Certificate of Occupancy (8) CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Permit#: MST2017-00182
COMMUNITY DEVELOPMENT Permit Issued: 09/21/2017
T E cjARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB07200
Jurisdiction: Tigard
Site address: 17384 SW CLEMENTINE ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 72
Project Description: New SF. 2/7/2018: REPRINT permit to include 147 sf deck.
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 72
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 3/30/2018 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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