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07201662 Permit File CITY OF DUBLIN Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 410-4680 C E R T I F I C A T E O F O C C U P A N C Y P E R M A N E N T Issue Date . . . . . . 5/05/08 Parcel Number . . . . . 274-000889 Property Address . . . 5961 ROUNDSTONE PL FR DUBLIN OH 43016 Subdivision Name . Legal Description . . . Property Zoning . . . . PLANNED LOW DENSITY RES Owner . . . . . . . . AVERY JAN K Contractor . . BIG 8 REMODELING, INC. 614 475-2265 Application number 07-00201662 000 000 Description of Work COM BUILDING ALTERATION Construction type . . . 5B - UNPROTECTED COMB Occupancy type . . RES > 3 UNITS FIRE SEP Flood Zone . . . . . . Special conditions . . BASEMENT FINISH Approved . . . . . . it T Official VOID UNLESS SIGNED BY BUILDING OFFICIAL CITY OF DUBLIN Division of Building Standards • 5800 Shier Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 410-4680 COMMERCIAL INSPECTION SIGN-OFF Project Name: U'1F t S11 Use Group: 3 Construction Type: !515 Application No: 01- ZO 16(mA Project Address: qqJO/ Q *Ak_ pl General Contractor: mpip~~ Buildin Code: O O r. Y 7777 r . INSP Sewer Tap "Rough Sprinkler Footing Electric Service Foundation Steel - Framing Footing Steel Grounding Shaft Walls Foundation Insulation Piers Fireplace /97°x°' Waterproofing Curb, Walk & Approach Electrical Underground Above Ceiling Electric Plumbing Underground Above Ceiling HVAC dS~. W //W "Sprinkler Underground "Above Ceiling Sprinkler Pre-Slab Above Ceiling Structural °r8s 68 Irrr S#t' Diamonds Final Electric -L Structural Steel Final Plumbing 4 -Dt Fireproofing Final HVAC 08' /Wr Masonry Wall Grout Final Gas Piping o~ as 0 4w "Fire Alarm Rough "Fire Prevention Rough Electric Zoning Final Rough Plumbing j Engineering Final Rough HVAC I I Occupancy 0L,og "f& Vf0' Rough Gas Piping del*, 00 'w S ' "Please call Washington Township Fire Department at 652-3920 to schedule these inspections. DATE INSPECTION COMMENTS APPROVAL INSPECTOR TYPE CODE A CITY OF D U B L11r 5800 Shier Rings Road Division of Building Standards Dublin, Ohio 43016 COMMERCIAL BUILDING Telephone: 614-4104670 PERMIT APPLICATION Inspection Line: 614.4104680 Facsimile: 614-761-6566 PROJECT INFORMATION ddress g;-.f Ita fz Ip~4a° Project Sq Fig. Project Name Estimated Cost of Construction . c %c> Parcel Number - PROPERTY OWNER INFORMATION Property Owner Name (Contact Person if owned by a Corporation) CompanyName Address Src~! 1c Cit, >z~ State O(.. Zqr a 3 of 7 hone Fax E-Val TENANT INFORMATION (If Applicable) Contact Name Company Name Address city State Zip hone Fax E4AA ARCHITECT, ENGINEER, OR OTHER DESIGN PROFESSIONAL INFORMATION Design Professional Name Ohio RegrCert Number Company Name Address ily State Zip Telephone Fax E-Mail GENERAL CONTRACTOR INFORMAT ON (Must be a City of Dublin Registered Contractor) Contact Name Dublin Registration # O S 3 Company Name Address Z4 Op L ~L city- o State 0 ~1 T.ip e(3 5 12 T &1 L4- L{7S'- ZZfos" Fax /~(-~(7S=/444 E-N~ ? a 0,4 AFFIDAVIT OF OWNER AUTHORIZATION FOR REPRESENTATION Note: This person will be contacted with all official correspondence. All signatures must be ORIGINAL. ees Representative . s Relationship to Proj 1. Company Name 137 Position- s Telephone 4 Z.c 2- Z69" I, i~y=c3,4 (please print), the owner and applicant, hereby authorize 'f". Sew t E o act as my representative and agent in all matters pertaining to the processing and approval of this application including modifying the project, and 1 agree to be nd by all repr lions and agreements made by the designated agent Signature of Property Owner Date: - 07 I $~-tt the er or the Owners Representative, have read and understand the contents of all 3 pages of this application. The