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HOP2005-00013 CITY OF T I GA R D HOME OCCUPATION PERMIT TYPE: I DEVELOPMENT SERVICES PERMIT HOP2005-00013 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/24/2005 APPLICANT NAME: DIANE BOHAN BUSINESS ADDRESS: 14115 SW FERN ST PARCEL: 2S10413C-00600 ZONING: R-7 JURISDICTION: TIG NATURE OF BUSINESS: Home occupation type 1 for long arm quilting business. BUSINESS NAME: DIANE'S QUILTING SERVICES 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 EXTERIOR SIGN?: N CUST/CLIENT @ RES: 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). C 0 (`C~c rZ G~ GCS Approved By Permittee Signature _ 02'16,'2005 14:39 FAX 5035981860 CITY OF TIGARD OU2 HOME OCCUPATION TYPE I APPLICATION CITY QF TIOARD 13125 SW Nall Blvd., Tigard, OR 97223 (503) 639-4171 FAX: (503) 684-7297 GFNERAI- INFORMATION Property Address/Location: Tax Map & Tax Lot o~ 1J ' ~~00 Zone: ' . z'S~ FOR STAFF USE ONLY Property OwneriDeed Holder(s): Case!Permit No.: ~ D I d005 o y0) ~ ` Address: /ll S S F~ ► ► ~~T Phone: Other Case No-(s): City, , r GD Yoh - zip: 7~3 Filing Fee Rec'd.:$ 1 Oy Applica~ntx;,l: t Q y 7a Receipt No.: Oc)5 Phone: Jd3sa ~ . ~ Appliciaticn Approved By: 0 • 0uL., Address: l S SuJ 5- Date Approved: A Business Phone: City: Zip: 7aZ Comp Plan)Zone Des'7 ation: r/iC~S Ned D~'~ t2eR- 7 Business Name: P S Business Type Code: 1 Nature of Business: L Business Tax Paid? C] Yes ❑ No Business Tax. Receipt No. --d~-~-~-- Rev. 113/06 i:lcurplnimssnerslrevisedthopl.Clot 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: V The above request does not violate an deed restrictions that may to attached to or imposed upon the subiect property. ~ Application Form If the appl?cation is granted, the applicant will exercise the rights ❑ Owner's SignatureNVritten Authorization granted in accordance with the terms and subject to all the conditions and limitations of the approval. ❑ Proof of Business Tax Certificate All of the above statements and the statements in the plot plan, Filing Fee: $37.00 attachments, and exhibits transmitted herewith, are true: and the applicants so acknowledge that any permit 43ued, based on this application, may be revoked it it is found that any such statements are false. 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 2/24/2005 13125 SW Hall Blvd. 12:02:24PM Tigard, Oregon 97223 (503) 639-4171 Receipt 27200500000000000793 Date: 02/24/2005 Line Items: Case No Tran Code Desc0ption Revenue Account No Amount Paid HOP2005-00013 [LANDUS] Type I Permit Fee 100-0000-438000 32.00 HOP2005-00013 [LRPF] LR Planning Surcharge 100-0000-438050 5.00 Line Item Total: $37.00 Payments: Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid Check DIANE E BOHAN CAC 1016 In Person 37.00 Payment Total: $37.00