Certificate of Occupancy (72) .11,1CITY OF TIGARD CERTIFICATE OF OCCUPANCY
X Permit#: MST2016-00470
COMMUNITY DEVELOPMENT Permit Issued: 11/17/2016
T I GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB10200
Jurisdiction: Tigard
Site address: 17488 SW AMELIA ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 102
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: River Terrace Northwest, Lot 102
Owner: ADLV LAND HOLDINGS LLC
BY FORSUM, MICHAEL
7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
Phone:
Contractor: WILLIAM LYON HOMES INC
109 E 13TH STREET
VANCOUVER,WA 98660
Phone: 360-695-7700
Fax:
This Certificate issued 7/26/2017 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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