Certificate of Occupancy 411,, c ITY OF T' GA R D CERTIFICATE OF OCCUPANCY
PERMIT #: MST2000 -00164
DEVELOPMENT SERVICES DATE ISSUED: 06/12/2000
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115BC -18100
ZONING:
JURISDICTION: KIN
SITE ADDRESS: 16688 SW QUEEN ANNE AVE
SUBDIVISION:
BLOCK: LOT:
CLASS OF WORK: ADD
TYPE OF USE: SF
TYPE OF CONSTR: 5N
OCCUPANCY GRP: R3
TENANT NAME:
REMARKS: void BUP2000 -00212 and made this permit Adding 220 sq ft to existing house
Owner:
JACKSON, GEORGE R AND
JOYCE M
16688 SW QUEEN ANNE AVE
KING CITY, OR 97224
Phone:
Contractor:
CEDAR MILL CONSTRUCTION COMPAN
PO BOX 1826
BEAVERTON, OR 97075
Phone: 503 - 349 -6404
Reg #: LIC 131345
This Certificate issued 07/21/2000 grants occupancy of the above referenced building or
portion thereof and confirms that the building has been inspected for compliance with the
Sta a of Oregon Specialty Codes for the group, occu . . ncy, . nd -. a under which the
re rence ermit s is ued. /
NO ti,P0:4' 0 10
B DING INSPECTO BUIL ' Ii . OFFICIAL
POST IN CONSPICUOUS PLACE