Certificate of Occupancy (22) CITY OF TIGARD CERTIFICATE OF OCCUPANCY
11111 q Permit#: MST2015-00214
COMMUNITY DEVELOPMENT Permit Issued: 12/03/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1060001500
Jurisdiction: TIGARD
Site address: 13515 SW CALABASH TER
Subdivision: RIVER TERRACE NORTHWEST Lot: 19
Project Description: New SF, 2/4/2016: REPRINT permit to correct address from 13510 to 13515.
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 1
Owner: ADLV LAND HOLDINGS LLC
BY FORSUM, MICHAEL
7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
Phone:
Contractor: POLYGON WLH, LLC
109 E 13TH STREET
VANCOUVER,WA 98660
Phone: 360-695-7700
Fax: 360-693-4442
This Certificate issued 12/12/2017 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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