information contained in this Application, attached exhibits and other information submitted is complete and' I respects true and correct, to the best of my knowledge and belief. i ature of Owner's Representative: Date: t 7 D Building Standards Division Use Only Date Received Building Standards lication Number D / -cRd J (ao ~ OOYMERCWL BMDING PEWfr APPLICATION Pape t do P.VASSMAAXAF0RMS%COMMAPP_W62 FomM SU),201 Data. 02/16D0 CITY OF DUBLIN Division of Building Standards COMMERCIAL BUILDING PERMIT APPLICATION Project Name Permit Number PROJECT INFORMATION NOTE: The following information is to be completed by the Design Professional, registered in the State of Ohio, who was primarily responsible for the preparation of the construction documents. Scope of Project TYPE OF WORK (Check all that apply) A. New Structure B. Addition f Fire Wall Yes No C. Alteration Article 34 Yes No D. Change of Use Entire Structure Partial E. Change of Occupan Entire Structure Partial Previous Use(s) Use Group(s) ANALYSIS OF NEW STRUCTURE, ADDITION, AND/OR AREA TO BE ALTERED A. Occupancy Description Use Group(s)_ B. Mixed Use: Yes Non-separated =Separated NoEJ C. Type of construction D. Fire resistive construction Fire Test Design Numbers Exterior Walls hr. Fire Walls hr. Floor/Ceiling hr. Columns/Bearing Wall hr. Exit Enclosures hr. Shafts hr. Corridors hr. Tenant Separation hr. E. Floor Area/Floor Occupant Load/Floor Egress Capacity/Floor Number of Exits Basement 1; 3 1st J 43S 2nd t 2(0 3rd 4th & above F. Allowable maximum floor area (first floor footprint) Ll ?8 Does the above include street frontage increase? Yes R NoFi7l Does the above include increase for sprinklers? Yes No G. Number of stories above grade '2- Height Basement YesFT No0 COMMERCIAL BUILDING PERMIT APPLtCAMON Pape 2 of 3 P'APASSOLDGWORMSICOMMAPP.WB2 Formal BLD•201 Daft: 10111199 CITY OF DUBLIN Division of Building Standards COMMERCIAL BUILDING PERMIT APPLICATION H. Horizontal exits Yes No 1. Limited sprinkler system Yes No 1.7 J. Full automatic sprinkler system Yes No K. Standpipe system Yes No r/ L. Smoke control/Removal system Yes No M. Unlimited area building Yes No N. Manual fire alarm Yes No ? 0. Auto fire alarm Yes No P. Handicap accessible route (exterior & interior) Yes No Q. Structural Loads: provide table of design loads with construction documents EXISTING STRUCTURE ANALYSIS (Complete for all alteration or addition projects) A. Occupancy Description Use Group(s) B. Mixed Use: Yes Non-separated =Separated E No C. Type of construction D. Floor Area/Floor Occupant Load/Floor Egress Capacity/Floor Number of Exits Basement 1st i y39, 2nd 120(0 3rd 4th & above E. Allowable maximum floor area (first floor footprint) W3 t Does the above include street frontage increase? Yes No m Does the above include increase for sprinklers? Yes 8 No I F. Number of stories above grade 2 Building Height Basement Yes[!' No0 G. Horizontal exits Yes No H. Limited sprinkler system Yes No 1. Full automatic sprinkler system Yes No v J. Standpipe system Yes No K. Smoke control/Removal system Yes No ? L. Unlimited area building Yes No ? M. Manual fire alarm Yes No ? N. Auto fire alarm Yes No 0. Handicap accessible route (exterior & interior) Yes No P. Structural Loads: provide tablle of design loads with construction documents I, S~vZI` the Design Professional, have read and understand the contents of this application. The information contained in this application, attached exhibits and other information submitted, is complete and in all respects true and correct, to the best of my knowledge and bel Signature of Design Professional: Date: L / 7t10--7 COMMERCM MALDING PERMIT APPLICATION Pape 3 of 3 P.'1PASSIBLDGIFORMSTOMMAPP.W62 Fw" BLD-Z M DaW 10M 1199 ' CITY OF DUBLIN Building Standards - 5800 Shier Rings Road - Dublin, Ohio 43016 Phone: (614) 410-4670 - Inspection Line: (614) 410-4680 WALK-THROUGH ELIGIBILITY EVALUATION FORM Project Name: ~-p Project Address: 5 r 6 / e` _ ct~,,. PLC Applicant: Sze Phone: Author of Drawings (in attendance): s )t-Tt___~_ { Phone:6, I General Contractor (required): c, ~iA- Contractor Registration Number: 0 $ - .15,3 Project Square Footage: q(o d Circle the appropriate categorylcategories in each box and put the corresponding point value in the equation at the bottom of the page. A B C D Square Footage Use Group(s) Type of Construction Plan Originator 0 to 1000 ..................1.0 Al ...........................3.0 IA............................ 3.0 Ohio Architect, 1001 to 2000 . A2...........................3.0 IB............................ 2.5 Ohio Engineer, 2001 to 3000 .............2.0 A3...........................1.8 Certified Designer or a 3001 to 4000 .............2.5 A4...........................1.6 IIA........................... 2.5 combination of 4001 to 5000 .............3.0 A5...........................1.0 11B...........................1.0 above ..1.0 B ..............................1.0 Projects over 3, 000 sq. ft. E ..............................1.8 111A 2.5 Non-professional........ 3.0 are not considered without F1 & F2 ....................2.5 IIIB.......................... 1.3 CBO permission. H N/P Author of the drawings "Rated corridor if 30 or 1 1,2,3 3.0 IV............................ 1.2 must be a certified more occupants. M ............................1.8 professional if the project ...........................1.5 VA............. 2.5 requires technical analysis S1 ...........................1.4 .......................2.5 of safety or sanitation. S2 ............................1.2 U .............................1.0 E F G H Nature of Work Permits Required Number of Floors Number of Drawings (Add all permits requir (involved in the review) (Excluding cover sheet Alteration .................1.0 Building................... 1............................ 1-4.................... .....1 Demolition & Zoning Compliance.... 2 .............................2.0 5-8.......................... 2.0 Build Out 1.2 HVAC minor/existing.. 1.0 9-13......................... 3.0 New Building HVAC new system(s) 0 Permission required from 14-20 ......................4.5 (<120 sq. ft.) .............1.2 Electrical (minor)....... ..0 CBO for any more floors Addition Electrical (new equip).. involved. (<1,000 sq. fi ............1.0 Change of Permit Occupancy ................3.0 Point Total.......... Additions > 1,000 sq. ft. and new buildings > 120 s q. ft. are ineligible. A B C D E F G H TOTAL - The sum of the above calculation may not exceed 14 for Walk-Through consideration. • The approved Record of Action or any required Zoning hearing is required at this review. - The Plans Examiners will table any examination that will take more than 25 minutes. Fax this completed form, Building Permit Application and Zoning Compliance form to Building Standards 614-761-6566. T:\OFFICE\WP\DOCS\DOC\Excel\2006 walkthrough I~~~ISI I~~~Irrrrrll r r~~ CITY OF DUBLIN M Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 410-4680 Date i s a-1a 0 Application No. y/ r APPLICATION FOR ELECTRICAL PERMIT Job Address 5 6 4 1 A o w 16 jop t /DZ_ Parcel No. Subdivision Lot No. Owner Name ? C- 11 ~ r 11-0e'Sj Telephone U't a18'~ Contractor Name I n Telephone ~ Contractor Address 10 73k Dublin Registration No. Residential: 4 New Sq. Ft. Alteration/Addition Sq. Ft. Temporary Service $40.00 $40.00 Minimum plus $20.00 for each additional 500 Sq. Ft. or fraction thereof over 1000 Sq. Ft. Low Voltage Systems: Square Feet $40.00 Minimum plus $10.00 for each additional 500 Sq. Ft. or fraction thereof over 1000 Sq. Ft. Commercial: New Sq. Ft. Alteration/Addition Sq. Ft. Temporary Service $60.00 $60.00 Minimum plus $60.00 for each additional 1000 Sq. Ft. or fraction thereof over 1000 Sq. Ft. M, 00 and up to 50,999 Sq. Ft. (sizes above, See Fee Schedule) Low Voltage Systems: Square Feet $30.00 Minimum (plus $20.00 for each additional 1000 Sq. Ft. or fraction thereof over 1000 Sq. Ft.) 3% State of Ohio Surcharge (commercial only) Total $ ? 