Permit CITY OF TIGARD MASTER PERMIT
I COMMUNITY DEVELOPMENT Permit#: MST2021-00279
Date Issued: 08/04/2021
T i t,A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112BD02500
Jurisdiction: Tigard
Site address: 14875 SW 79TH AVE
Subdivision: DURHAM ACRES Lot: 49
Project: Dodds
Project Description: New 520 sq ft accessory structure#2
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
No
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $26,665.60 Rear: 5
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 Drains: 0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Bckflw Prevntr: 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
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=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/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT ACS VB R-3 0
Owner: Contractor:
DODDS,RICHARD P ERIC'S QUALITY BUILDING INC Required Items and Reports(Conditions)
DOWNS,MALISSA M 4204 EGAN ST 1 Ersn Cntrl 503-639-4175
14875 SW 79TH AVE GERVAIS,OR 97026
TIGARD,OR 97224
PHONE: PHONE: 503-989-5762
FAX:
Total Fees: $1,069.10
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
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Issued By: �Y 1 t�/L� "�Y Permittee Signature: �� `i/'/°G! t'� � 7 Q/ i
// 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.
:-Y1f/dJ4 A ,? ��/ s
Building Permit Application ?"--710 is
Residential RECEIVED y FOR OFFICE USE O\1_1
City of Tigard Received Date/By: ��/ GCJ // Permit No.: S/2O2J''QO2-7
- " 13125 SW Hall Blvd.,Tigard,OR 97223 0 6 2021 Plan Review ^�
Phone: 503.718.2439 Fax: 503.598.1960 �U� Date/By: / ?I -'' A Other Permit:
i 1 G A R D Inspection Line: 503.639.4175 Z�+A r]{l Date Ready/By: /l Juyg•
., ® See Page 2 for
Internet: www.tigard-or.gov �� Pam/DIVISION
Notifyie/d/Metethod:�Z �� �(/ ' r Supplemental information
>rl�l Dsv,svON G'-Vr/(-- t
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
fkiNew 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 ❑Other: equipment,materials,labor,overhead,a he piofit f he/,ll
CATEGORY OF CONSTRUCTION work indicated on this application. y ig t '(nr
❑ 1 and 2-family dwelling ❑Commercial/industrial
Valuation: $ t`,-(.y _
"Accessory building El Multi-familyNumber of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /' j 79/, - New dwelling area: square feet
City/State/ZIP: /2'4. 04/V Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross str directions to job site: ��, /` Deck area: .,- square feet
25 1i I E �� / 6 t.7-- 6jy`a - /Q (�r,� Other structure area: 52D 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.
I • i
Valuation: $ ; „
AA,'
_/ / Existing building area: square feet
New building area: square feet
ROPERTY OWNER 0 TENANT Number of stories:
Name: ,/,
,�/4 Ai- �� Type of construction:
Address: / f ? .1J 79/A go e Occupancy groups:
City/State/ZIP: `2' ,1y
�' ,�j�� �/f° Existing:
Phone:60g — 6 9_//79C Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
Structural plan review fee(or deposit): 23C 7$
Contact name: /J � /��/ �� ���71
�,
�J/ �G`/ FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone:( ) Fax: :( ) Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:oi11 c�cs p1Uax; but:i id rsm Commercial and residential prescriptive installation of
CONTRA OR roof-top mounted Photo Voltaic Solar Panel System.
Business name: /4.,/ S Z-i q� Ze,i J Submit two(2)sets of roof plan with connection details
�'i and fire department access,along with the 2010 Oregon
Address: �Q clan 3P 1 Solar Installation Specialty Code checklist.
City/State/ZIP: j0/ a f Permit Fee(includes plan review $180.00
and administrative fees):
Phone 9...'% 57k2.: Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: aQ447,7
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:, �`��/? ��o�- Date: *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46 3T(1 /02/COM/WEB) f.,v` / a 4,7 . / O
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLs
City Tigard Ti d Receives
111 Date/By: Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
m Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 El Electrical 0 Plumbing 0 Mechanical
TIGARD
Internet: www.tigard-or.gov ❑ other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW tit'. No yi,k
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ■ !'
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0
3 Verification of approved plat/lot. 0 0 ❑
4 Fire district approval required. Name of district: . 0 ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0
6 Sewer permit. ❑ 0 0
7 Water district approval. V:1 ❑
8 Soils report. Must ca original applicable stamp and signature on file or with application. ❑
9 Erosion control plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑
b in protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑
ilding codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 ❑ 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ 0
systems,see item 22,"Engineer's calculations." ,
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Ore•on and shall be shown to be as slicable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ■ ■
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 ❑ 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. 0 ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB)
City of Tigard
d ad
111 r COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Residential
Building Permit #: M S Y20 21-O U 2.79
Site Address: 14875 SW 79th Ave
Project Name: Dobbs NG�.01 V2 Lot #:
Planning Review ��11
Proposal: New 520 SF accessory structure
gl Verify address/suite# active in Accela. ® In River Terrace: ® No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: ®Erosion Control
®3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 1etained trees with drip line and tree protection measures
NDrawn to scale(standard architect or engineer scale) Xl Footprint of new structure(including decks)and FFE
[ North arrow /Utility locations&easements(required for new and additions)
IC Site address,project or subdivision name and lot number r Sidewalk/driveway approach
]Applicant information(name and phone number) iiiLocation of wells/septic systems
]Lot dimensions and building setback dimensions rStreet tree size,type and location
hifquare footage of buildings to be demolished ]Street names
®Existing structures on site Corner elevations(2'contours if more than 4'differential)
iftot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? Was ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No
® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ® Yes,applicant was notified ❑ No Received: ❑ Yes XI No
K] Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified L$ No Received: ❑ Yes ❑ No
Ill SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
® Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified W No Applied For: ElYes ❑ No,stop intake
la Land Use Case#: IXZoning: 1ap "z}.s.-
® Required Setbacks: Front: na Rear: 5 Side: 5 Street Side: na Garage: na
Building Height: Max.Height: 15 Actual Height: 1S f
ila Landscape Area: % f Lot Coverage Max:
Entrance Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45< s or less
Windows ❑ Mi ' 12%of area of all stet}f cfacades
Garage ❑ Garage door' ' d widest street drag wall ❑ Ye o,one of the following is met:
❑ Door extends no mo 5'from wall and the • covered porch extending beyond garage.
