Certificate of Occupancy (9) CITY OF TIGARD CERTIFICATE OF OCCUPANCY
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Permit#: MST2016 00010
COMMUNITY DEVELOPMENT Permit Issued: 02/22/2016
T IG AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109DB01800
Jurisdiction: TIGARD
Site address: 13058 SW BLACK WALNUT ST
Subdivision: WOODSIDE Lot: 10
Project Description: New SF. Model home with sales office. 4/12/2016: REPRINT permit to add fire sprinkler
system.6/20/16, REPRINTED to add 50'of drainage trench to rear of lot.
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R-3
Occupancy Load:
Fire Sprinkler Required:
Project Name: Summit Ridge No.5, Lot 159
Owner: VENTURE PROPERTIES INC
4230 GALEWOOD ST STE 100
LAKE OSWEGO, OR 97035
Phone:
Contractor: DR HORTON INC PORTLAND
4380 SW MACADAM AVE SUITE 100
PORTLAND, OR 97239
Phone: 503-222-4151
Fax: 503-222-1304
This Certificate issued 7/6/2017 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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