Certificate of Occupancy (18) CITY
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a' ` Permit#:� MST2017-00038
COMMUNITY DEVELOPMENT
Permit
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1a�uo8vv*aoB|vu,TigamOnsrzzn 503.718z*39 Parcel: 2G106DB12800
Jurisdiction: Tigard
Site address: 17391 SW SHADOW TRAIL ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 128
Project Description: New SF.4/12/17: REPRINT to add patio cover,
Class of Work: NEW
Type nfUse: SF
Type of Constr: VB
Occupancy Group: R-3
Occupancy Load:
Fire Sprinkler Required:
Project Name: River Terrace Northwest, Lot 128
Owner: ADLV LAND HOLDINGS LLC
BY FORSUM, MICHAEL
7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
Phone: 602'894'4031
Contractor: WILLIAM LYON HOMES INC
109 E 13TH STREET
VANCOUVER, WA 98660
Phone: 300'695'7700
Fax:
This Certificate issued 10/11/2017 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