Certificate of Occupancy (11) CITY OF TIGARD CERTIFICATE OF OCCUPANCY
4 Permit#: MST2015-00224
COMMUNITY DEVELOPMENT Permit Issued: 12/07/2015
T I(-1 Ali U 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102BC01102
Jurisdiction: Tigard
Site address: 12802 SW KING PL
Subdivision: GRACELAND Lot: 4
Project Description: New SF. 5/10/16: REPRINTED permit to include(1)laundry tray.
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R-3
Occupancy Load:
Fire Sprinkler Required:
Project Name: Graceland, Lot 3
Owner: PACIFIC EVERGREEN HOMES LLC
7410 SW OLESON RD#133
PORTLAND,OR 97223
Phone:
Contractor: ALAN NATHANIEL GOFFMOORE
13950 SW BARLOW RD
BEAVERTON,OR 97008
Phone: 503-664-6423
Fax:
This Certificate issued 5/20/2016 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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