Certificate of Occupancy (34) CITY OF TIGARD CERTIFICATE OF OCCUPANCY
III a , Permit#: MST2017-00042
COMMUNITY DEVELOPMENT Permit Issued: 02/14/2017
T I R 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB12200
Jurisdiction: Tigard
Site address: 17497 SW SHADOW TRAIL ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 122
Project Description: New SF. 4/13/17: REPRINT to add patio cover.
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 122
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 8/24/2017 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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