Certificate of Occupancy CITY OF TIGARD CERTIFICATE OF OCCUPANCY
II i . Permit #: MST2012 -00133
COMMUNITY DEVELOPMENT Permit Issued: 09/10/2012
TtGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S114BA17700
Jurisdiction: TIGARD
Site address: 9654 SW FERN HOLLOW CT
Subdivision: FERN HOLLOW Lot: 3
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: Fern Hollow, Lot 3
Owner: RIVERSIDE HOMES LLC
17933 NW EVERGREEN PKWY SUITE 370
BEAVERTON, OR 97006
Phone: 503 - 645 -0986
Contractor: RIVERSIDE HOMES LLC
17933 NW EVERGREEN PKWY 370
BEAVERTON, OR 97006
Phone: 503 - 645 -0986
Fax: 503 - 690 -2942
This Certificate issued 12/3/2012 grants occupancy of the above referencedbuilding or portion thereof
and confirms that the building has been inspected for compliance with the 2011 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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