HOP 11-80 9370 SW OMARA STREET ::. - ,_s..::�,,.,:.,_� ,.nfMt`M..�.Ywar+�........._........._..,............aw..w+ _..___..�.+ww.,....w............+,.+..�r .wr...r..w.w.
ROUSSE, JERRIE HOP 11-80
9370 SW Omara St.
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HOMY, r"":UPATION PERMIT APPLICATION
( , It ,ANCE # 79- 12
i 1,38M io%x-/7 9
APPLICANT .r_J - ��-(�
r7
BUSINESS NAME ,e
HOME/BUSINESS ADDRESS G��' j C� LA
HOME TFUEPHONE NUMBER� — pQ BUSINESS TELEPHONE NUME3ER
TAX MAP # TAX LIT #
ZONE DESIGNATION
i
NATTTRE OF THIS RFQU`&ST . . . BE S P E C I F I C . . . . . . . . . . . . . . . . . . .. . . .
This application shall be submitted to the Planning Director for review. Certain
conditions may be added to the approval of this permit.
Prior to commencement of business, you will obtain a Business License.
LICENSE NUMBER _
SIGNATURE DATE
10/22/79%im!
APtLICATION FOR BUSINESS LTCENSE
CITY OF TIGARD
• 12420 S.W. Main StrPot
P.O. Box 23397
Tigard, Oregon 97223
PFCEIPTT: LZ
-5
73
AMOUNT:
BUSINESS NA.,LE:
BUSINESS TELEPHONE NUMBER:
BUSINESS ADDRESS: "!m
TYPE OF BUSINESS: �)c
ADDITIONAL INFO. : # o'; employe^_s, # of company vehicles, # of customer visits per day, operation
hours, sq. ft. hidg.. r �_ _-- -----
!JAILING ADDP.ESS (II' DYFFERENT THAN ABOVE)
TAX MAPF +_ TAX LOT
NMIE +Y TITLE OE APPLICANT: J,:E k 9 /f
SIGNATURE: 4
TELEPHONE NUMBER OF APPLICANT:
N A.*(S) OF OWNER(S) :
IF CONTRACTOR, STATE NUMBER:
NOTE: SOLICITATION OR SALES "DOOR TO DOOR" ARE PROHIBITED WITHIN THF COM11-1UNITY. BUSINESS
LICENSES WILL NOT BE ISSUED FOR. SUCH ACTION.
ACTION TA_uB:i: APP?OVED.BY:�./ � DATE:
DENIED BY DATE:
REASON:
CorIUI'PIONS���� �v