04200157 Permit File
_ 1?
Vvision of Building Standards
5800 Shier Rings Road
Dublin, Ohio 43017-2182
7C Phone: V/TDD 614/761-6556
1 rh~ l'..~' i Inspection Line: 614/761-6557
h
City of Dublin Use Only
Permit Number: - ,j'7 Date Applied:
Job Address: 5Y95 kolhoS goad X550
Description of removal project:- I)errro coreAeretice room non-.s~i^ucfura/~~cawo treP&ce-
c4r4ff, 1~a~oti re-P.,Kf+ demo corner wi//wor, ih coy-fit-retice root.
Occupancy Type: - $uS/Ness , 7I Ci ~ FULLY YNWA I-C- 0E D
Owner (please print): DvAeg 45,4r ry C'ogi0oiznr/ox) Telephone: 93"2- a 0 06
Contractor: DvkE ~OA1STRt~Gr/off /--P Telephone: 9YA-6/a.'-
DublinContractor Registration No.: 0q- 0070$'
Please submit the following with this application:
(Complete Removals: Items 1,2,3,5,6 - Tenant Improvements: Item 4)
1. Deed showing ownership,
2. A receipt from the County Auditor's office showing the real estate taxes have been paid to date,
3. Franklin County Board of Health approval to disconnect private sanitary sewer (if applicable),
4. A drawing showing which portions of the building are to be removed (if applicable),
5. Copy of EPA "Notification of Demolition and Removal".
6. Signed affidavit from applicant stating that the building has been reviewed for hazardous materials
and that none exist or the hazardous material has been abated, or copy of hazardous material report.
St~.Plan s?,c,w;r.~c~jcce..kR~Pcrt+e5
The owner and/or contractor assumes all responsibility for compliance with the Building and Zoning Codes of the City
of Dublin. All violations of the Building and/or Zonin Codes shall be corrected at the request of the Division of
Building Standards.
Owner (signature): Date: -
Contractor (signature): Date:
Permission is hereby granted to start removal of existing construction prior to obtaining building permit, after zoning
approval.
Certificate of Zoning
Clearance No.: Entry No.: 11011 Date ed: ! Other Permits:
By-.( Date:
Chief Building Official: ( Date: -2 1C),(
e
1'
FF5
Ei
a
i i
`'CC
~ G
f m bz
¢1
o a 3 C'! C
v
d s' O to
CD Cj)
m C
0
0 0 y M
C11
c Z N
m o' D
CD cn r
m n
o
a
0
r
CITY OF DUBLIN
Division of Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
Application Number . . . . . 04-00200157 Date 2/12/04
Pin number . . . . . . .547728
Property Address . . . . . . 5455 RINGS RD
Parcel Number . . . . . . . . 273-008241
Alternate Address . . . . . . SOUTH TOWER
Tenant nbr, name . . . . . . 550 DEMOLITION
Application description . . . DEMOLITION PERMIT
Property owner . . . . . . . *UNKNOWN
Contractor . . . . . . . . . DUKE CONSTRUCTION MANAGEMENT
Permit . . . . . . DEMOLITION PERMIT
Additional desc . .
Permit Fee . . . . 120.00 Plan Check Fee .00
Issue Date . . . . V/l1/o4 valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 120.00
Other Fees . . . . . . . . . SURCHARGE FEE - BLDG 3.60
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 3.60 .00 .00 3.60
Grand Total 123.60 .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.