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HOP2005-00096 CITY OF TIGARD HOME OCCUPATION PERMIT TYPE: I DEVELOPMENT SERVICES PERMIT HOP2005-00096 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/21/2005 APPLICANT NAME: SHIRLEY STEELE BUSINESS ADDRESS: 15920 SW CENTURY OAK CIR PARCEL: 2S111CC-05200 ZONING: R-7 JURISDICTION: TIG NATURE OF BUSINESS: Home occupation type 1 for online medical billing. BUSINESS NAME: SHIRLEY STEELE 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: NO 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). Approved By Permittee Sig ature I HOME OCCUPATION i TYPE I APPLICATION CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 FAX: (503) 684-7297 GENERAL INFORMATION /~c1o74 CS.~,f. 06n11-,-pvy DAB CSR. Property Address/Location:1 hRI) CR. FOR STAFF USE ONLY Tax Map & Tax Lot r~ nZonCe:: Property Owner/Deed Holder(s)*: GA•(J~•{J~ ff _ X37-E/..E Case/Permit No.: Hop-. 0-6 -rJ~is`~h Address:,NdqLL(& AS 4J-;;0J[6- Phone:sb3-Oq-47- Filing Fee Rec'd.:$ _38 . o0 i City: IP-T) lJ zip: Receipt No.: D 05 - (a`I ~0 Application Approved By: C C C 2~ Applicant*: <Sf/I6~ ST~~.Z Date Approved: i -q Address: ~,YAA1E 49& R/3D'✓ Phone: Business Phone: Comp Plan/Zone Designation: Ni ed j) e, t v %R `7 City: Zip: Business Name: ~S.1 E Business Tax Paid? Yes ❑ No Nature of Business: A V1 zIA11"l Business Tax Receipt No. f. n J 11F a j ~/0 ~~~(n Rev. 11/15/05 \curpln\masters\revised\hop1.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 ✓ Application Elements Submitted: THE APPLICANT SHALL CERTIFY THAT: ✓ The above request does not violate any deed restrictions that ❑ Application Form may be attached to or imposed upon the subject property. ❑ Owner's Signature/Written Authorization ✓ If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the ❑ Proof of Business Tax Certificate conditions and limitations of the approval. ❑ Filing Fee: $38.00 ✓ 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. ✓ 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 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 App 'c is $i nature: to all potentially toxic and/or flammable materials associate with the use; Date: 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: W414 ner's ig a ur . - a.) Auto-body repair and painting; 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 CITY OF TIGA" 12/21/2005 13125 SW Hall Blvd. 2:17:42PM Tigard, Oregon 97223 (503) 639-4171 Receipt 27200500000000006446 Date: 12/21/2005 Line Items: Case No Tran Code Description Revenue Account No Amount Paid HOP2005-00096 [LANDUS] Type I Permit Fee 100-0000-438000 33.00 HOP2005-00096 [LRPF] LR Planning Surcharge 100-0000-438050 5.00 Line Item Total: $38.00 Payments: Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid Check SHIRLEY STEELE CAC 1006 In Person 38.00 Payment Total: $38.00 cRcceipt.rpt Page l of 1 January 1999 James T. Steele III and/or Shirley L. Steele Dear James and/or Shirley: Enclosed is General Power of Attorney which you are to hold and use as you deem necessary when you become successor Trustee of the Steele Family Trust U/I/D January 1999. Until that time you are not to use the General Power of Attorney. Very truly yours, Emma A. Steele „ 654 - GENERAL POWER OF ATTORNEY - DURABLE - (Short Form) COPYRIGHT 19W STEVENS-NESS LAW PUBLISHING CO., PORTLAND, OR 9720: STATE OF OREGON, l J ss. POWER OF ATTORNEY County of I I certify that the within instrument was received for record on the day j of _ , 19 at l Emma A.