HomeMy WebLinkAboutMiscellaneous Planner 3/8/2023Verification of City/Cou, ..y Approval
Planning and Zoning, Occupancy, and Building Codes
Prior to licensing, you must provide the Office of Child Core with verificotion thot your facility meets local
plonning ond zoning, occuponcy, ond building requirements.*
To be Filled Out by the Child Care Program
Type of License Applying for:
Q negistered Family Child Care Home (RF)
@ Certified Family Child Care Home (CF)
C
C
Certified Child Care Center (CC)
Certified School-age Center (SC)
--. I)tl'..,
Age Range of Children Being Served:
trtr
lnfants/Toddlers
Preschool
Date
Verification of Compliance with city/county ordinances needed because:
ffi r1[:;f[ Not living in the home where care will be providedu (only planning ond zoning opprovol required) r
ffi r,r7Cr Home is converted or additional space, not part of the original living quarters, being used for child care
- (only occupancy ond building codes requiredl
Ct Home is not located in a commercial or residential zone
CC Building may/may not be zoned to operate a child care business
5C School-age only center thot is not in o public schoolmust meet building code and zoning requirements
To be Filled Out by the Appropriate Local Authority
Planning and Zoning Approval
The d child care facility/home is in an approved zone 0 y., O ruo
Site Address:)rtzs \)wa st
(street address)
re authorized representative of Planning and Zoning
Occupancy and Building Codes Approval
The faci meets occupancy and building codes
Signature of authorized representative of Occupancy and Building
I School age
SPvi'''$.frdq.,oro* ,:*r'ql,laa^
Lr
Signa u alN
dor.ro
L3
Date
*Registered Family: OAR 414-205-0150(3) ln instances where care that is subject to registration, as defined in subsection (2) of rule 414-205-0000, will not be
provided in the provider's own residence, the applicant/provider must request and receive approval for an exception prior to providing care at that location. ln all
respects, the location must appear and be arranged as a residence.
Certified Family: OAR 414-350-0130(2) A home that is not the residence of the provider or a home located in a zone other than residential or commercial shall meet
all state and local planning and zoning, occupancy, and building code requirements for a child care facility.
Certified Center: OAR 414-300-0010(12Xa) and (b) An operator shall provide verification to OCC that the center meets all applicable building codes and zoning
requirements that apply to child care (a) Before initial certificate is issued; and (b) Whenever the facility is remodeled.
Certified School-age Center: OAR ce that the school-age center meets all applicable building codes and zoning requirements, unless the
center is in a public school building.
Oregon Administrative Rules (Oregon of Education, Early Learning Division, Chapter 4l-4, Divisions 205 Reqrstered Fanrrly Chtld
iare $cqles, 300 3
23
Date elrOlet
cost. lf you need help in yolr longuoge or other
Signature der rator of Facility
You ore entitled to longuoge ossistonce services ond other occommodotions ot no
occommodotions, pleose contoct the Office of Child Core ot 503-947-L400.
Oregon Department of Education . Early Learning Division . Office of Child Care . www.oregonearlylearning.com I OCC-O108 (LOl22l