0 JOB DESCRIPTION R& 2442.8,72/ This permit is granted on the express condition that the said work shall in all respects, conform to the ordinances of the City of Dublin, all the laws of the State and the National Electric Code regulating construction, installation, repair and alteration, and may be revoked at any time upon violation of any provisi s of said laws. Signature of licensed contractor or homeow er Division of Building Standards Date: 1/1/2001 CITY OF DUBLIN Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 410-4680 Application Number . . . . . 07-00201662 Date 1/23/08 Property Address . . . . . . 5961 ROUNDSTONE PL Parcel Number: 274-000889 Alternate Address: LAKES Q BALLANTRAE BLD 8C Tenant nbr, name . . . . . . BASEMENT FINISH Application type description COM BUILDING ALTERATION Property owner . . . . . . . AVERY JAN K Contractor . . . . . . . . . BIG 8 REMODELING, INC. Structure Information 000 000 Construction Type . . . . . 5B - UNPROTECTED COMB Occupancy Type . . . . . RES > 3 UNITS FIRE SEP Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 120.00 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date . . 7/21/08 Qty Unit Charge Per Extension BASE FEE 60.00 1.00 60.0000 THOU COM ELECTRIC SERVICE 1K-50K SF 60.00 Special Notes and Comments IF IN THE COURSE OF CONSTRUCTION, WORK IS DELAYED OR SUSPENDED FOR MORE THAN SIX MONTHS, THE APPROVAL OF PLANS OR DRAWINGS AND SPECIFICATIONS OR DATA IS INVALID. TWO EXTENSIONS SHALL BE GRANTED FOR SIX MONTHS EACH IF REQUESTED BY THE OWNER AT LEAST 10 DAYS IN ADVANCE OF THE EXPIRATION OF THE APPROVAL AND UPON PAYMENT OF A $20.00 EXTENSION FEE SIGNED CHIEF BUILDING OFFICIAL Jeffrey S. Tyler, AIA Other Fees . . . . . . . SURCHARGE FEE - ELECTRIC 3.60 SURCHARGE FEE - BLDG 3.00 SURCHARGE FEE - HVAC 3.00 Fee summary Charged Paid Credited Due Permit Fee Total 120.00 .00 .00 120.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 9.60 6.00 .00 3.60 Grand Total 129.60 6.00 .00 123.60 This permit is granted on the express condition that said work shall in all respects, conform to the ordinances of the City of Dublin and all laws of the State of Ohio regulating construction, installation, repair and alteration and may be revoked at any time upon violation of any provisions of law. CITY OF DUBLIN Division of Building Standards * 5800 Shier-Rings Road * Dublin, Ohio 43016 Phone: (614) 410-4670 * Inspection Line: (614) 410-4680 Supplement to Plan Approval Application Date: 12/3/2007 Application Number: 07 -201662 Property Address: 5961 ROUNDSTONE PL Project Description: BASEMENT FINISH THIS IS NOT A BUILDING PERMIT. IT IS A SUPPLEMENT TO OUR REVIEW OF DOCUMENTS SUBMITTED WITH YOUR APPLICATION FOR A BUILDING PERMIT This SUPPLEMENT TO THE PLAN APPROVAL is issued by the City of Dublin, Division of Building Standards. Listed below are items which may not appear in the construction documents, but which are not considered to constitute a hazard serious enough to warrant withholding Plan Approval. The fo/lo wing items are conditions of the issuance of the Plan Approval,, when applicableItem 1. OBC 109.2 Lot line markers required. Before any work is started in the construction of a building or an addition to a building to which the rules of the Board are