the accuracy
Individuals (including sole proprietors) are of your tax return. You roust provide your
not exempt from backup withholding.
Corporations are exempt from backup
withholding for certain payments, such as
interest and dividends. For a complete list
of exempt payees, see the separate
Instructions for the Requester of Form
W-9.
U.S. Government Printing Offloe: 1995 - 387-09S'"79