Certificate of Occupancy 74 CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Permit #: MST2010 -00007
COMMUNITY DEVELOPMENT Permit Issued: 03/05/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S109DD09600
Jurisdiction: Tigard
Site address: 15623 SW RAPHAEL LN
Subdivision: BELLA VISTA Lot: 26
Project Description: New SF
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R -
Occupancy Load:
Fire Sprinkler Required:
Project Name: Bella Vista
Owner: RIVERSIDE HOMES INC
17933 NW EVERGREEN PKWY #370
BEAVERTON, OR 97006
Phone: 503 - 645 -0986
Contractor: RIVERSIDE HOMES LLC
17933 NW EVERGREEN PKWY 370
BEAVERTON, OR 97006
Phone: 503 - 645 -0986
Fax: 503 - 690 -2942
This Certificate issued 6/22/2010 grants occupancy of the above referenced building or portion thereof
and confirms that the building has been inspected for compliance with the 2008 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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