Certificate of Occupancy (10) IIII4CITY OF TIGARD CERTIFICATE OF OCCUPANCY
i Permit#: MST2015-00303
COMMUNITY DEVELOPMENT Permit Issued: 04/11/2016
TIts "RT] 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110BA12200
Jurisdiction: TIGARD
Site address: 14163 SW 118TH CT
Subdivision: MEDALLION MEADOWS Lot: 15
Project Description: New SF. 6/6/2016: REPRINT permit to correct number of bathrooms from 4 to 3.
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 15
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: 503-720-7445
Fax: 503-590-1751
This Certificate issued 10/27/2016 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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