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07201324 Permit File
Office CITY OF DUBLIN Division of Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016 Phone: (614) 410-4670 • Inspection Line: (614) 410-4680 WTFD: (614) 652-3920 SEP 0 5 2007 a FIRE PROTECTION PERMIT APPLICATION Application Date Bldg. App. #®-1-_\C ? 0Q Fire Protection App. # o4' PROJECT INFORMATION Project Address .S-6 0 -0 '7 Project Name 0L(3i-: ,J lie -ter=~ Owner/Tenant Contact Name Telephone APPLICANT INFORMATION Fire Protection Contractor ,"9i/ ST.Vri= 4,,1 e Pi d recT Address ~T'Ss /l 2S7}'~ Lou do.-1,1. 1/t A Yy99ZTelephone 217s' 0,61 Number - /,o 3 / 4) l y - Dublin Registration Number0 • _S State Certificate , l Installer Name ''©CS"= State Certificate Number 4314t~ 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 /o Limited Area Other FEES FIRE DETECTION OR SUPPRESSION PERMIT PROCESSING FEE $6"e 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 lu 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 part thereof, nor to make any connection to a water main. Signature of Licensed Contractor DATE s ` 7 Print Name DATE FOR OFFICIAL USE ONLY Revie Comments: ec 11'-ee { d~ / °L ~ -~c P Fire Department Date: l"I O Plans Examiner: ate: Issued by CBO: Date: O7