Certificate of Occupancy IIICITY OF TIGARD CERTIFICATE OF OCCUPANCY
COMMUNITY DEVELOPMENT Permit#: MST2017-00013
Permit Issued: 02/14/2017
T1(3A..D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB13500
Jurisdiction: Tigard
Site address: 17438 SW FOREST HOLLOW ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 135
Project Description: New SF. 5/18/17: 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 135
Owner: ADLV LAND HOLDINGS LLC
BY FORSUM, MICHAEL
7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
Phone:
Contractor: WILLIAM LYON HOMES INC
109 E 13TH STREET
VANCOUVER,WA 98660
Phone: 360-695-7700
Fax:
This Certificate issued 12/22/2017 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
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