applicable under Section 10 1.2, all boundary lines shall be clearly marked at their intersections with permanent markers or with markers which are offset at a distance which is of record with the owner. Item 2. OBC. 106.3.1 Approval of construction documents. When the construction documents have been determined to conform to the applicable provisions of the rules of the Board in accordance with the procedures set forth in Section 105.3.1, the building official shall endorse or stamp such plans as approved. One set of construction documents shall be kept by the building official. The other set(s) shall be returned to the applicant, kept at the work site and shall be open for inspection by the the building official or the building official's designated representative. Item 3. OBC 105.7.2 Posting. The certificate of plan approval shall be posted in a conspicuous location outside of the building and in the front part of the premises on which is, or will be the approved building or equipment to which the approved plans relate. The owner and the contractor shall, so far as possible, preserve and keep the certificate posted until the completion of the work to which the approved plans relate. Item 4. OBC. 106.4 Amended construction documents. If substantive changes to the building are contemplated after first document submission, or during construction, those changes must be submitted to the building official for review and approval prior to those changes being executed. The Building official may waive this requirement in the instance of an emergency repair or similar instance. Item 5. OBC 109.1 General. Construction or work for which an approval is required shall be subject to inspection by the building official and such construction or work shall remain accessible and exposed for inspection purposes until approved. This includes firestopping and draftstopping /Chapter 7 OBCJ, mechanical work piping, ducts and systems fChapter 3 OMCJ, structural members and connections /Chapter 16, OBCJ, and electrical work fChapter 27 OBCJ. Existing electrical conductors, if removed, abandoned, or altered, shall be accomplished to the electrical field inspector's approval. Electrical work found not to meet the code's standards shall be corrected to the electrical field inspector's approval All systems and elements covered by code are to be inspected and approved before being covered. Page 1 of 2 Item 6. OBC 1 103.1 Where required. Building and structures, temporary or permanent, including their associated sites and facilities, shall be accessible to persons with physical disabilities. OBC 1 103.2.1 Specific requirements. Accessibility is required in building and facilities, or portions thereof, to the extent indicated in ADAAG Section 4.1 and this chapter. The start of construction indicates acceptance of all the conditions listed above. This review does not preclude the necessity to conform to provisions which may have been omitted or overlooked in the review process, but which are requirements of the code. Ultimate responsibility for legal compliance with the Standards of Safety rest with the registered design professional, the tenant and the owner. Plan Approval will be valid only upon receipt by the City of Dublin, Building Standards, of one signed copy of the addendum to the submitted plans. TO REQUEST AN APPEAL HEARING, YOU MUST send a written request, listing the items to be appealed and the relief sought and one copy of this order to: Jeffrey S. Tyler, Chief Building Official City of Dublin 5800 Shier Rings Road Dublin, Ohio 43016-1236 Reviewed and Signed, Ra M. H rphaA chitect j Tyler, AIA Commercial Plans Examiner Chi B ilding Official City of Dublin City o ublin Si &ture - Architect, Engineer or Contractor Date Print Name and Title as Signed Page 2 of 2 CITY OF DUBLIN Building Standards - 5800 Shier-Rings Road - Dublin, Ohio 43016 Phone: (614) 410-4670 - Inspection Line: (614) 410-4680 Application Number . . . . . 