Certificate of Occupancy (15) 1,1 CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Permit#: MST2015-00293
COMMUNITY DEVELOPMENT Permit Issued: 06/23/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110BA12400
Jurisdiction: TIGARD
Site address: 14137 SW 118TH CT
Subdivision: MEDALLION MEADOWS Lot: 17
Project Description: New SF.
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 17
Owner: JT ROTH CONSTRUCTION INC
FOUR D CONSTRUCTION CO
12600 SW 72ND AVE#200
TIGARD, OR 97223
Phone:
Contractor: J T ROTH CONSTRUCTION
12600 SW 72ND AVE#200
TIGARD, OR 97223
Phone: 503-639-2639
Fax: 503-624-0239
This Certificate issued 3/2/2017 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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