Certificate of Occupancy (10) CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Permit #: BUP2010 -00150
• COMMUNITY DEVELOPMENT Permit Issued: 06/29/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S136DD05300
Jurisdiction: TIGARD
Site address: 11850 SW 67TH AVE, STE# 210
Subdivision: TIGARD TRIANGLE COMMONS Lot: 13
Project Description: TI
7/2/2010: REPRINTED TO CORRECT SITE ADDRESS.
Class of Work: ALT
Type of Use: COM
Type of Constr: IIIB
Occupancy Group: B
Occupancy Load:
Fire Sprinkler Required: Yes
Project Name: American Family Insurance
Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
Phone: 503 - 624 -6300
Contractor: TRIANGLE CONSTRUCTION LLC
35155 NE ROCKY HILL RD
NEWBERG, OR 97132
Phone: 503 - 625 -9194
Fax:
This Certificate issued 7/16/2010 grants occupancy of the above referenced building or portion thereof
and confirms that the building has been inspected for compliance with the 2010 State of Oregon Specialty
Codes for the group, occupancy, and use under which the referenced permit was issued.
Mark VanDomelen
Building Official
City of Tigard
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