Certificate of Occupancy CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Permit#: MST2015-00057
COMMUNITY DEVELOPMENT Permit Issued: 06/17/2015
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S110BA11200
Jurisdiction: TIGARD
Site address: 14146 SW 118TH CT
Subdivision: MEDALLION MEADOWS Lot: 5
Project Description: New SF. Demo credits from BUP2014-00189 to be applied to this permit. 11/5/15,
REPRINTED to add a/c.
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R-3
Occupancy Load:
Fire Sprinkler Required:
Project Name: Medallion Meadows, Lot 5
Owner: JT ROTH CONSTRUCTION INC
FOUR D CONSTRUCTION CO
12600 SW 72ND AVE#200
TIGARD, OR 97223
Phone:
Contractor: FOUR D CONSTRUCTION
PO BOX 1577
BEAVERTON, OR 97075
Phone: 503-590-0805
Fax: 503-590-1751
This Certificate issued 12/7/2015 grants occupancy of the above referenced building or portion thereof
and confirms that the building has been inspected for compliance with the 2014 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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