HOP 26-80 12750 SW KATHERING 5
ROSE MPD IE , DISTRIBUTOR HO.?
12750 SW Katherine 26_86
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HOME OCCUPATION PERMIT APPLICATION
(Reference Ordinance ,
Passed )
APPLICANT
ADDRESS -
V[�idly
TELEPHONE NUMBER_,
TAX MAP
TAX LOT ZONE DESIGNATION
BUSINESS NAMEE�`���Q,
ADDRESS
' 97.?a.3.._BUSINESS TELEPHONE NUMBER 6'39- S Yy9
NATURE OF THIS REQUEST. BE SPECIFIC.
ee
This application shall be submitted to the- Planning Director for
review . Certain conditions may be added to the approval of this
Permtt . You are hereby notified .
Prior to commencement of business . you will obtaLn a. Business License .
LICENSE NUMBER
APPLICAT_ A FOR BUSINESS LICENSE
• CI1V OF TIGARD
• 12420 S.W. Main Street
P.O. Box 23397
Tigard, Oregon 97223
DATE: ^�(�2
RECEIPT"': -7c, {
LICENSE":
AMOUNT: ? (:
USINESS NA:IE:
BUSINESS TELEPHONE NUMBER: 3 9- S yy9
USINESS ADDRESS: J 7-57/) wee � q�g,FC 20
TYPE OF BUSINESS: ��tcLrtlCt:lc� T��r Ll:uci�rr lcL�Lr_
DITIONAL INFO. : # of employees, # of company vehicles, # of customer visits per day, operation
hours, sq. ft. bldg..
ILING ADDRESS (IF DIFFERENT TPP,11 ABOVE)
'Ax MAP A A — TAX LOT
DAME & TITLE OF APPLICANT: I) 1���.��P
SIGNATURE:
ELEPHONE NUMBER OF APPLICANT:
AME(S) OF OWNER(S) : a�
77L�c/1.S
F CONTRACTOR, STATE NUMBER:
DTE: SOLICITATION OR SALES "DOOR TO DOOR" ARE PROHIBITED WITHIN THE COMMUDTITY. BU. TtJ^5S
LICENSES WILT, NOT BE ISSUED FOR SUCH ACTION.
CTION TAKEN: APPROVED BY:C --' — DATE:
DENIED BY DATE:
REASON:
CONDITIONS: