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8095 SW CHURCHILL CT
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CITYOF TIGARD DATEPERMIT .
ISSUED:•
04/25/966-0109
COMMUNITY DEVELOPMENT DEFARTMENT
'3125 SW Hal.Blvd Tigard,Oregon 97223*8199 (503)839-4171 PARCEL: 2'S112CC-02800
SITE ADDRESS. . .. - 08015, SW CHURCHILL CT
SUBDIVISION. . . . : BOND PARK NO. 3 ZONING: R12
BLOCK. . . . . . . . . . . 1-01.. . . . . . . . . . . . . :56
CLASS OF WORK. . tALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :A1 VENTS W10 APP;_: 0 VENT SYSTEMS: 0
STORIES. . . . . . . - . 0 BOILERS/COMPRESSORS HOODS. . . . . .. . : 0
FUEL TYPES--------------- 0-3 HP. . . . : 0 DOMES. INCIN: 0
/GAN/
3-15 HFI. . . . ; 0 COMML. INCINs 0
MAX INPUT: 0 BTU 15-30 HP. . . . -. 0 REPAIR UNITS: 0
Flk-':- DAMPERS?. . : 30- tO HP. . . . il 0 WOODSTOVES. . : 1
GAS PRESSURE. . . : 50+ HP. . . . 1 0 CLO DRYERS. . : 0
NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 0 10000 cfm: 0 GAS OUTLETS. : 1
FURN ) =100K BTU: 0 > 10000 cfms 0
Remarks: Installing one residential gas fireplace to 30, 000 BTU and gas pliplyly
to
four outlets.
Owner: FEES
ROFER KOHNE type amount by dat e re(-pt
8095 SW CHURCHILL CT PRMT $ 25. 00 CJS 04/25/96 96-278613
5PCT $ 1. 25 CJS 04/25/96 96-27861,.,
TIGARD OR 97223
Phone #s
Contractoril
HOT SPOT FIREPLACE & PATIO
11525 SW CANYON RD
BEAVERTON OR 97005
Phone #: 503-626-4652, $ 26. 25 TOTAL
Reg #. . t 71782
REQUIRED 1NSPEC41ONS
This persit is issued subject to the regulations contained in the Mechanical I-isp
Tigard Municipal Code, State of Ore. Specialty Lodes and all ol:er Woodstuve Insp
applicable laws. All work will be lone in accordance with Final Inspectio-i
approved plans. This pernit will expire if work is not started
within 180 days of issuance, or if work is suspende,' for more
than 180 days.
i.,ermittee Siqnature:
d Sy
Call foi- inspection 639-4175
Citv of Tigard MECHANICAL PERMIT Planck/Rec. # 96. a 7Zr2
13125 sw Hall Blvd. APPLICATION Permit # #W96 oZ09
Tigard, OR 9722.3
(503) 639-41.71
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P t (- 1-• 1(�,}j 1 able 3A Mechanical Code CITY PRICE AMT
x• —
Jou
AddreC' J (�, u ! 1 j Permit Fee _0 _ 0- 10.00
2 �"7 2) Supplemental Permit 3.00
Furnace to T0177017-13TU—
/j 1) incl. ducts 6 vents 6.00
Furnace 100,000 BTU + �- --'
Owner L 2) incl. ducts&vents 7.50
FloorFumance --
3) incl. vent 6.00
�^• ^-^
Suspended heater, wall heater``— �
--.�n 44 _ _ 4) or floor mounted heater _ 3.00
Occupant 5)
notinc. in
5) appliance permit 3 no
ap Ropai—a of heahng,re nq. —
6) cooling,absorption unit 6.00 _
^ or comp, ea p
pum ,air con .
(, frA J(L4- 7) to 3 HP absorp unit M 100K BTU 6.00
—AoTr or comp,hoal pump, air corn .
O o/j 8) 3-i5 HP absorp unit to 500K BTU 1 i.00
Contractor r --13oilor or comp,heaTpump,air cond.
9) 15-30 HP absorp unit 5-1 mil BTU 15.00
MTM it or.omp, eat pump7air cond.
C_ 10) 30.50 HP absorp unit 1-1.75 mil BTU 22.50
hereby acmnowletgo that I nave read is application,that Bailor or comp,heat pimp, air con .-
information given is correct, that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU 37.50
of the owner,that plans submihod are in cornplian(xi with State it andifr unit 5 `—
laws, that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
-At the number given is correct. (If exempt from State registration, — it an Ming um
please give reason below.) 13) 10,000 CTM+ 7.50
—�— on portable — — ---
14) evaporate cooler _ 4.50
Vent fan connec
15) to a single duct 300
entiation system not — --—
tc 16) included in appliance permit 4 5n
Hood served y'- --
17) mechanical exhaust 450
escn wo new ar:lTun--0—alteration repair ammarcia Tor in t:5tna
to br,done residential non-residential Q 18) type incinerator J' 30 00
Existing use o -er o e.,wo s ova,,water 1
building or property_ 19) heater, solar,clothes dryers,otc. 4 50 h--
"roposed usr+0t 20) Cas piping one to four outlets 2.00
building or property ----
T e of fuel -oil natural as LPG 21) More than 4-per outlet
YP � 9 �� O electric Q
NOTICE
Minimum Fee$25 00 SUBTOTAL rC
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NO"COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR ---- -
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special Conditions
Date issuod y' LI 6 t: Cr/1G%-lam^ S[{inn c f