Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2021-00284
T L A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7!6/2021
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Parcel: 2S 101 AD02800
Jurisdiction: Tigard
Site address: 12665 SW 69TH AVE
Project: US Investors Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Add a restroom to reconfigured space and relocated break room fixtures.
Contractor: OREGON PLUMBING AND PUMP LLC Owner: OMEGA ALPHA LLC
PO BOX 261 760 NE 23RD AVE
MOLALLA, OR 97038 CANBY, OR 97013
PHONE: 503-678-9886 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 07/03/2021 $25.02
Specifics: 1 ea Sink 07/03/2021 $25.02
1 ea Lavatories 07/03/2021 $25.02
Type of Use: COM 1 ea Tub/Shower/Shower Pan 07/03/2021 $12.51
Class of Work: ALT 1 ea Water Closet 07/03/2021 $25.02
Type of Const: 1 12%State Surcharge- 07/03/2021 $13.51
Occupancy Grp: Plumbing
Stories:
Total $126.10
Required Items and Reports(Conditions)
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 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: •
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.
r 4"
Plumbing Permit Application CiEllki L 1_,./
Building Fixtures
'UN 2 4 2021
City of Tigard Roca:fa' y./');/-L-/ <-(:(' 14'It N,411.-C7 ie:I 2/ ZZ.
1111 13125 SW Hall Blvd.Tigard,OR sr7210F TIGARD Pl
II an Review
Phone 503 718.2439 Fax .
5°3411 NC-‘,DIVISION Date/By: Other Penua No: ,-2_2t, -2 i.-z,c
Inspection Line. 503 639 4175 •
Date Ready/By .,/ .." l‘,,,i zi , i runs 0 See Page 2 for
Internet. www tigard-or gov Notified/method./ *7 C Supplemental Information
-- - - . iiiii'ov worte - , P..14-71,--1 • '4: -' .nr. 96iititi-'... 7,.. , .. . .
. .
0 New construction 0 Demolition .For special infonuation use checklist
__. Description I Qty. I Ea. I Total
aiWakddition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft for each utility connection)
:-. " ''-.- • - '..- 7.1,"' MlIGORY IOW COR.14.100OR - ' :.';',...-..,-,',. :. - SFR(1)bath 312 70
SFR(2)bath 437,78
Eli-and 2-family dwelling 'Jig:Commercial/industrial ,
SFR(3)bath 500 32
P Accessory building 1:1 Multi-family
Each additional bath/kitchen ' 25.02
El Master builder CI Other: Fire sprinkler( sq.if) Page 2
.. . . . .. •. .. -. ... -... . - --... , . •
JOB SUE INFORMATION AND LOCATION : Site utilities:
Catch basin or area drain 18 76
Job site address: if i.‘„4:6— 6 iA) c,c? ill ,rve
Drywall,leach line,or trench drain 18.76
City/State/ZIP: .-TT_.c,-,tift, Og. 9.?.ZZ- -5 Footing dram(no linear ft. ) Page 2
Suite/bldg./apt.no.: I Project name: Et 5 rAIVEST-oC.S. Manufactured home utilities 50 03
Cross street/directions to job.site: . Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no linear ft.: ) Page 2
" Storm sewer(no.linear ft.:_) Page 2
Water service(no linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.;
Backflow preventer ' 31.27
Backwater valve • 12.51
Clothes washer 25.02
ADDrAid,- IV () 8A-r4Koom -rb / sr F-1-0010-- Dishwasher 25.02 .
KC:Lo&ArT T,416 8K RcloAl J210411-1ati 6- Drinking fountain 25.02
ilei9L.,te Teti& -7--0 rcer 1:..;„/5 Af4,,,e-le 11,4. $-rooes Ejectors/sump 25 02
•• ' *PROPERTY OWNER I •-j71.7ENANT .._ Expansion tank 12 51
Fixture/sewer cap I 25.04
Name: Om F64 A bp M A, i_t_c_.
