Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2020-00277
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2020
Parcel: 2S114BB14900
Jurisdiction: Tigard
Site address: 10433 SW RIVERWOOD LN
Subdivision: SWANSON'S GLEN NO.2 Lot: 90
Project: Arrigoni
Project Description: Addition to GLU-LAM beam for garage ceiling/roof strengthening.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $2,500.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/voll: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description:
Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor: __
ARRIGONI,JAMES MICHAEL&CYNTHI OWNER Required Items and Reports(Conditions)
REVOCABLE LIVING TRUST
10433 SW RIVERWOOD LN
TIGARD,OR 97224
PHONE: PHONE:
FAX:
Total Fees: $221.71
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010,tth` \roouggh OAR 91 '52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
T Issued By: )v`3 ir\�C KJ�5.C, Permittee Signature: OYNk Q ILghOn
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
13- 10 15 120
Building Permit Application
Residential •
City of Tigard l may: /O /2 O2c, Permit Ne.:msr202(!'W27j
w 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 y Date/By: ID(ro T Pau
T I GA R.i:> Inspection Line: 503.639.4175 ;'-, Date ReadyBy: 1 / ,,9 .( 7�s.�� I H See Page 2 for
Internet: www.tigard-or.goy_... Notified/Method: Q !�/ZD �CVd t Supplemental Information
ice`?ell-- ._.37'i
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
\lid El 1-and 2-family dwelling 0 Commercial/industrial
r Valuation: $ 2Too
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathtwu,s:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 Cr 133 _so) 1 1 sic r W o 0 d 1,,A ia e New dwelling area: square feet
City/State/ZIP: 1 , 414 0 Q i722,11 Garage/carport area: square feet
Suite/bldg./apt.no.: �lgProject name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
A el11V)on oC ( LU -LRYA beam cor Gara9C Valuation: $
cei t v r^�o O f- S}1"e n ill e11.t a h Existing building are square feet
( All N.r.t0rr` Se-If pe( Melt ) New building area: square feet
ii PROPERTY OWNER 0 TENANT Number of stories:
Name: j aw‘[S A ft Igo r`. Type of construction:
`
Address: J o H 33 %tut33'' 1Yru e oats 1 4N e. Occupancy groups:
City/State/ZIP: -11 t. A r A 0 g Existing:
Phone:(503) (g Z 15 - 2 3) 8 Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer le fee schedule
r Structural plan review fee(or deposit): 77:$G
Contact name: C/t2 "h/o ft t O 70 le ' t-46r . r-(1✓✓L, FLS plan review fee(if applicable):
Address: /
Total fees due upon application:
City/State/ZIP:
Amount received:
Phone:( ) Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Conmtercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: Total fee due upon application: $201.60
Authorized signature:
' ' ' / ajv
2- This
wi permit application expires if a permit is not o plotned
e.
7 -a within 180 days after it has been accepted as complete.
Print name: Sw• _s Ili 4 rr �d tAi Date: /O/o/2 0 *F�me icemethodology set by Tri-County Building Industry
C:\Building\Permits\BUP-RESPermitApp.doc 02/242011 440-4613T(l 1/02/COM/WEB)
RED--
Property Owner Statement E®
oc7 '�
Regarding Construction Responsibilities l20
Oregon Law requires residential construction permit applicants who are not licensed with the -,"�SION
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325 (2))
This statement is required for residential building, electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this statement. This statement will be filed with the permit.
Please check the appropriate box: OCT 0 2020
CITY OFTIGARD
I own, reside in, or will reside in the completed structure and my general contractor is'-.DING DIVISION
Name CCB# Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
xI will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
JcinAe 5 MI4rc j0 ..1:
Print Name of Permit Applicant
gnature of Permit Applicant Date
Permit#: MS i 0,01 GC) 77
Address: / 93 3 .s() //c4 kiev,6 44/
1; 'yl
Issued by: w Date: VO\ZSIZcze
This Copy for Permit Offices