HOP2004-00134
1R
CITY OF TI GARD HOME OCCUPATION PERMIT
TYPE: I
T DEVELOPMENT SERVICES PERMIT HOP2004-00134
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/5/2004
APPLICANT NAME: CHRIS LIVINGSTON
BUSINESS ADDRESS: 10258 SW STUART CT
PARCEL: 2S1141313-17400 ZONING: R-7 JURISDICTION: TIG
NATURE OF BUSINESS: Home occupation Type 1 for home inspection business.
BUSINESS NAME: ONAWA INC. DBA PILLAR TO POST
SQ FT - DETACHED: GENERATE EXTRN NOISE: N
SQ FT - RESIDENCE: DAYS/HOURS OF OPS :
SQ FT - BUSINESS: BUS. VEHICLES GARAGED @ RES:
SIC CODE: OUTSIDE STORAGE: NONE
PAID NON RES EMPL: N
CUST/CLIENT @ RES: N EXTERIOR SIGN?: N
PICK/DELIV @ RES:
ACKNOWLEDGEMENT:
I understand this Home Occupation Permit is approved for the above described business at the specified location
only, and does not require renewal. Further, I understand that the City of Tigard Business Tax must be renewed
annually in order to maintain permit authorization.
I acknowledge that this Home Occupation Permit approval may be revoked if the conditions and standards of
approval have not been complied with and/or this home occupation is otherwise being conducted in a manner
contrary to the Tigard Community Development Code (18.742). Permit revocation due to a violation of
requirement(s) of this Home Occupation Permit cannot be renewed for a minimum period of one year. (18.742.070).
Approved by Permittee Signature
HOME OCCUPATION
TYPE I APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 FAX: (503) 684-7297
GENERAL INFORMATION
Property Address/Location: 02-SS~ ~~13Ri?T
Tax Map & Tax Lot Zone: FOR STAFF USE ONLY
Property Owner/Deed Holder(s)`:GQj g Spoo- llr
`F
Address: ~p 7-\-s 4,W3 i1lAftr CT-- Phone: 93 S4 Z7 Case/Permit No.: H Pa m4 -yD 13
Other Case No.(s):
City:~hA~' Zip: cr72N Filing Fee Rec'd.:$ 91-0b
Applicant": Receipt No.: a DD 5~ -
Address: Phone: Application Approved By: «,zc~
Date Approved: / / - v -O
Business Phone:
City: Zip: Comp Plan/Zone Designation:
Business Name: Fi1~IA~n~pt Si3C ~SA u Z T~ ~v (t Ain Rr r Z R ` -7
Business Type Code:
Nature of Business: grwnF ~skEQ3 5 Business Tax Paid? ❑ Yes ❑ No
--rT Business Tax Receipt No.
Rev. 2/28/2003 is\curpln\masters\revised\hopl.doc
' When the owner and the applicant are different people, the
applicant must be the purchaser of record or a lessee in possession
with written authorization from the owner or an agent of the owner.
The owner(s) must sign this application in the space provided on the
back of this form or submit a written authorization with this application. REQUIRED SUBMITTAL ELEMENTS
THE APPLICANT SHALL CERTIFY THAT: ✓ Application Elements Submitted:
3 The above request does not violate any deed restrictions that
may be attached to or imposed upon the subject property. ❑ Application Form
3 If the application is granted, the applicant will exercise the rights ❑ Owner's Signature/Written Authorization
granted in accordance with the terms and subject to all the ❑ Proof of Business Tax Certificate
conditions and limitations of the approval.
❑ Filing Fee: $ 31.00
3 All of the above statements and the statements in the plot plan,
attachments, and exhibits transmitted herewith, are true; and the
applicants so acknowledge that any permit issued, based on this
application, may be revoked if it is found that any such statements
are false.
3 The applicant has read the entire contents of the application,
including the policies and criteria, and understands the
requirements for approving or denying the application.
