07201688 Permit File
C~,u,~l i ~ far
CITY OF DUBLIN
m
ffice
R PORM Building Standards - 5800 Shier-Rings Road - Dublin, Ohio 43016
hone: (614) 410-4670 - Inspection Line: (614) 410-4680
DEC 1 1 2007 WTFD: (614) 652-3920
BUILDING DIVISION
CITY-OF DUBLIN FIRE PROTECTION PERMIT APPLICATION o
Application Date Bldg. App. # 01- aONcl 1 Fire Protection App. #
PROJECT INFORMATION
Project Address g317_ TULLE? RO z QUILb I M L -0-Li Project Name J icoJ ~3y Tr),Hoowd
Owner/Tenant Contact Name Telephone
APPLICANT INFORMATION
C~ .
Fire Protection Contractor EI4TI. f T /ZC PR6TSC-T I b 0
Address j54/0 P RkW ` C I z L 1 1? oi4 b26Telephone tv U - '7-7'7- GOO
State Certificate Number -5 -,45- IT c? Dublin Registration Number b''1- 32-08
Installer Name T I M Il (ty State Certificate Number 5q-Z5- 0351
SCOPE OF WORK
(Mark One) New Replace Repair Alteration
FIRE DETECTION AND ALARM SYSTEM (Number of Each)
Detectors Strobes Horns Fire Alarm Boxes Other
SUPPRESSION SYSTEM (Number of Each)
Standpipes _ On Site Water Piping Sprinkler Heads Limited Area Other
FEES
FIRE DETECTION OR SUPPRESSION PERMIT PROCESSING FEE $60.00
LOW VOLTAGE PERMIT (DETECTION ONLY) $30.00 Minimum fee
plus $20.00 each 1,000 sq ft or fraction thereof over 1,000 sq ft
OUTSIDE PLAN REVIEW SERVICES (EXAMINER'S FEE AS CHARGED)
STATE SURCHARGE (3%)
TOTAL FEE DUE
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 said laws. This permit conveys no right to
open any street, alley or sidewalk or any art thereof, nor to r y 1connection to a water main.
Signature of Licensed Contractor 6&.4 ' DATE
Print Name -Jc/4 g y k 1DATE
FOR OFFICIAL USE ONLY
Review Comments: The SPr1h1r1,-r q1&rahbn c~i-gwi~g mn_-7& Wgsh~;n*17 7-2>w sh%D
Fire Deyg/fir~Pnt 192rovA/
Fire Department: aAw Or fire s Date: /c9 /y4 v7
Plans Examiner: Date: 07
Issued by CBO: Date: i d
CITY OF DUBLIN
Building Standards - 5800 Shier-Rings Road - Dublin, Ohio 43016
Phone: (614) 410-4670 - Inspection Line: (614) 410-4680
Application Number . . . . . 07-00201688 Date 12/20/07
Property Address . . . . . . 4362 TULLER RD
Parcel Number: 273-008958
Alternate Address:
Tenant nbr, name . . . . . . SIGNS BY TOMORROW SUPPRES
Application type description FIRE PROTECTION
Property owner . . . . . . . CENTURY LIFE OF AMERICA
Contractor . . . . . . . . . GENTRY FIRE PROTECTION CO.
Permit . . . . . . FIRE SUPPRESSION PERMIT
Additional desc . .
Permit Fee . . . . 60.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 60.00
Special Notes and Comments
CONTACT WASHINGTON TOWNSHIP FIRE
PREVENTION FOR INSPECTIONS AT 766-0857
Other Fees . . . . . . . . . SURCHARGE FEE - FIRE 1.80
Fee summary Charged Paid Credited Due
Permit Fee Total 60.00 .00 .00 60.00
Plan Check Total .00 .00 .00 .00
Other Fee Total 1.80 .00 .00 1.80
Grand Total 61.80 .00 .00 61.80