Certificate of Occupancy � n CITY OF TIGARD CERTIFICATE OF OCCUPANCY
a •.. Permit #: MST2011 -00155
COMMUNITY DEVELOPMENT Permit Issued: 09/22/2011
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S110CB08400
Jurisdiction: Tigard
Site address: 12467 SW ST ANDREWS LN
Subdivision: MOUNTAIN VIEW ESTATES Lot: 9
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: Mountain View Estates, Lot 9
Owner: JT ROTH CONSTRUCTION INC
PO BOX 1969
LAKE OSWEGO, OR 97035
Phone: 503 - 806 -0602
Contractor: J T ROTH CONSTRUCTION
12600 SW 72ND AVE #200
TIGARD, OR 97223
Phone: 503 - 639 -2639
Fax: 503 - 624 -0239
This Certificate issued 8/24/2012 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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