Certificate of Occupancy (69) 'PICITY OF TIGARD CERTIFICATE OF OCCUPANCY
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COMMUNITY DEVELOPMENT Permit#: MST201600505
T t C ARL) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit Issued: 12/29/2016
Parcel: 2S110BA13200
Jurisdiction: Tigard
Site address: 14068 SW 118TH CT
Subdivision: MEDALLION MEADOWS Lot: 25
Project Description: New SF. 6/21/17, REPRINTED to add a/c.
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 25
Owner: JT ROTH CONSTRUCTION INC
FOUR D CONSTRUCTION CO
12600 SW 72ND AVE#200
TIGARD,OR 97223
Phone: 503-720-7445
Contractor: FOUR D CONSTRUCTION
PO BOX 1577
BEAVERTON, OR 97075
Phone: 503-720-7445
Fax: 503-590-1751
This Certificate issued 7/3/2017 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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