HOP2006-00074 .f. .q
a CITY OF TIGARD HOME OCCUPATION PERMIT
° TYPE: I
° DEVELOPMENT SERVICES PERMIT HOP2006-00074
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/28/2006
APPLICANT NAME: CHRISTINE FITZGERALD
BUSINESS ADDRESS: 10835 SW TIGARD ST
PARCEL: 1S134DD-00501 ZONING: R-4.5 JURISDICTION: TIG
NATURE OF BUSINESS: Type I HOP for skin care, facials, body treatments, waxing, glycolic peels and
microdermabrasion
BUSINESS NAME: SKIN RITUALS DAY SPA
SO FT - DETACHED: GENERATE EXTRN NOISE:
SO FT - RESIDENCE: DAYS/HOURS OF OPS :
SO FT - BUSINESS: BUS. VEHICLES GARAGED @ RES: 1
SIC CODE: OUTSIDE STORAGE:
PAID NON RES EMPL: EXTERIOR SIGN?: N
CUST/CLIENT @ RES:
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
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Planning Division
Request for Permit Action or Refund
TO: CITY OF TIGARD
Permit System Administrator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960
FROM: ❑ Owner ❑ Applicant ❑ Contractor ® City Staff
(check one)
1 D Name: Christine A. Fitzgerald
(Business or Individual)
Mailing Address: 10835 SW Tigard St.
City/State/Zip: Tigard, OR 97223
Phone No.: 620-4761
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED
® CANCEL PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach receipt, if available).
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit # : HOP2006-00074
Site Address or Parcel # : 10835 SW Tigard St.
Project Name: Fitzgerald HOP Type I
Subdivision Name: Lot
EXPLANATION: Created case in error- should have been for a Type II application. I
reversed the check transaction in Cashier and will return the check to
the applicant. Check amt. $48.16
Signature: 'Date: 8/16/06
Print Name: Shirley Tre t
Refund Policy
1. T1te Director may authorize the refund of:
a) any fee which was erroneously paid or collected.
h) not more than 80 percent of the application fee when an application is withdrawn or canceled before any review effort
has been expended.
Refunds will be mnuned to the original Pa}rr in the same method in which payment was received.
FOR OFFICE USE ONLY
Rte to Sys Admin: Date B Rte to Bldg Admin: Date B
Refund Processed: Date B Invoice Processed: Date B
Permit Canceled: Date r,2,P B Parcel Tag Added: Date B
Receipt # Date Method Amount $
I:ACRtsideATidemark\Fomis\RegPenntAction-Ping.doc Rev 02127106
CITY OF TIGARD
13125 SW Hall Blvd, 8/16/2006
Tigard, Oregon 97223 2:33:14PM
e (503) 639-4171
Refund Receipt 27200600000000004127
Date: 08/16/2006 p
Line Items:
Case No Tran Code Description Revenue Account No
Amount Paid
HOP2006-00074 Refund - [LANDUS] Type I Permi 100-0000-438000
(34.00)
HOP2006-00074 Refund - [LRPF] LR Planning Su 100-0000-438050
(5.00)
BUSTAX Business Tax - 9.1600 @ $1.0000 100-0000-430000 (9.16)
Line Item Total: ($48.16)
Refund:
Method Payer User m Acct./Check No. Approval No. How Received
Amount Paid
Check Refund CHRISTINE FITZGERALD 1225 In Person (48.16)
Refund Total: ($48.16)
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CITY O1+' '1'1GARD 01 L V/ ~Vvv
v 13125 SW Hall Blvd. 10`.01:46AM
Tigard, Oregon 97223
n (503) 639-4171
Receipt 27200600000000004114
Date: 08/16/2006
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
HOP2006-00074 [LANDUS] Type I Pcrmit Fee 100-0000-438000 34.00
HOP2006-00074 [LRPF] LR Planning Surcharge 100-0000-438050 5.00
BUSTAX Business Tax - 9.1600 @ $1.0000 100-0000-430000 9.16
Line Item Total: $48.16
Payments:
Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid
Check CHRISTINE A FITZGERALD ST 1225 In Person 48.16
Payment Total: $48.16
cReceipt.rpt Page 1 of 1