07-00201662 Date 12/06/07 Property Address . . . . . . 5961 ROUNDSTONE PL Parcel Number: 274-000889 Alternate Address: LAKES @ BALLANTRAE BLD 8C Tenant nbr, name . . . . . . BASEMENT FINISH Application type description COM BUILDING ALTERATION Property owner . . . . . . . AVERY JAN K Contractor . . . . . . . . . BIG 8 REMODELING, INC. Structure Information 000 000 Construction Type . . . . . 5B UNPROTECTED COMB Occupancy Type . . . . RES > 3 UNITS FIRE SEP Permit . . . . . . COMMERCIAL BUILDING PERMIT Additional desc . 1,438 SQUARE FEET Permit Fee . . . . 100.00 Plan Check Fee .00 Issue Date . . . . ia- tl°o'-1 Valuation . . . . 0 Expiration Date 6/03/08 Qty Unit Charge Per Extension BASE FEE 100.00 Special Notes and Comments IF IN THE COURSE OF CONSTRUCTION, WORK IS DELAYED OR SUSPENDED FOR MORE THAN SIX MONTHS, THE APPROVAL OF PLANS OR DRAWINGS AND SPECIFICATIONS OR DATA IS INVALID. TWO EXTENSIONS SHALL BE GRANTED FOR SIX MONTHS EACH IF REQUESTED BY THE OWNER AT LEAST 10 DAYS IN ADVANCE OF THE EXPIRATION OF THE APPROVAL AND UPON PAYMENT OF A $20.00 EXTENSION FEE SIGNED CHIEF BUILDING OFFICIAL ey S. Tyler, AIA Other Fees . . . . . . . . . SURCHARGE FEE - BLDG 3.00 Fee summary Charged Paid Credited Due Permit Fee Total 100.00 .00 .00 100.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 3.00 .00 .00 3.00 Grand Total 103.00 .00 .00 103.00 CITY OF DUBLIN Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 410-4680 APPLICATION FOR GAS PIPING PERMIT a t Q Date Application No. (24 - AQ `~k4o Job Address .51: 6/ ! ~ G~ r 3 f Parcel No. a 7V -0 00 9 0-7 - 00 o?~ S Subdivisions Lot No. Owner Name atr! Telephone Contractor Name r? •i c h Telephone to LY "y7-1r 33 9 Contractor Address S! S l S~ l`•' ' v S d y~~ Dublin Registration No esidential ( ) Commercial ( )Alter Existing Addition to Building ( ) Replace/Repair Existing Type of Pipe to be Installed: ( ) Iron CSST ( ) Other _ Min. Pipe Size Required: 1 in. Regulator Size BTU Max. Gas Appliances BTU/IIR Range Water Heater Dryer Gas Logs Log Lighter Furnace(s) _/OD Other: IT-AS la,_ FEE $70.00 3% State of Ohio Surcharge (commercial only) e~ • 10 Total Total $ • ~Ao JOB DESCRIPTION ~"71 'q0_5 /.go tifa rc~O~t At~~ • ' d7 6 °Z This permit is granted on the express condition that the said ork sha in all respects, conform to the ordinances of the City of Dublin and all the laws of the State regulating construction, install , rep 'r a alteration, and may be revoked at any time upon violation of any provisions of said laws. Signature of licensed contractor or homeowner Division of Building Standards y CITY OF DUBLIN Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 410-4680 Application Number . . . . . 07-00201662 Date 2/19/08 Property Address . . . . . . 5961 ROUNDSTONE PL Parcel Number: 274-000889 Alternate Address: LAKES @ BALLANTRAE BLD 8C Tenant nbr, name . . . . . . BASEMENT FINISH Application type description COM BUILDING ALTERATION Property owner . . . . . . . AVERY JAN K Contractor . . . . . . . . . BIG 8 REMODELING, INC. Structure Information 000 000 Construction Type . . . . . 5B - UNPROTECTED COMB Occupancy Type . . . . . . RES > 3 UNITS FIRE SEP Permit . . . . . . GAS PIPING PERMIT Additional desc . . Permit Fee . . . . 70.