HOP2014-00026 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENV 0 1 0
III _ Request Permit Action f
q O /y/ y
I I c i,\R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd.,Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: p Owner dApplicant ❑ Contractor Mr City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) Ryan Walker
Mailing Address: I26O5 SW 2ZTI-h AVM,
City/State/Zip: —II 3ard , OR 97223
Phone No.: 503--1S1 —q -1 O/4
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
I� CANCEL/VOID PERMIT APPLICATION.
[� REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: 1-40P 20 N — p���,.,26
Site Address or Parcel#: 12605 SW 122+ t Ave.
Project Name: Wa 5 Wal ICl r J
Subdivision Name: -- Lot #:
EXPLANATION: Perm i- rec ces io cancel HOP 611-�
business Ii censer; 8o% re&nci -ro,r HOP
Signature: 4 / Date: 7 f2f IY
Print Name: Tim \ P h c,!h 94.eV La PO 20 = 74 •PO /9,2.0
/`1. et) NPe%, = //, .?d .2.P-0
Refund Policy p -"" '
I. The Community Development Director or Building Official may authorize the refund of: nU,_,,�r °� '
a) any fee which was erroneously paid or collected. 2 Z% ve, /L67#INIEA
b) not more than 80%of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80%of the land use application fee for issued permits.
d) not more than 80%of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80%of the building permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Rte to S s Admin: Date MIMI Rte to r.-. kdmin: Date k AWZI' B' 447
Refund Processed: Date 8 / By ■d ' Invoice Processed: Date By
Permit Canceled: Date e/ y/ By ,t_.d Parcel Tag Added: Date By
Receipt# Date Method Amount$
I:\Building\Forms\RegPemutAction_062614.doc
II a
,
T I GARD
City of Tigard
August 21, 2014
Ryan Walker
12605 SW 128`h Ave.
Tigard, OR 97223
Re: Permit No. HOP2014-00026
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 12605 SW 128`h Ave.
Project Name: Woof! Dog Walking
Job No.:
Refund Method: ❑ Check#214739 in the amount of$88.00.
❑ Credit card "return" receipt in the amount of$ .
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account"deposit" receipt in the amount of$ .
Comment(s): Per applicant's request to cancel permit. Refund 80% of application fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Ryan Walker DATE: 8/14/2014
12605 SW 128th Ave.
Tigard, OR 97223 REQUESTED BY: Dianna Howse
TL
TRANSACTION INFORMATION:
Receipt#: 196035 Case#: HOP2014-00026
Date: 5/14/2014 Address/Parcel: 12605 SW 128th Ave.
Pay Method: Check Project Name: Woof! Dog Walking
EXPLANATION: Per applicant's request to cancel permit. Refund 80%of application fees per Tim
Lehrbach.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Home Occupation Permit-Type I 100-0000-43116 $76.80
Home Occupation Permit-Type I-LRP 100-0000-43117 fit A+ BD'
TOTAL REFUND: $88.00
APPROVALS: SIGNATURE/SATE:
If under$5,000 Professional Staff
under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: _ Date: I c/.//y By: 4y
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
CITY OF TIGARD HOME OCCUPATION PERMIT
of COMMUNITY DEVELOPMENT Permit#: HOP20 1 4-00026
13125 SW Hall Blvd.,Tigard OR 97223 503.718 2421 Date Issued: 05/14/2014
TIGARD Parcel: 2S104AD02000
Jurisdiction: Tigard
Applicant Name: Woof!Dog Walking
Business Address: 12605 SW 128TH AVE
Nature of Business: Home occupation permit for a dog walking business located at 12605 SW 128th Avenue.
Business Name: Woof! Dog Walking Generate Extrn Noise: No
Sq Ft-Detached: 0 Days/Hours of Operation: 8am-7pm
Sq Ft-Residence: 1958 Bus.Vehicles Garaged @ Res: one
Sq Ft-Business: Outside Storage: none
SIC Code: Exterior Sign?: No
Paid Non Res Empl: No
Cust/Client @ Res: No
Pick/Deliv @ Res: No
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 \J Permittee Signature
• . RECEIVED
: . g 1111 City of Tigard MAY 1 4 2014
TIGARD
Home Occupation — Type I App ,r; •�u'y GARD
F WEERI∎
GENERAL INFORMATION ` 1 /� �j ^�
Property Address/Location: k oZ(c� ia.ce ` P v —V80,6 oe 1 C s a. 3
Tax Map&Tax Lot#: 21 141 AD 02000 Zone:
Property Owner/Deed Holder(s)*: faa L S. Lu. + Lorna k. LAC.. p� ,, `r
Address: I of Ip 0 S S ) I oZ b C i twg, Phone: GO - a TO-T S30
City/State: Ti q,A•l('Q/ 0ie Zip: l? 2.3
Applicant*: 9j'J \ WQ.kW
Address: \�-( OS SW off-v R\i - Phone: C v `3 J 1 e 11
City/State: TS , ` r Zip: 0 R E-mail: � Qifl ?Cob t ZZ_e 3rnc61, CO M.
