Certificate of Occupancy (5) CITY OF TIGARD CERTIFICATE OF OCCUPANCY
IN ' Permit#: MST2016-00189
COMMUNITY DEVELOPMENT Permit Issued: 05/17/2016
T f C;A li 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DC11400
Jurisdiction: Tigard
Site address: 17372 SW JEAN LOUISE RD
Subdivision: POLYGON AT WEST RIVER TERRACE Lot: 114
Project Description: New SF. 9/26/2016: Mechanical and electrical for A/C were issued under separate permits.
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R-3
Occupancy Load:
Fire Sprinkler Required:
Project Name: Polygon at West River Terrace, Lot 114
Owner: ADLV LAND HOLDINGS LLC
7600 EAST DOUBLETREE RANCH RD, STE
SCOTTSDALE,AZ 85258
Phone:
Contractor: WILLIAM LYON HOMES INC
109 E 13TH STREET
VANCOUVER,WA 98660
Phone: 360-695-7700
Fax:
This Certificate issued 9/26/2016 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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