1
* s
1. Home occupations may be undertaken only by the principal 10. There shall be no exterior storage of
occupant(s) of a residential property; vehicles of any kind used for the
business except that one commercially
2. There shall be no more than three deliveries per week to the licensed vehicle of not more than three-
resident by suppliers; quarters ton GVW may be parked outside
of a structure or screened area.
3. There shall be no offensive noise, vibration, smoke, dust, odors,
heat or glare noticeable at or beyond the property line resulting Standards:
from the operation. Home occupations shall observe the provisions
of TDC Chapter 18.725 (Environment Performance Standards); According to Tigard Development Code
Chapter 18.742.050, a Home Occupation
4. The home occupation shall be operated entirely within the dwelling Permit - Type I shall exhibit no evidence that a
unit and a conforming accessory structure. The total area which business is being conducted from the
may be used in the accessory building for either material product premises. Home Occupation Permits - Type I
storage and/or the business activity shall not exceed 528 square shall not permit:
feet. Otherwise, the home occupation and associated storage of
material and products shall not occupy more than 25 percent of the A. Outside volunteers or employees to be
combined residence and accessory structure gross floor area. engaged in the business activity other
The indoor storage of materials or products shall not exceed the than the persons principally residing on
limitations imposed by the provision of the building, fire, health and the premises;
housing codes; B. Exterior signage which identifies the
property as a business location;
5. A home occupation shall not make necessary a change in the C. Clients or customers to visit the premises
Uniform Building Code use classification of a dwelling unit. Any for any reason; and
accessory building that is used must meet Uniform Building Code D. Exterior storage of materials.
requirements.
I hereby certify that I have read and
6. More than one business activity constituting two or more home understand the above conditions and
occupations shall be allowed on one property only if the combined standards for the operation of a home
floor space of the business activities does not exceed 25 percent occupation. I acknowledge that this home
of the combined gross floor area of the residence and accessory occupation approval may be revoked if the
structure. Each home occupation shall apply for a separate home above conditions and standards have not been
occupation permit, if required per this chapter, and each shall also complied with and/or the home occupation is
have separate Business Tax Certificates; otherwise being conducted in a manner
contrary to the Tigard Community
7. There shall be no storage and/or distribution of toxic or flammable Development Code (18.742). Revocation due
material, and spray painting or spray finishing operations that to a violation of the home occupation
involve toxic or flammable material which in the judgement of the requirement(s) cannot be renewed for a
Fire Marshall pose a dangerous risk to the residence, its minimum period of one year (18.742.080).
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 Applicant's Signature:
to all potentially toxic and/or flammable materials associate with
the use;
a e: 91 94~ M?
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: Owner' Signature:
a.) Auto-body repair and painting; Da (e
:
b.) On-going mechanical repair conducted outside of an entirely
enclosed building;
c.) Junk and salvage operations; and
d.) Storage and/or sale of fireworks. Owner's Signature:
Date:
2
s
009'17-9380 TAXPAYo 04276
Form 941 Employer's Quarterly Federal Tax Return
(Rev. January 2004) ► See separate instructions revised January 2004 for information on completing this return.
Department of the Treasury
internal Revenue Service Please type or print.
Enter state OMB No. 1545-0029
code for state
in which T
deposits were ONAWA INCORPORATED SEPT 30 2004 FF
made only if 10258 SW STUART CT FD
different from
state in TIGARD OR 97224 26-0052129 FP
address to
the right
(see page Ill. M U T
2 of separate
instructions).
