HOP1994-00112 City of Tigard, Oregon
• FOR STAFF USE ONLY
HOME OCCUPATION APPLICATION CASE NO. \ 6k. u-\ - I o�
CITY OF TIGARD, 13125 SW Hall, . OTHER CASE NO'S:
Tigard, Oregon 97223 - (503) 639 -4171 RECEIPT NO.
APPLICATION ACCEPTED BY:
DATE: IL '4
1. GENERAL INFORMATION Applic ation elements submitted:
PROPERTY ADDRESS/LOCATION 9150 SO (oho Puc ,/ c (A) Application form (1)
T ID)Q.ict / Og IV - (B) Owner's signature/written
TAX MAP AND TAX LOT NO. tS1 -3 PA 005 authorization •
One L\ . n' (C) Title transfer instrument (1)
SITE SIZE I V (D) Plot plan (1 copy)
t
PROPERTY OWNER/DEED HOLDER * Kl� r'fak1G.r. 'MASA (E) Applicant's statement (1 copy)
ADDRESS S tugte PHONE "Ae.ftierel V (F) Filing Fee $10 - Type I
CITY ' "'.� 1 ZIP _f Filing Fee $50 - Type II
P°
A ICANT* ' ZUI ' 4& IDA4
AESS S PHONE
CITY ' I E
ZIP DATE DETERMINED TO BE COMPLETE:
BUSINESS NAME 1.U6 Ll�•i�( 1 1- 3 l 1
When the owner and the applicant are different people, the
applicant must be the purchaser of record or a lessee in FINAL DECISION DEADLINE:
possession with written authorization from the owner or an
agent of the owner with written authorization. The owner(s)
must sign this application in the space provided on page two COMP. PLAN/ZON DESIGNATION:
or submit a written authorization with this application. t
2. PROPOSAL SUMMARY
The owners of record of the subject property N.P.O. Number:
request approval of a home occupation to
allow specific) Con 5 Iiu-s o.e . e
4kcnc tJo Wr,.lk•in chic Nanning Director , proval Date
•
ness Tax:
3. Specify whether you are using a detached building on
your property and give djr eensions:
(( — Pp roJc
3. List any variance or other land use actions to be considered as part of this application:
4. Applicants: To have a complete application you will need to submit attachments 1111
described below:
A. One application form with signature or written authorization
B. One copy of the title transfer instrument (eg. deed)
C. One copy each of the attached question sheet and floor plan
D. . Filing fee: Type I - $10 Type II - $50
5. THE APPLICANT(S) SHALL CERTIFY THAT:
A. The above request does not violate any deed restrictions that may be attached
to or imposed upon the subject property.
B. If the application is granted, the applicant will exercise the rights granted In
accordance with the terms and subject to all the conditions and limitations of
the approval.
C. 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.
D. The applicant has read the entire contents of the application, including the s
policies and criteria, and understands the requirements for approving or denying
the application.
DATED this
a"'l day of Nt\A,1 , 19 ° y y' .....
SIGNATURES of each owner (eg. husband and wife) of the subject property.
kCIAAJt S. ROAL
LA. a - � ►� 4
Revised 11/21/91
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TO APPLY FOR A HOME OCCUPATION PERMIT, PLEASE ANSWER THE FOLLOWING
QUESTIONS:
III 1. Will you have any paid employees working in the home in conjunction with the
business who are not residents of the home?
2. Will you have customers/clients coming to your residence? If so, how many per day?
0
3. Will you have deliveries or pickups made of products or supplies to your residence? If
so, how many and what type?
4. What will your hours and days of operation be?
9 - 5
5. Will the business generate any noise which can be heard outside of the structure?
\D
6. How many square feet is your residence and how many square feet will be devoted to
the operation of your business, including storage areas?
1 \ 00 D 5o0
7. What vehicles will be associated with the business that are garaged at the residence?
q on,,fi t ck-t beAty 151.144f
8. Do you intend to store any materials, vehicles or products outdoors at the premises in
conjunction with the business?
9. Will you have any signs or advertising visible from the exterior of the premises?
1D
10. Please show the floor layout of your house and the area to be used for your home
occupation on the attached graph paper. Please designate those areas which shall be
utilized 1) entirely for the home occupation and 2) partially for the home occupation.
Please designate the approximate dimensions of the rooms(s) to be used for the home
occupation.
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