Certificate of Occupancy (29) _�. CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Permit#:� MGT2O17'00012
- COMMUNITY DEVELOPMENT
Permit Issued: 02/14/2017
TIG/\}<D 13125 SW Hall BlvdTigardOnoro2n onor�824nn
� Parcel: 2S106DB13300
Jurisdiction: Tigard
Site address: 17392 SW FOREST HOLLOW ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 133
Project Description: New SF. 5/17/17: REPRINT to correct plumbing fixtures to add laundry sink from original
plans. 5/22/17: REPRINT to add additional water heater.
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R-3
Occupancy Load:
Fire Sprinkler Required:
Project Name: River Terrace Northwest, Lot 133
Owner: ADLV LAND HOLDINGS LLC
BY FORSUM, MICHAEL
70O0EDDUBLETREERANCH RDSTE1
SCOTTSDALE,AZ 85258
Phone:
Contractor: WILLIAM LYON HOMES INC
109 E 13TH STREET
VANCOUVER, WA 98660
Phone: 360-085-7700
Fax:
This Certificate issued 11/22/2017 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