1 1 1 1 1 1 1 1 1 1 2 3 3 3 3 3 3 3 3 4 4 4 5 5 5
If address is H
different
from prior
return, check
here ► 6 7 8 8 8 8 8 8 8 8 9 9 9 9 9 10 10 10 10 10 10 10 10 10 10
A If you do not have to file returns in the future, check here ► and enter date final wages paid►
9 If you are a seasonal employer, see Seasonal employers on page 1 of the instructions and check here► ❑ 1 Number of employees in the pay period that includes March 12th. ► 1
2 Total wages and tips, plus other compensation (see separate instructions) . . . . . . . 2.... 32642 5 0
3 Total income tax withheld from wages, tips, and sick pay . . . . . . . . . . . 3 3391 05
4 Adjustment of withheld income tax for preceding quarters of this calendar year . . . 4 00
5 Adjusted total of income tax withheld (line 3 as adjusted by line 4) . . . 5 3391 05
6 Taxable social security wages 6a 32642150 x 12.4% (.124) = 6b 4047 67
Taxable social security tips . . . . . . 6c 0 0 x 12.4% (.124) = 6d 00
7 Taxable Medicare wages and tips 7a 3 2 6 4 2 150 x 2.9% (.029) = 7b 946 63
8 Total social security and Medicare taxes (add lines 6b, 6d, and 7b). Check here if wages
are not subject to social security and/or Medicare tax . . . . . . ► 8 4994 30
9 Adjustment of social security and Medicare taxes (see instructions for required explanation)
Sick Pay $ ±Fractions of Cents $ *04 ± Other $ = 9 04
10 Adjusted total of social security and Medicare taxes (line 8 as adjusted by line 9) . . , , , , , 10 4994 34
11 Total taxes (add lines 5 and 10) . . . . . . . . . . . . . . . . . . . . 11 8385 39
12 Advance earned income credit IEIC) payments made to employees (see instructions) . . . . . . . 12
13 Net taxes (subtract line 12 from line 11). If $2,500 or more, this must equal line 17,
column (d) below (or line D of Schedule B (Form 941)) . . . . . . . . . . . 13
14 Total deposits for quarter, including overpayment applied from a prior quarter . . . . . . . . . 14 8385 39
15 Balance due (subtract line 14 from line 13). See instructions . . . . . . . . . . . . . . 15 00
16 Overpayment. If line 14 is more than line 13, enter excess here ► $
and check if to be: ❑ Applied to next return or ❑ Refunded.
• All filers: If line 13 is less than $2,500, do not complete line 17 or Schedule 8 (Form 941).
• Semiweekly schedule depositors: Complete Schedule B (Form 941) and check here . . . . . . . . . . . . . ► ❑
• Monthly schedule depositors: Complete line 17, columns (a) through (d) and check here . . . . . . . . . . . ►
17 Monthly Summary of Federal Tax Liability. (Complete Schedule B (Form 941) instead, if you were a semiweekly schedule depositor.)
(a) First month liability (b) Second month liability (c) Third month liability (d) Total liability for quarter
2729.72 2776.70 2878.97 8385.39
Third Do you want to allow another person to discuss this return with the IRS (see separate instructions)? E] Yes. Complete the following. No.
Party
Designee Designee's Phone Personal Identification
• name ► no. ► ( ) number (PIN) ►
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge
and belief, it is true, correct, and complete.
Sign
Here REFERENCE COPY PREPARED Sr PAYCNEX. Print Your ATTY-IN-FACT 10/02/04
Signature ► 00 NOT Fltf. Name and Title ► Date ►
For Privacy Act and Paperwork Reduction Act Notice, see back of Payment Voucher. Form 941 (Rev. 1-2004)
CITY OF TIGARD 11/5/2004
13125 SW Hall Blvd. 9:08:11 AM
Tigard, Oregon 97223
(503) 639-4171
Receipt 27200400000000004830
Date: 11/05/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
HOP2004-00134 [LANDUS] Type I Permit Fee 100-0000-438000 31.00
Line Item Total: $31.00
Payments:
Method Payer User ID Acct./Check Approval No. How Received Amount Paid
Check ONAWA MC, DBA PILLAR TO CAC 1075 By Mail 31.00
POST
Payment Total: $31.00
I