Certificate of Occupancy (3) thCITY OF TIGARD CERTIFICATE OF OCCUPANCY
• Permit#: MST201 9-001 4 5
COMMUNITY DEVELOPMENT Permit Issued: 07/16/2019
T I G A k I7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104BC10600
Jurisdiction: Tigard
Site address: 14090 SW WALNUT LN
Subdivision: FERN STREET SUBDIVISION Lot: 3
Project Description: New SF. 8/6/2019: REPRINT permit with fire sprinkler requirement due to grade of site,
submitted under separate permit.10/16/19: REPRINT to add (1)gas line for BBQ and NC.
11/7/19: REPRINTED permit to include a second kitchen sink for the island.
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R-3
Occupancy Load:
Fire Sprinkler Required:
Project Name: Fern Ridge, Lot 3
Owner: K5 URBAN PROPERTIES&MANAGEMENT
PO BOX 25571
PORTLAND, OR 97239
Phone: 503-292-9344
Contractor: BELLA TERRA HOMES
PO BOX 25571
PORTLAND, OR 97298
Phone: 503-2929344
Fax: 503-297-7524
This Certificate issued 5/19/2020 grants occupancy of the above referenced building or portion thereof
and confirms that the building has been inspected for compliance with the 2017 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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