HOP2006-00050
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a CITY OF TIGARD HOME OCCUPATION PERMIT
TYPE: I
DEVELOPMENT SERVICES PERMIT HOP2006-00050
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/1/2006
APPLICANT NAME: THOMAS ROGERS
BUSINESS ADDRESS: 07185 SW SHADY LN
PARCEL: 1 S125DB-08200 ZONING: R-4.5 JURISDICTION: TIG
NATURE OF BUSINESS: Appliance repair
BUSINESS NAME: TOM ROGERS ENTERPRISES LLC
SQ FT - DETACHED: GENERATE EXTRN NOISE: N
SQ FT - RESIDENCE: DAYS/HOURS OF OPS :
SQ FT - BUSINESS: BUS. VEHICLES GARAGED @ RES: ONE
SIC CODE: OUTSIDE STORAGE: NO
PAID NON RES EMPL: N EXTERIOR SIGN?: N
CUST/CLIENT @ RES: N
PICK/DELIV @ RES: N
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 Perm itte S gnature
04/24/2006 13:22 FAX 5035961960 CITY Ut 11(,AxL
HOME OCCUPATION
TYPE I APPLICATION
CITY OF TlGARD 13125 SW Hall Slvd., Tigard, OR 97223 (503) 639-4171 PAX: (503) 684-7297
GENERAL INFORMATION
Property Address/Location:(~ y L
FOR STAFF USE ONLY
Tax Map & Tax Lot Zone:
Property Owner/Deed Holder(s)': Case/Permit No.: l~l-w
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Address: -t Phone Filing Fee Rec'd.:$
: ~c >
City: l' l Zip, Receipt No.:
Application Approved By:
Applicant': _ Date Approved: ~I i o 7
Address: Phone:
Business Phone: Comp Plan/Zone Dsigna ion:
City: Zip:
Business Name: Business Tax Paid? 0/yes ❑ No
Nature of Business: Business Tax Receipt No.
Rev, 11115105 1lcurp1nVnasters%revised\hop1Am
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:
✓ The above request does not violate any deed restrictions that ❑ Application Form
may be attached to or imposed upon the subiect property.
❑ Owner's SignatureNVrltten 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
V 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 9 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.
I
CITY OF TIGARD 5/1/2006
13125 SW Hall Blvd. 1:49:49PM
Tigard, Oregon 97223
(503) 639-4171
Receipt 27200600000000001959
Date: 05/01/2006
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
HOP2006-00050 [LANDUS] Type I Permit Fee 100-0000-438000 33.00
HOP2006-00050 [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 THOMAS M. ROGERS KJP 3608 In Person 38.00
Payment Total: $38.00
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