Certificate of Occupancy (11) CITY
CERTIFICATE OF OCCUPANCY
COMMUNITY�Jw
Perm #: MS12016-00306
COMMUNITY ��
DEVELOPMENT '
permit Issued: 08/31/2018
TVG/�RC* 13125 SW Hat Blvd.,Tigard OR 97223 503 718.2439 Parcel: 2G110BA12800
Jurisdiction: Tigard
Site address: 14075GVV118THCT
Subdivision: MEDALLION MEADOWS Lot: 21
Project Description: New SF
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R'5
Occupancy Load:
Fire Sprinkler Required:
Project Name: Medallion Meadowm, Lot 21
Owner: JT ROTH CONSTRUCTION INC
FOUR D CONSTRUCTION CO
12600 SW 72ND AVE#200
TIGARD, OR 97223
Phone:
Contractor: J T ROTH CONSTRUCTION
12600 SW 72ND AVE#200
TIGARD,OR 97223
Phone: 503'639-2633
Fax: 503-824'0233
This Certificate issued 4/21/2017 grants occupancy of the above referenced building or portion thereof
and confirms that the building has been inspected for compliance with the 2014 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
POST IN CONSPICUOUS PLACE
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