___Steele________ o'clock M., and recorded in - - ~I book/reel/volume No. on page SPACE RESERVED and/or as To FOR fee/file/instrument/microfilm/reception No. RECORDER'S USE Records of said Count i arn~ _ T ~__~t<ee~ I_1_-_an.-d.,/-Q---------- - Y• Shirley _L., _-5_te-e le Witness my hand and seal of County ii affixed. I' il I After recording, return to (Name, Address, Zip): f I NAME TITLE I j II B Deputy Y I E__MM_ I,t KNOW ALL BY THESE PRESENTS that I , A __A ,__STEELF have made, constituted and appointed, and b these resents do hereby make constitute and appoint _ and/ or__SHI RLEY _ L~__~TEI~J,E - I i my true and lawful attorney for me and in my name, place and stead, and for my use and benefit: to demand, sue for, recover, collect and receive all such sums of , I money, debts, rents, dues, accounts, legacies, bequests, interests, dividends, annuities and demands whatsoever, as are now or shall hereafter become due, owing, i payable or belonging to me; to have, use and take all lawful ways and means in my name or otherwise for the recovery thereof, and to compromise, settle and adjust I; and to execute and deliver acquittances or other sufficient discharges for any of the same; to bargain, contract for, purchase, receive and take lands, tenements, here- ditaments, and accept the seism and possession thereof and all deeds and other assurances in the law therefor, and to lease, let, demise, bargain, sell, remise, release, convey, mortgage and hypothecate lands, tenements and hereditaments, including my right of homestead in any of the same for such price, upon such terms and con- ditions and with such covenants as my attorney shall think fit; to sell, transfer and deliver all or any shares of stock owned by me in any corporation for any price and Il receive payment therefor, and to vote any such stock as my proxy; to bargain for, buy, sell, mortgage, hypothecate and in any and every way and manner deal in and I . I with goods, wares and merchandise, choses in action, and other property to possession or in action, and to make, do and transact all and every kind of business of whatsoever nature or kind; for me and in my name and as my act and deed, to sign, seal, execute, acknowledge and deliver all deeds, covenants, indentures, agree- ments, trust agreements, mortgages, pledges, hypothecations, bills of lading, bills, bonds, notes, evidences of debt, receipts, releases and satisfactions of mortgages, judgments and other debts payable to me and other instruments in writing of whatever kind and nature which my attorney in his/her absolute discretion shall deem to be for my best interests; to have access to any safe deposit box which has been rented in my name, or in the name of myself and any other person or persons; to sell, discount, endorse, deliver and/or deposit all checks, drafts, notes and negotiable instruments payable to my order; to withdraw any moneys deposited in my name with any bank, by check or otherwise, and generally to do any business with any bank or banker on my behalf; to complete, sign, and deliver any tax return or form and pay taxes thereon or collect refunds therefrom-, also To make changes in or to exercise any rights and options which I have in any annuities, in my capacity as owner, annuitant, beneficiary or otherwise, consistent, however, with my estate plan set out in any trust or will j in effect at that time. No issuer of an annuity or other person or entity will be responsible to oversee or verify I that my attorney in fact is following these instructions and shall have no liability whatsoever in following the instructions of my attorney in fact. GIVING AND GRANTING unto my