Certificate of Occupancy (30) CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Permit#: MST2017-00154
COMMUNITY DEVELOPMENT Permit Issued: 05/16/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 106D613800
Jurisdiction: Tigard
Site address: 17492 SW FOREST HOLLOW ST
Subdivision: RIVER TERRACE NORTHWEST Lot: 138
Project Description: New SF.
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 138
Owner: ADLV LAND HOLDINGS LLC
BY FORSUM, MICHAEL
7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
Phone: 602-694-4031
Contractor: WILLIAM LYON HOMES INC
109 E 13TH STREET
VANCOUVER,WA 98660
Phone: 360-695-7700
Fax:
This Certificate issued 12/21/2017 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
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