Certificate of Occupancy (14) CITY OF TIGARD TEMPORARY CERTIFICATE OF OCCUPANCY
z Permit#: BUP2016-00273
COMMUNITY DEVELOPMENT Permit Issued: 09/13/2016
TICjA D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE# 150
Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: TI for existing tenant. Tenant is downsizing from second floor to first floor, and reconfiguring
offices.
Class of Work: ALT
Type of Use: COM
Occupancy Group: B
Occupancy Load: 129
Fire Sprinkler Required: Yes
Project Name: American Family Insurance
Remarks: Temporary occupancy for 30 days from 12/14/2016
Owner: PNWP LLC#2
PNWP LLC
6600 SW 105TH AVE#175
BEAVERTON, OR 97008
Phone:
Contractor: VANOSDEL CONSTRUCTION
PO BOX 1057
BATTLEGROUND,WA 98604
Phone: 360-600-9916
Fax: 360-687-7677
It is understood by the owner/tenant that the issuance of this Temporary Occupancy Permit by the City of Tigard for the use
and/or occupancy of the structure located at the site address listed above (hereinafter "structure"), does not grant or convey
to the owner or tenant any property right or other protectable property interest in the use and/or occupancy of the structure for
any purpose. It is further understood that this Temporary Occupancy Permit shall only be valid for the number of days from
the date of issuance listed above and that the owner/tenant will no longer be authorized to occupy the structure after the
period specified, unless and until all the conditions of approval imposed under the City's or County's Notice of Decision for the
project's land use case(s) issued by the City's Development Services Department or the County's Department of Land Use
and Transportation and/or the Clean Water Services and all building and related code requirements and any other applicable
requirements have been completely fulfilled and complied with to the City's or County's satisfaction.
Mark VanDomelen
Building Official
City of Tigard
POST IN CONSPICUOUS PLACE