attorney the full power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done in and about the premises, as fully to all intents and purposes as I might or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that my attorney shall lawfully do or cause to be done by virtue of these presents. This power shall take effect (delete inapplicable phrase): (a) on the date next written below; i ! If neither p raseis e ete t is power sato e e eft on t e ate next wntten e ?ow. rfed~~~ My attorney and all persons unto whom these presents shall come may assume that this power of attorney has not been revoked until given actual notice either of such revocation or of my death. In construing this instrument, and where the context so requires, the singular includes the plural. 4 I ~i l IN WITNESS WHEREOF, I have hereunto set my hand on J_ s3riLtiaXy------ 19-9-9-. I EMMA A. STEELE ;i STATE OF OREGON, County of Washington--___-----_-) ss. 1 ! This instrument was acknowledged before me on JanuarY------- 19_9 9_ bY Emma --A=--Steele-------------------------- ii ~I OFFICIAL SEAL - - 1 CHARLES J I IC CLURE - NOTARY PUBLIC-OREGON Notary Public for Ore COMMISSION NO. 304344 MY COMMISSION SION EXPIRES NOV 1 144, ,200 2001 My commission expires i! - CA5C iDE PHY51IC-IATNLS P ~o 19250 S.W. 65TH AVENUE, SUITE 110 dSTRATION TUALATIN, OREGON 97062 503 242-9850 N.W. OFFICE 503 226-4091 CAROLS.BOGARDUS, M.D. FRANK J. KURZ, M.D. DUANE R. IVERSON, M.D. LORRAINE 'NOSKOW, M.D. SAM TAAGEN, M.C. F PMCILLA D. LE, M.D. Re: Emma Steele TUALATIN OFFICE 503 692-1205 January 7, 2005 JEFFREY D. FULLMAN, M.D. GGRDGN L. 1iJOlfE, M.D. J.THOMAS FORSYTHE, M.D. TO Whom It May Concern: SUZANNE MIGCHELdRINK, M.D. Emma Steele suffers from dementia and can therefore no longer BRIDGETOWN OFFICE manage her own affairs or finances,,.-, 503 249-5780 A. PERRY HENDIN, M.D. Sincerely, TIMOTHY RODDY, M.D. LESUE L. ROOT, M.D., PH.D. J. Thomas Forsythe, MD Y L. LaDLEY, M.D. 19250 SW 65th, suite 110 uuANE A. BURROUGHS, M.D. Tualatin, Oregon 97062 1-503-692-1205 1 i ;y 6 v r r 4~ , v I. OR& I Y V,. I y I.YT I I 1,1 + ri r a s!I '~I,IdPr.r i~ < '9I.~r`i°S~w~ X g", 11 N -i TYPE OR 431464 OREGON DEPARTMENT OF HUMAN SERVICES CENTER FOR HEALTH STATISTICS j p PRINT IN PERMANENT I.D. TAG NO, i~ - BLACK INK Local File Number CERTIFICATE OF DEATH State File Number 1. DECEDENTS First Mlddto Last 2, sEX 3. DATE OF DEATH (Month Day, Year) James Thomson STEELE, JR. Male Dec. 31, 2004 4. SOCIAL SECURITY NUMBER 69. AGE-Lest Birthday d r e 6a Under B. BIRTHPLACE (CRY and State or Foreign 7. DATE OF BIRTH (Month, Day, Year) (Years) Mos. Daye Hours Mine.. Country) 522-03-1083 90 , Denver, CO Oct. 2, 1914 yJA B. WAS DECEDENT EVER 1 Be. PLACE OF DEATH (Check one oNy. Ye/ - , .l Ij~U.S,eAFfO FORCES NC ? L{j)SPITAL [I Q~J LJ In t)-t ERADu1paBent ❑ ❑ DOA pTyEg Nuremg Home E] Deoadenre Home El Other (Spedry) A _ F _ _ Bb. FACILITY NAME(Ilrmt an lnsNfufloc, glw aUSer 1 and number.) Be CITY, TOWN, OR LOCATION OF DEATH 9d. COUNTY OF DEATH 1 -k 15920 SW Centur Oak Circle Ti and Washington 2, Ion, DECEDENTS USUAL OCCUPATION 10b. KIND OF BUSINESBBNDUSTRY 11. MARITAL STATUS-Monied, 12, SPOUSE(!( Marled, LMdowod) (Ghw kind of worlr done dudng moor olxvrk7nB file. Never Married Wldowed, agg(USe eNmd.J Dlumad. (Sp6*) Regional Manager Industrial Metals Married Emma A. Lukens f 4, 13a. RESIDENCE - STATE 13b. COUNTY 13.. CITY, TOWN OR LOCATION 13d. STREETAND NUMBER 5 Oregon Washin ton Ti and 15920 SW Century Oak Circle 13e. INSIDE CITE 13f. ZIP CODE 14. WAS DECEDENT OF HISPANIC ORIGIN? 