Floor drain/floor sink/hub 25.02
Address: /Z6/0,5^ S vj bet to 4 vc-
Garbage disposal 25.02
City/State/ZIP: TreAp._13 ak zZ _ s Hose bib 25.02
Phone:(Co 3) -34 6 3037.. Fax:( ) Ice maker 12.51
'.40teirrAc3 pgpsoN 1 Interceptor/grease trap 25 02
Medical gas(value.$ ) Page 2
Business name: A 4),Dge;t4) mcoge a.,,,,,-„,_,--",,A)
Primer 12 51
Contact name: Roof drain(commercial) 12 51
Address: O.9416g- 9 ‘, &ZL R...+el Sink/basin/lavatory 12.. 25.02
City/State/ZIP' ()OLT,io pk, el. q 70) -f- Solar units(potable water) 62 54
Phone:(S-03) -703 Fax. :( ) Tub/shower/shower pan I 12.51
Urinal 25.02
E-mail; a/rob cc bu lit e goicc. f e - C04-7
Water closet I 25 02
. - . l- IMNTWACTCilt ,. - ,
Water heater 37 52
Business name:OREI riAM413//lier k .1]) Ftlit4P U.Z.d
/ Water piping/DWV 56 29
Address. j..43 0, 1(40 Lk u,,,s, Aut. Other 25.02
City/State/ZIP; 1114:1LA U1A . die- 1703r Subtotal
Minimum permit fee $72 50
Phone.( 3) 61 r_et e,e,to Fax.( )
Plan review (25%of permit fee)
CCB Lie.: l p.(3 Li s-D P umbing Lie,no.: pg le,v7
Authorized signature:
- State surcharge(12%of permit fee)
TOTAL PERMIT FEE /Z 4.2 ,. /,.:1
Print name: /1-6.0/24 Gifel-ra Date:10/013/14 This permit application expires if a permit is oot obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry-Service Board
I IhnIchngTermnsPLMU-PernntApp doc 10,01/09 440-4616T(10102/COMAVEB)
r
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utihitiea (3n'• Fee(e*) " Tew Square Footage: Permit Fee:
Footing drain-I"100' 50.03 0 to 2,000 $121.90
Footing dram-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233 20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37 52 vRlu ion: Permi Teo_
Storm&Rain Drain-1st 100' 62.54 $1 00 to$5,000 00 Minimum fee$72.50
Storm&Rain
Drainn--}each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000,00 and$1.52 for
Other I>9 onls or.Fees Fats) Total each additional$IOO 00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000 00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge—1/2 hour) and including$25,0011.00_
Inspections outside of normal business 90.00/hr $25,001 00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$10000 or fraction thereof,to
Reinspection Fees 90.00/r and including$50,000.00.
Additional plan review for revisions 90.00/hr _ $50,001 00 and up $742.00 for the first$50,000 00 and$1 20 for
(minimum charge—1/2 hour) each additional$100.00 or fraction thereof
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees* Plan Review fit Plumbing l tlons>
Quand by Future Type - Plan review is required for any of the following.
Fixture Type for liepacei Capped AddedRelocate Please check all that apply.
Werltperf rmed: ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath. -Tub/Shower
-Jacuzzi/Whirlpool engineer.
❑
Car Wash: -Each Stall New exterior plumbing site utilities for any complex structure
Drive Thin as defined in OAR918-780-0040.
CuspidorfWater Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink. -2"
3" Isometric or Riser
0 Isometric or riser diagram is required for new buildings
Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related ,�,J
-Industrial food related �/14°
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station) ode; 5 nthc /3AJ0 ONE To It- T Lt)2•LL
Rec Vehicle Dump Station BC
Al Ew 1 OTHtL P=X rt-te e'S A R E
Shower. -Gang CocerTEO Cs F.e4t»
-Stall I I
Sin k: -lav/Bar non-food related I
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet ` r plumbing permit can be issued.
Urinal
Other Fixtures.
I:\Building\Pennits\PLMF_PermitApp.doc 08/04/2011 k 2
Dianna Ornelas
From: Andy Moore <amoorebuilt@gmail.com>
Sent: Friday, July 2, 2021 3:17 PM
To: #Building Permit Technicians
Subject: Re: Us Investors - Plumbing permit application - 12665 SW 69th Ave.
Caution! This message was sent from outside your organization.
You got it
Sent from my iPhone
On Jul 2, 2021, at 2:15 PM,#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>wrote:
Thanks,Andy.
For this permit, here is the scope of work as I understand it:
• New bathroom on first floor:
o Add (1) toilet
o Add (1) lay
• Upstairs bathroom:
o Cap (1)toilet
o Add (1) shower stall
• First floor breakroom:
o Relocate (1) sink
Please confirm if the above described work is correct.
Thanks.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
From: Andy Moore<amoorebuilt@gmail.com>
Sent: Friday,July 2, 2021 1:58 PM
To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject: Re: Us Investors- Plumbing permit application - 12665 SW 69th Ave.
Yes on the original drawings they were adding a shower in downstairs bathroom and when they decide
to add the new bathroom on first floor they want to move the shower to one of the upstairs bathrooms
deleting a toilet and putting shower stall in it's location.
