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HOP2004-00099 CITY OF TI GARD HOME OCCUPATION PERMIT TYPE: I DEVELOPMENT SERVICES PERMIT HOP2004-00099 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/10/2004 APPLICANT NAME: BUSINESS ADDRESS: 07440 SW TAYLORS FERRY RD PARCEL: 1S125CA-06900 ZONING: R-4.5 JURISDICTION: TIG NATURE OF BUSINESS: Home occupation type 1 for internet photo business. BUSINESS NAME: ALLEN AND ANN'S PHOTOS 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 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: O Tax Map & Tax Lot , S 0 OD Zone: FOR STAFF USE ONLY Property Owner/Deed Holder(s)*: N\ z•^ f\,,,\ -,f Case/Permit No.: Address: -7 44o ~.ti Tom" lo' F y ' „1 Phone:--'To 4J 2- s i~7~ _ Other Case No.(s): City: Zip:` 7 3 .~.00 n Filing Fee Rec'd.:$ 411110b q Applicant": I"eA'~ Receipt No.: g6o,4 35y7 Address: -J 4 Phone: c,S J~ Application Approved By: C• `u,c,,,t~J Business Phone: Date Approved: $ /o -a City: Zip: ci Z 2 3 Comp Plan/Zone Designation: Business Name: f\L„fps 1 ! c S Lot,.) Den F'Zts / R • -5 Business Type Code: Nature of Business: h \1 o f-6 s Business Tax Paid? Yes ❑ No s~ t `l Business Tax Receipt No. o (~3SYB 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 0 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 CITY OF TIGARD 8/10/200't 13125 SW Hall Blvd_ 4.1 * 10Py1 Tigard, Oregon 97? (503) 639-4 17 1 Receipt 272004000001~li+iKii. 4: Date: 08/10/2004 Line Items: Case No Tran Code Description Revenue Account No Amount l'aid HOP2004-00099 [LANDUS] Type I Permit Fee 100-0000-438000 32 Line Item Total: $32.00 Payments: Method Payer User ID Acct./Check Approval No. How Received Amount Paid Cash ALLEN & ANN PERONT CAC In Person 1.00 Check ALLEN & ANN PERONT CAC 3616 In Person 31.00 Payment Total: $32.00