Certificate of Occupancy CITY OF TIGARD CERTIFICATE OF OCCUPANCY
,,. Permit #: MST2010 -00090
COMMUNITY DEVELOPMENT Permit Issued: 07/14/2010
!CARD • 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S103CD05900
Jurisdiction: Tigard
Site address: 11640 SW FAIRVIEW LN
Subdivision: TERRACE TRAILS Lot: 19
Project Description: Addition and remodel and Conversion of 180 sq ft to home theater. 12/08/2010: Reprinted to
include (1) 400 amp service, (30) branch circuits, and (1) cable /audio low voltage system.
Class of Work: ADD
Type of Use: SF
Type of Constr: VB
Occupancy Group: R -3
Occupancy Load:
Fire Sprinkler Required:
Project Name: Van Noy
Owner: VAN NOY, ELDON
11640 SW FAIRVIEW LN
TIGARD, OR 97223
Phone: 503 - 803 -1558
Contractor: VAN HULZEN CONSTRUCTION
2020 KINGS HWY
MEDFORD, OR 97501
Phone: 541 - 944 -1452
Fax:
This Certificate issued 4/19/2011 grants occupancy of the above referenced building or portion thereof
and confirms that the building has been inspected for compliance with the 2008 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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