16. RACEAmedcan IndYan, to. DECEDENTS EDUCATION LIMITS? (Specffy No or yes) Nyes, spedry Crdun, Bieck WNle, A,,17, (Spedryl (Sp,C'"* highost grade completed,) 6. Mexican, Pueda RJcan, etc E1.rn. ,y1Socondary (0.12) Coeage (1.4 a fir) M Yes ❑ No 97224 ~J No ❑ Yes Whyte 1 17. FATHER'S NAME FYat Middle Last I& MOTHER'S: NAME Fkst Middle Mad.0 19. INFORMANT'S NAME and relationship <eaaed James T. Steele, SR. Annie DeWar Jame T. Steele, on ~,gg 20a. METHOD OF DISPOSITION 20b. PLACE OF DISPOSITION 20c. LOCATION (City or Town. Stale) q (Name ofcemerery, Crematory, or olherplace.) ® Burlai ❑ Cremallon ❑ Mausoleum ❑ Removal from State Willamette Na t i o n a 1 7 ❑Donauon ❑oher(Spedy) Portland, Oregon 21.AG O OREGON FU VICE LICENSEE OR 21b.ORE00N ENSE NO. ZZ. NAME, DRESS AND ZIP CODE OF FACILITY 6. (0fuc°nd00) Young's Funeral Home 97223 AF-1875 11831 SW 4acifiQ__HWV Tigard, OR B" 2 TE FIL D ( no, M p, Year) - JA 2 2005 24. REGISTRAR'S GNATURE RESERVED FOR REGISTRAR'S USE - ' J ` 10, TOBE.COMPLETED BY CERTIFYING'AW9ICIAN _ _ 27. TIME OF DEATH U. WAS MEOICAL EXAMINER NOTIFIED? (The Medkal Examiner 31a: THE OF OEAtH 31b. DATE PRONOUNCED DEAD (Month, Day,, Year, Hour) ` 11. MUST be noti0ed of all injury and poisoning deaths.) 043.0 M ® Yee ❑ No M M '29, To the bast of my knowledge, de M scarred at the Bme, dale, place, and due to the cause(s) 32. On the basis of.x Inathn and/or Inyesbgation, In my opinlon death occurred en _ d rnannar slated at an 0me, data, Place, and due to the cause(s) and manner stated. 5 (slgnshlreJ (Signehae) 12 30. DATE SIGNED (Mon , D , Y..') 33. DATE SIGNED (Month, Day, Year) COUNTY ~i 13. : 30. NAME, TITLE,ADDRESSANDZJP CODE OF CEFmFIERI EDICALEXAMINER(rypeorPrfnt) 97062 14, John Thomas Forsythe, M. D. 19250 SW 65th AveSt~l 10 TT1a1 at; n r nP DESIGNATE 35. NAME C OFATTENDINO PHYSICIAN IF OTHER THAN CERTIFIER (type orPrlnQ CONDITIONS IF ANY, WHICH GAAVE' 30, IMMEDIATE CAU E (ENTER ONLY ONE CAUSE PER LINE FOR e b AND Do nor enter mode or dying (a.g., Camiao or RespkeroryArracQ. Interval between Dose! RISE O, (Al) IMMEDIATE and death L (b) STAT1TMG 1E UNDEI7LYING DUE TO, OR X SEQUENCE OF: - rvel between onset 2 CAUSE LAST. and death , 40 t {l DUE TO OR ASACON9EDUENCE OF: t rvel behvaen ..at • and death r c r •PART OTHER SIGNIFICANT CONDITIONS - 37. Did tobacco use contribute 38. AUTOPSY 39. IF YES, were findings II Conditions conrneuting to death but not re5Ld&v In the undenyNa cause glen In PART I. to the death? Conelderod In oelennlMng 15. ( C//// ❑ Yos ❑ Probably ❑ Yes cause of death? fl-t L No ❑ Unknmvn ® No. ❑ Yea ❑No DNA 40. MANNNNER OF DEATH At.. I E F INJURY 41b. TIME OF Ate. INJURY d. DESCRIBE HOW INJURY OCCURRED + 16, Fondl (M th, Day, Year) INJURY AT WORK? NetuM ❑ Acddant In," atlan ❑ Yoe 0 Undetermined M ❑ No ❑ Suicide Mann- -)CAUSE OF 419. PLACE OF INJURY-At home, farm, street, factory, olfke Alf. LOCATION (Street and Number or Rural Routs Number, Chy or Town, Slate) ❑ DEATH Homicide ❑-Legal buftng, etc. (Specify) N97RUCTIONS TIONS rventbn ARE RESERVED FOR REGISTRAR'S USE ON REVERSE SIDE T OF GREEN I t, PINK COPY ",11tt1jl, 4k+ D I~l-0 I CERTIFY THAT THIS ISATRUE, FULLAND CORRECT COPY OF THE ORIGINAL CERTIFICATE ON FILE OR THE VITAL RECORD FACTS ON FILE IN THE VITAL RECORDS UNIT OF THE OREGON CENTER F R HEALTH STATISTICS. i(~F ~R'~QU I~/ hi Q - - ~ i i.t, ~ T" ;4i. i JENNIFER A. WOODWARD, Ph.D. i Vt{~~ Yr- # ttr ~h DATE ISSUED: STATE REGISTRAR 1 dr f! y THIS COPY IS NOT VALID WITrr)UT INTAGL O'TAT AL AND BORD R. r( f 1 J.J h tint vir Y t II 41 18 5 9 - itgth~wT" -~~+-.Y:-,~`~~' ~ ~ . i~ ~ t e o -I ' e mt e~j`~ T` L r T° NMI