Certificate of Occupancy (2) �� CITY OF TIGARD CERTIFICATE OF OCCUPANCY
Permit#: BUP2019-00023
• COMMUNITY DEVELOPMENT Permit Issued: 04/29/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102AA00906
Jurisdiction: Tigard
Site address: 12084 SW MAIN ST
Subdivision: Lot: 4
Project Description: Installing (1)office, (2)treatment rooms,janitor room, break room, men's/women's toilet,
exercise room, exit door for TI.
Class of Work: ALT
Type of Use: COM
Type of Constr: VB
Occupancy Group: A-3
Occupancy Load: 225
Fire Sprinkler Required:
Project Name: Kimberly Berg's Rebel Fit
Owner: BSM REALTY LLC
BY RITE AID
PO BOX 3165
HARRISBURG, PA 17105
Phone:
Contractor: SUMMIT PROPERTIES AND DEVELOPMENT CO INC
6445 CITATION DR SUITE G
CLARKSTON, MI 48346
Phone: 248-6254711
Fax:
This Certificate issued 10/15/2019 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