❑ Door extends no more than 5' r nd there is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12' ss ❑ 50°o of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch Recessed entrance ❑ Wall o s 1'Roof eave ❑ Roof offset
❑ Fires ' s ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip, brel roof ❑ Dormer
❑ ccent siding ❑ Window trim ❑ Window recess ❑ Window prolec' ❑ Balcony
! Visual Clearance nil Urban Forestry Plan
® Sensitive Lands: f7 Yes ❑ No Type: Low value habitat
ID Conditions met prior to issuance of building permit
Notes: ,,((
/ Approved By Planning: 1` ..., Date: 3 Z ,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
i
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: U7/4'/2402)
Site Plans: # 3
Building Plans: # 3
Building Permit#: ErEnter building permit#above.
Workflow Routing: Planning re--Engineering a—Permit Coordinator ®' Building
Workflow Sign-off: [ -Sign-off for Planning(include notes from planning review)
Route Application Documents: Lb-Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
original plan review routing form.
(-Building: original permit application,site plans,building plans, engineer and
beam calculation and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: eTA/2oz"
Engineering Review
L3 Slope at building pad: 2 ig
CfrConditions "Met"prior to issuance of building permits fa-
[ "Easements (encroachments)per engineering conditions of approval and platy fa-
C "Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 21 No
Assess Water Quantity Fee in-lieu: ❑ Yes 2/No
LIDA Facility on lot: ❑ Yes ❑i/No
E Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:^
L t Approved by Engineering: ge—v e>t- gr Date: 7//y/2p? I
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
ttlitConditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received te Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 4 N/A
Tigard Trans SDC: ❑ Yes 61 N/A
Parks SDC: ❑ Yes X N/A
LIDA ❑ Yes 7 N/A
OK to Issue Permit
Approved by Permit Coordinator: kilThrn
Date: 1 toil 2,0%(
t
I:1Building\Forms\BldgPermitRvw_RES_122419.docx
/t/5r- A/ -a d 79
/VI7s r 79 4-("7‘-
Clean Water Services-Service Provider Letter RECEIVED
AUG o 4 2021
CITY OF TIGARD
BUILDING DIVISION
Submission Date: 8/3/2021 Confirmation#: 617
Applicant Name: Allen Baer Review Type: Partner City Plan Review
Contact Email: allen@ericsqualitybuilding.com Ground Disturbance: 999 Sq. Ft.
Contact Phone: 503-989-5762 New Impervious Area: 999 Sq. Ft.
Primary Address: 14875 SW 79TH AVE Mod.Impervious Area: 0 Sq. Ft.
Primary Jurisdiction: Tigard Development Activity: Single-Family Dwelling Addition
Affected Tax Lots: 2S112BD02500
INSTRUCTIONS:This pre-screening report is the Service Provider Letter(SPL)as required by Resolution and Order 19-5,Section
3.02.1,as amended by Resolution and Order 19-22. PROVIDE A COPY OF THIS SPL TO THE JURISDICTION RESPONSIBLE FOR LAND
USE REVIEW AND PERMIT ISSUANCE.This pre-screening review does NOT eliminate the need to evaluate and protect water quality
sensitive areas if they are subsequently discovered and this review does NOT eliminate the need to obtain additional CWS permits
or reviews if project changes in scope or location.All required permits and approvals must be obtained and completed under
applicable local,State and federal law.
Permit or Review Required Next Steps
Environmental Site Assessment No ".
Review
Water Quality Treatment Review TBD Contact city(primary jurisdiction)responsible for land use review and permit
and Stormwater Inspection issuance.
Erosion Control Inspection Permit TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
Erosion Control Inspection Permit TBD Contact city(primary jurisdiction)responsible for land use review and permit
with Site Plan issuance.
Line Tap Inspection Permit TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
Disconnection Permit TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
Connection Permit TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
!Connection Permit with Plumbing TBD Contact city(primary jurisdiction)responsible for land use review and permit
Plan issuance.
Easement Review TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
The CWS Development Services group is here to review your project in the most effective and efficient way,while protecting the Tualatin River Watershed.Our
partners include municipalities,environmental organizations,and developers large and small.
Contact Us•2550 SW Hillsboro Highway Hillsboro,Oregon 97123
phone:503-681-5100*email:splreview@cleanwaterservices.org•website:www.cleanwaterservices.org/permits-development
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