City of Lake Oswego
Business License Application
380 A Avenue PO BOX 369 Lake Oswego, OR 97034
Phone (503) 635-0279  Fax (503) 534-5220

I. Proposed business name and type

Application Date: 
Name of business:
 Telephone Number:
If your proposed business is listed below, please place an "X" in the box in front of it:

Adult Foster Care
Car Wash
Delicatessen
Fuel Wholesaler
Laundry
Day Care

 Auto Dealer
Salon
Dental Lab
Gas Station
Manufacturing
Food Processing		 Auto Service
Second Hand Pawn Shop
Dry Cleaners
Gun Dealer
Medical Lab
Nursery		 Bakery
Coffee Shop
Restaurant
  Sit down
  Take out
 
If your proposed business is not listed above, please provide a brief description:
Address City State Zip
Mailing Address (if different) City State Zip
II. BUSINESS OWNER(S) INFORMATION
OWNER NAME EMAIL ADDRESS
ADDRESS CITY STATE ZIP
PHONE NUMBER DRIVER'S LICENSE NUMBER STATE
ADDITIONAL OWNER/OFFICER NAME Email Address
ADDRESS CITY STATE ZIP
PHONE NUMBER DRIVER'S LICENSE NUMBER STATE
III. PLEASE ANSWER THE FOLLOWING QUESTIONS AND COMPLETE ADDITIONAL SECTIONS, IF REQUIRED

1. Including owners, how many people will work under this license in the City of Lake Oswego?

2. Will this business involve door-to-door solicitation in Lake Oswego?

Yes No

3. Will the proposed business involve the use of any toxic, flammable, poisonous, or potentially hazardous materials? (If "yes" fill out section "C")

Yes No

4. Are you a registered Building Contractor with the State of Oregon? (If "yes" complete section "B".)

Yes No

5. Is the location of your proposed business your home in Lake Oswego? (If "yes", read and sign section "A".)

Yes No

6. If this a Home Occupancy business, how many customers do you anticipate coming to your home on a daily basis?

7. Will this proposed business require any interior and/or exterior remodeling requiring a building permit?

 Yes No

8. Will this proposed business require a new sign or modification to an existing sign?

 Yes No

9. If this is a Commercial business, what is the total square footage that will be occupied at the proposed business site in Lake Oswego?

10. If another Commercial business previously occupied the space of your proposed business, please specify what kind of business it was:

11. Is this business a beauty salon or manicure?

Yes  No
If yes, how many stations will be in your shop?

If you answered "yes" to question(s) 4, 5, or 7, please indicate the question number(s) and provide a brief explanation.

SECTION A
HOME OCCUPATION LETTER OF COMPLIANCE

You have applied for a City License to operate a business in a zone that does not permit an outright commercial activity. In this zone, you may operate a business only as a home occupation.

Lake Oswego code 20.02.025 states that:

A Home Occupation may be conducted where allowed by other provision of this chapter if the following conditions are continuously complied with:

  1. The use does not alter the residential character of the neighborhood or infringe upon the right of residents in the vicinity to the peaceful enjoyment of the neighborhood.
  2. A current and valid business license is maintained.
  3. No employees other than family members who reside at the dwelling.
  4. No outside storage of goods or materials other than vegetation.
  5. No more than 25% of the dwelling is devoted to non-residential use.

I understand the provisions of LOC 20.02.025 concerning home occupations, and certify that my business down now and will continue to meet those provisions. (*Typed name will substitute for a handwritten signature.)

(Signed)

SECTION B
BUILDING CONTRACTORS MUST COMPLETE THE FOLLOWING IN ACCORDANCE WITH ORD 701.055(3)
1. Is the business conducted by you subject to regulation by the Builders Board of the State of Oregon under the provisions of ORS 701? Yes  No
2. What is your CCB registration number?
3. What is the expiration date of your registration? (MM/DD/YYYY)

SECTION C
HAZARDOUS MATERIALS INFORMATION

PLEASE NOTE: Your answers to the following questions in this section and/or the nature of your proposed business may require you to complete an Industrial and Commercial Environmental Survey form. These questions and those in the "...Survey", allow the City of Lake Oswego to assess safety issues. While the use of hazardous materials is a common practice and rarely prevents the issuance of a Business License, the amount you use, the way you use it, the kind of building you use it in, and the proximity to other business may be issues that need to be addressed.

1. Does your proposed business involve the storage or use of any flammable materials or supplies? Yes  No
If your answer is "Yes", provide the name(s) of each material and the quantity kept at the business site.
Material Name Amount on premise

SECTION D
OWNER/PRINCIPAL OFFICER SIGNATURE STATEMENT

Owner/Principal Officer represents that I (We) will conduct such business during the year for which the business license is hereby applied for in conformity with all laws of the State of Oregon and Ordinances of the City of Lake Oswego, Oregon.

AFFIDAVIT: I hereby certify that all information is true, correct and complete based on all information of which I have knowledge.

Signature of owner/principal officer (*Typed name will substitute for a handwritten signature.)

SECTION E
BUSINESS LICENSE FEES

Non-refundable Business License Application Fee Schedule:
1-3 Employees (including owners) $75.00
4-10 Employees (including owners) $105.00
11+ Employees (including owners) $145.00
Visa MasterCard  Amount: $ 
Credit Card Number
Expires:  Month:   Year: 
Signature (*Typed name will substitute for a handwritten signature.)