Business Name: 1")°°T ,• T)C W�1 ∎`n•
Nature of Business: DO,' uk.kx11/ ,‘„, �J
Business Phone: 6.03 -781 1 l o il
*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
FOR STAFF USE ONLY REQUIRED SUBMITTAL ELEMENTS
Case/PLn it No.: 411 V...J -- OA 1
Filing Fee Rec'd: WM
Receipt No. ti 0 ,❑ Application Form
Application Approve By I AI
Date Approved: 114 L Owner's Signature/Written Authorization
Co�mp�Plan/Zone Designation: Proof of Business License Certificate
12 Deity. 1 1 P\t5 _..,2(Filing Fee
Business License Paid Yes V No ❑
Business License Receipt No. _COD S/
Revised: 6/24/2013
I:\CURPLN\Macterc\Land the Application%\Home Occupation-Type 1.doc
City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2421 I www.tigard-or.gov I Page 1 of 2
HOME OCCUPATION CONDITIONS AND STANDARDS
1. Home occupations may be undertaken only by the principal occupant(s)of a residential property;
2. There shall be no more than three deliveries per week to the resident by suppliers;
3. There shall be no offensive noise,vibration,smoke,dust,odors,heat or glare noticeable at or beyond the property line resulting from the
operation.Home occupations shall observe the provisions of TDC Chapter 18.725(Environment Performance Standards);
4. The home occupation shall be operated entirely within the dwelling unit and a conforming accessory structure. The total area which may
be used in the accessory building for either material product storage and/or the business activity shall not exceed 528 square feet.
Otherwise,the home occupation and associated storage of material and products shall not occupy more than 25 percent of the combined
residence and accessory structure gross floor area. The indoor storage of materials or products shall not exceed the limitations imposed
by the provision of the building,fire,health and housing codes;
5. A home occupation shall not make necessary a change in the Uniform Building Code use classification of a dwelling unit. Any accessory
building that is used must meet Uniform Building Code requirements.
6. More than one business activity constituting two or more home occupations shall be allowed on one property only if the combined floor
space of the business activities does not exceed 25 percent of the combined gross floor area of the residence and accessory structure.
Each home occupation shall apply for a separate home occupation permit,if required per this chapter,and each shall also have separate
Business License Certificates;
7. There shall be no storage and/or distribution of toxic or flammable material,and spray painting or spray finishing operations that involve
toxic or flammable material which in the judgment of the Fire Marshall pose a dangerous risk to the residence,its occupants, and/or
surrounding properties. Those individuals who are engaged in home occupation shall make available to the Fire Marshall for review that
Material Safety Data Sheets which pertain to all potentially toxic and/or flammable materials associate with the use;
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:
a.) Auto-body repair and painting,
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.
10. There shall be no exterior storage of vehicles of any kind used for the business except that one commercially licensed vehicle of not more
than three-quarters ton GVW may be parked outside of a structure or screened area.
In addition,a Home Occupation Type I shall not permit:
A. Outside volunteers or employees to be engaged in the business activity other than the persons principally residing on the premises;
B. Exterior signage which identifies the property as a business location;
C. Clients or customers to visit the premises for any reason;and
D. Exterior storage of materials.
I (applicant) hereby certify that I have read and understand the above conditions and standards for the operation of a home
occupation. I acknowledge that this home occupation approval may be revoked if the above conditions and standards have not
been complied with and/or the home occupation is otherwise being conducted in a manner contrary to the Tigard Community
Development Code (18.742). Revocation due to a violation of the home occupation requirement(s) cannot be renewed for a
um period of one year(18. 42.080).
App s Signature Date
04411k, )(2- C) tt._ C 14— I
Owner's Signature Date
Owner's Signature Date
Authorized Agent's Signature Date
RciCk0 W eX MC• 0-03 -7E3, 1 — q `1° `I
Print Name Title Phone Number
City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2421 I www.tigard-or.gov I Page 2 of 2