Certificate of Occupancy (9) 7CITY OF TIGARD CERTIFICATE OF OCCUPANCY
3E '. Permit#: MST2017-00140
COMMUNITY DEVELOPMENT Permit Issued: 09/21/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB07400
Jurisdiction: Tigard
Site address: 17476 SW CLEMENTINE ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 74
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 74
Owner: ADLV LAND HOLDINGS LLC
BY FORSUM, MICHAEL
7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
Phone: 602-694-4031
Contractor: WILLIAM LYON HOMES INC
703 BROADWAY STREET, SUITE 510
VANCOUVER,WA 98660
Phone: 360-695-7700
Fax:
This Certificate issued 3/28/2018 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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