1
Sent from my iPhone
On Jul 2, 2021, at 1:14 PM, #Building Permit Technicians
<TigardBuildingPermits@tigard-or.gov>wrote:
Hi Andy,
I am working on this permit and need additional information.
The permit description reads "replacing toilet w/shower upstairs". Can you please
clarify? Are you capping a toilet and adding a new shower stall?
Thanks.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
From:Andy Moore<amoorebuilt@gmail.com>
Sent: Friday,July 2, 2021 11:14 AM
To: #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject: Re: Us Investors- Plumbing permit application
Hi there
Any progress on this application?Andy
Sent from my iPhone
On Jun 24, 2021, at 8:42 AM, #Building Permit Technicians
<TigardBuildingPermits@tigard-or.gov>wrote:
Thank you Andy. We will get this processed within one week.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
2
From:Andy Moore<amoorebuilt@gmail.com>
Sent: Wednesday,June 23, 2021 7:54 PM
To: Edgardo Maldonado <edgardomPtigard-or.gov>
Subject: Us Investors- Plumbing permit application
Hi
could you please get this to the right person. I was told I needed to
email it but I wasn't sure who to email it to and you are the last person I
emailed at Tigard. Thanks Andy Moore
On Thu,Jun 17, 2021 at 11:49 AM Edgardo Maldonado
<edgardom@tgard-or.gov>wrote:
Andrew Moore,
I have conducted a thorough records search and I have located
electronic records you have inquired about. I was able to find some
approved plans from 2003.
You should be able to view these records directly through the City
of Tigard website. The records will be available for viewing for up to
14 days. To access these records, you should:
• For best results, please use Chrome, Firefox, or Edge as
your browser
• Click on this link http://publicrecords.tigard-
or.gov/Public/
• Select Records Requests
• Select the folder that Is named with the permit number
or address that you have inquired about
• Please Log Out when you have finished viewing the
records. Thank you!
I would be happy to answer any questions you may have.
Thank you
Eggie Maldonado
Permit Technician Assistant
City of Tigard I Community Development
13125 SW Hall Blvd,Tigard, OR 97223
3
Ph. (503)718-2452
From: City Records<CitvRecords@tigard-or.gov>
Sent:Tuesday,June 8, 2021 4:22 PM
To:amoorebuilt@gmail.com
Cc: City Records<CitvRecords@tigard-or.gov>;
BuildingRecordsRequests<BuildingRecordsRequests@tigard-or.gov>
Subject: RE: Public Records Request-Andrew Moore
Andrew Moore,
Your records request has been received and sent to the appropriate
department for review and processing.You will be notified within 5
business days confirming the City has the requested record or
informing you that we are not the custodian of the record or are
uncertain whether we have the requested record. Records requests
are handled on a first come,first serve basis,and most are completed
in 7-10 business days. However, depending on the nature and
complexity of the request it could take longer and we will advise you if
this applies to your request. Please note that the City offices are closed
on Fridays.
Public records requests that involve more than one half hour of staff
time for identification, location, retrieval, review,and duplicating will
include a charge for staff time. All records requests for which the
estimate exceeds$50 will require a payment of the estimated charges
in advance. The request will not be started until the deposit is
received. After reviewing your request, if a deposit is required we will
contact you with the details.
The person assigned to your request will be in contact with you
soon. Have a great day!
O
Debbie Manning, MMC
Records Management Specialist
4
r
• City of Tigard
13125 SW Hall Blvd, OR 97223
Tigard,Oregon 97223
Phone: 503.718.2483
From: noreply@revize.com <noreplv@revize.com>
Sent:Tuesday,June 8, 2021 3:06 PM
To:City Records<CityRecords@tigard-or.gov>
Cc: Nancy Lof<Nancy@tigard-or.gov>
Subject: Public Records Request
Contact Name =Andrew Moore
Phone Number=5037037570
Email=amoorebuilt@gmail.com
Property Address= 12665 SW 69th Tigard Oregon 97223
Description of Records Requested = I'm in search of all records for
building, plumbing, and electrical pertaining to above address
I am contractor doing remodel for permit number bup 2021-00090 and
I would like to have any records from bup2003-00379 which I believe is
the original building permit.Thanks Andrew Moore
City Contact=
Client IP= 174.204.200.47
DISCLAIMER: E-mails sent or received by City of Tigard employees are
subject to public record laws. If requested, e-mail may be disclosed to
another party unless exempt from disclosure under Oregon Public
Records Law. E-mails are retained by the City of Tigard in compliance
with the Oregon Administrative Rules "City General Records Retention
Schedule."
5