Certificate of Occupancy CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Q : Permit #: MST2012 -00248
COMMUNITY DEVELOPMENT Permit Issued: 03/14/2013
T [GARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Parcel: 2S114BA18000
Jurisdiction: TIGARD
Site address: 9592 SW FERN HOLLOW CT
Subdivision: FERN HOLLOW Lot: 6
Project Description: New SF 6/24/13, reprinted to add a /c. Placement if a/c unit must comply with manufacturer's
clearance requirements
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 6
Owner: RIVERSIDE HOMES LLC
17933 NW EVERGREEN PKWY SUITE 370
BEAVERTON, OR 97034
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 6/26/2013 grants occupancy of the above referenced building 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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