07201575 Permit File
CITY OF DUBLIN
Jision of Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
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WTFD: (614) 652-3920
office
FIRE PROTECTION PERMIT APPLICATION
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Application Date Bldg. App. # Fire Protection App. #Q-4 •,)o
PROJECT INFORMATION
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)/~'~'~~%~~~c' Project
Project Address 7C
Owner/Tenant Contact Name Telephone
APPLICANT INFORMATION
Fire Protection Contractor c,
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Address zL11Z ~~'sl~,~fh~~c i-s e'j Telephone
State Certificate Number k-4'& Dublin Registration Number is7iX<s'
Installer Name /`~G'.?~._~~~~ State Certificate Numbek,'4
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 x x
FIRE DETECTION OR SUPPRESSION PERMIT PROCESSING FEE
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 e)t)
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.
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Signature of Lice Contractor ~ DATE
Print Name 77 e-_)A-r' DATE i/-.~• D 7
FOR OFFICIAL USE ONLY
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Review Comments: The s / k/er q/~crg~ion drgcvii?g /necfs k.hs/Sih
File Der//newf 4ae~oyo/ X"X
Fire Department: c~( ,,%e N.71S q Date: /S o7
Plans Examiner. + Date: I 1 0
Issued by CBO: Date: /ll~
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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 . . . . . 07-00201575 Date 11/19/07
Property Address . . . . . . 6670 PERIMETER DR
Parcel Number: 273-011173
Alternate Address: AVERY PLACE OFFICES II
Tenant nbr, name . . . . . . COL CARDIOLOGY/SUPPRESSIO
Application type description FIRE PROTECTION
Property owner . . . . . . . AVERY PERIMETER LLC
Contractor . . . . . . . . . SIMPLEX GRINNELL
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
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.