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/17/08 Qty Unit Charge Per Extension BASE FEE 70.00 Special Notes and Comments IF IN THE COURSE OF CONSTRUCTION, WORK IS DELAYED OR SUSPENDED FOR MORE THAN SIX MONTHS, THE APPROVAL OF PLANS OR DRAWINGS AND SPECIFICATIONS OR DATA IS INVALID. TWO EXTENSIONS SHALL BE GRANTED FOR SIX MONTHS EACH IF REQUESTED BY THE OWNER AT LEAST 10 DAYS IN ADVANCE OF THE EXPIRATION OF THE APPROVAL AND UPON PAYMENT OF A $20.00 EXTENSION FEE`*** SIGNED CHIEF BUILDING OFFICIAL Jeffrey S. Tyler, AIA Other Fees . . . . . . . SURCHARGE FEE - GAS LINE 2.10 Fee summary Charged Paid Credited Due Permit Fee Total 70.00 .00 .00 70.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 2.10 .00 .00 2.10 Grand Total 72.10 .00 .00 72.10 This permit is granted on the express condition that said work shall in all respects, conform to the ordinances of the City of Dublin and all laws of the State of Ohio regulating construction, installation, repair and alteration and may be revoked at any time upon violation of any provisions of law. - CITY OF DUBLIN Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 410-4680 APPLICATION FOR HVAC PERMIT Date O l Application No. G) ( 9 S t~ Job Address ~V Lsad~Parcel No. Subdivision Lot No. Owner Name Telephone Contractor Name (k)" Telephone (D Lh3~ IbJ Contractor Address o • ~Jl) lC X'W~~ N h lin Registration No. Residential: Sq. Ft. $60.00 Minimum plus $30.00 for each additional 500 Sq. Ft. or fraction thereof over 1000 Sq. Ft. $60.00 REPLACEMENT UNITS GAS ELECTRIC. (Minimum fee only) Commercial: New/Addition Sq. Ft. Alteration I ' • ` New/Addition: $70.00 Minimum plus $30.00 for each additional 1000 Sq. Ft. or fraction thereof over 1000 Sq. Ft. Alteration: $70.00 Minimum plus $20.00 for each additional 1000 Sq. Ft. or fraction thereof over 1000 Sq. Ft. 3% State of Ohio Surcharge (commercial only) Total $ G6(?wATk_ $ JOB DESCRIPTION -2~~4 R S This permit is granted on the express condition that the said work shall in all res , conform to the ordinances of the City of Dublin and all the laws of the State regulating construction, installation, rep and alt raqn, may be revoked at any time upon violation of any provisions of said laws. ' Signature of licensed contractor or homeowner Division of Building Standards CITY OF DUBLIN Building Standards - 5800 Shier-Rings Road - Dublin, Ohio 43016 Phone: (614) 410-4670 - Inspection Line: (614) 410-4680 Application Number . . . . . 07-00201662 Date 1/15/08 Property Address . . . . . . 5961 ROUNDSTONE PL Parcel Number: 274-000889 Alternate Address: LAKES @ 13ALLANTRAE BLD 8C Tenant nbr, name . . . . . . BASEMENT FINISH Application type description COM BUILDING ALTERATION Property owner . . . . . . . AVERY JAN K Contractor . . . . . . . . . BIG 8 REMODELING, INC. Structure Information 000 000 Construction Type . . 5B - UNPROTECTED COMB Occupancy Type . . RES > 3 UNITS FIRE SEP Permit . . . . . . COM HEATING, VENTILATING, A.C. Additional desc . Permit Fee . . 100.00 Plan Check Fee .00 Issue Date . Valuation . . . . 0 Expiration Date . 7/13/08 Qty Unit Charge Per Extension BASE FEE 70.00 1.00 10.0000 THOU COM HVAC ALT 10.00 1.00 20.0000 THOU COM HVAC NEW/ADD 20.00 Special Notes and Comments' IF IN THE COURSE OF CONSTRUCTION, WORK IS DELAYED OR SUSPENDED FOR MORE THAN SIX MONTHS, THE APPROVAL OF PLANS OR DRAWINGS AND SPECIFICATIONS OR DATA IS INVALID. TWO EXTENSIONS SHALL BE GRANTED FOR SIX MONTHS EACH IF REQUESTED BY THE OWNER AT LEAST 10 DAYS IN ADVANCE OF THE EXPIRATION OF THE APPROVAL AND UPON PAYMENT OF A $20.00 EXTENSION FEE SIGNED CHIEF BUILDING OFFICIAL Jeffrey S. Tyler, AIA Other Fees . . . . . . SURCHARGE FEE - HVAC 3.00 Fee summary Charged Paid Credited Due Permit Fee Total 100.00 .00 .00 100.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 3.00 .00 .00 3.00 Grand Total 103.00 .00 .00 103.00 This permit is granted on the express condition that said work shall in all respects, conform to the ordinances of the City of Dublin and all laws of the State of Ohio regulating construction, installation, repair and alteration and may be revoked at any time upon violation of any provisions of law. CITY OF DUBLIN Division of Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 462-3865 (Franklin County) Application No. 0-4• ~to` b Date ? New ? Remodel ? Residential ? Commercial APPLICATION FOR PLUMBING PERMIT The undersigned hereby applies for a permit to do plumbing and an inspection of same at the following location in accord with Chapter 4101:2-51 of the Ohio Administrative Code, and all regulations of the Franklin County Board of Health. Job Address I b 1 hip i11 o a 4 D: IFWJ F Parcel No•J 7 V -b 6D Subdivision/Project Name Lot No. Owner's Name Telephone Contractor's Name tf F'Jr PL U WZ_J to Telephone Contractor's Address h. b 3 6-7 C{ 9 Dublin Registration Number A Mar Af it? F~ a R Does the sewer discharge into an individual sewage disposal system o sanitary sewer? How far distant from any dwelling, well or cistern is the sewage tank? What is the size of the main drain? q IL Of what materials do the vent pipes consist? ~UC. Of what material does the house drain consist? P V C~ *INDICATE NAME OF CERTIFIED BACKFLOW TESTER This form must be properly filled out and returned to the office of the City of Dublin at least four days prior to the date of the FIRST INSPECTION, accompanied by a fee calculated upon the following basis: WATER TANK REPLACEMENT FEE $35.00 RESIDENTIAL COMMERCIAL Application for permit & first fixture $50.00 Application for permit & first fixture $60.00 Number of remaining fixtures X $10.00 = $ Number of remaining fixtures X $12.00 = $ Total Inspection Fee $ Total Inspection Fee Re-inspection fee (based upon disapproved Inspection and collected by the Franklin County Board of Health ONLY) $45.00 Qty. Qty. _ Qty. Air Admittance Valve ` Garbage Disposal Showers *Backflow Preventers Gas Water Heater Sterilizers Bath Tubs Electric Water Heater Sum Pump Bed Pan Washers Interceptor Trap Primer Bidet Kitchen Sink Urinal Chemical Sinks Laundry Trays Wash Fountain Dental Cuspidors Lavatories Washing Machine Dilution Sum Mop Sinks Water Closets Dish Washers Outside Faucets Water Lines Drinking Fountain Roof Drains Water Stora a Tank Floor Drains Rough-in Openings for Future Other / Garage Catch Basin Sewage Ejectors GRAND TOTAL Division of Building Standards \ - ~3k <DB CITY OF DUBLIN .low Building Standards - 5800 Shier-Rings Road - Dublin, Ohio 43016 Phone: (614) 410-4670 - Inspection Line: (614) 410-4680 Application Number . . . . . 07-00201662 Date 1/22/08 Property Address . . . . . . 5961 ROUNDSTONE PL Parcel Number: 274-000889 Alternate Address: LAKES @ BALLANTRAE BLD 8C Tenant nbr, name . . . . . . BASEMENT FINISH Application type description COM BUILDING ALTERATION Property owner . . . . . . . AVERY JAN K Contractor . . . . . . . . . BIG 8 REMODELING, INC. Structure Information 000 000 Construction Type . . . . . 5B - UNPROTECTED COMB Occupancy Type . . . RES > 3 UNITS FIRE SEP Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 84.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/16/10 Qty Unit Charge Per Extension BASE FEE 60.00 2.00 12.0000 EA -COM PLUMBING >1 FIXTURE 24.00 Special Notes and Comments IF IN THE COURSE OF CONSTRUCTION, WORK IS DELAYED OR SUSPENDED FOR MORE THAN SIX MONTHS, THE APPROVAL OF PLANS OR DRAWINGS AND SPECIFICATIONS OR DATA IS INVALID. TWO EXTENSIONS SHALL BE GRANTED FOR SIX MONTHS EACH IF REQUESTED BY THE OWNER AT LEAST 10 DAYS IN ADVANCE OF THE EXPIRATION OF THE APPROVAL AND UPON PAYMENT OF A $20.00 EXTENSION FEE SIGNED CHIEF BUILDING OFFICIAL Jeffrey S. Tyler, AIA Fee summary Charged Paid Credited Due Permit Fee Total 84.00 .00 .00 84.00 Plan Check Total .00 .00 .00 .00 Grand Total 84.00 .00 .00 84.00