08200068 Permit FileCITY OF DUBLIN
Division of Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
This is to ce
described below and
ADDRESS: ?I I !z- fl le m5ih,L.t _?;/-
PERMIT
the residence
or occupancy.
No.: B Jza????
By. FINAL INSPECTION DATE:
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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) 462-3865 (Franklin County)
Application No. o( )•
Date 1-31_08 ? New ? Remodel )dResidential ? 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 ? ? 9 2 PIQT N S 1419115 sr ;y,' ? . Parcel No. 2- 73 "? ??5 ??
Subdivision/Project Name JAi),UY u
Owner's NameA_)n??KA"TH L EC-1.)
Contractor's Name
Contractor's Address ?
?
Does the sewer discharge into an indiv
How far distant from any dwelling, well or cist"rr"
What is the size of the main drain?
Of what material does the house drain consist? _
*INDICATE NAME OF CERTIFIED BACKFLOW
This form must be properly filled out and retumed to
accompanied by a fee calculated upon the followin
_ Lot No 2.3
:Telephone I q I - l 1
Telephone
" ??Wation Number
sanitary 8000r? AVO
the
Of
pipes consist?
R
of the City of Dublin at least four days prior to the date of the FIRST INSPECTION,
R TANK REPLACEMENT FEE $35.00
RESIDENTIAL COMMERCIAL
Application for permit & first fixture .. ......... ................ $50.00 Application for permit & first fixture.............................. $60.00
?- Number of remaining fixtur"?C $10.00 =$ Number of remaining fixtures X$12.00 =$
Total Inspection Fee ..................................... ........ ..... $ ?D•0-0 . Total Inspection Fee ....................................................$
Re-inspection fee (based upon disapproved Inspection and collected by the Franklin County Board of Health ONLY) $45.00
Qty.
Air Admittance Valve
"Backflow Preventers
Bath Tubs
Bed Pan Washers
Bidet
Chemical Sinks
Dental Cuspidors
Dilution Sum
Dish Washers
Drinkin Fountain
Floor Drains
Garage Catch Basin
Division of Building Standards
Washing Machine
Water Closets
Water Lines
.
?
CITY OF DUBLIN
Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
Application Number ..... 08-00200068 Date 2/04/08
Property Address ...... 6192 PIRTHSHIRE ST
Parcel Number: 273-009543
Alternate Address: SANDY CORNERS 1#23
Tenant nbr, name ...... BASEMENT FINISH
Application type description RES REMODEL
Property owner ....... HOLOWATY ANDREW A JR & KATHLEE
Contractor . . . . . . . . . HOMEOWNER/OWNER
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . NOT APPLICABLE
Occupancy Type . . . . . . NOT APPLICABLE
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee .... 80.00 Plan Check Fee .. .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/29/10
Qty Unit Charge Per Extension
BASE FEE 50.00
3.00 10.0000 EA RES PLUMBING >1 FIXTURE 30.00
----------------------------------------------------------------------------
Special Notes and Comments
NOTICE TO APPLICANT
SEPARATE OWNER/CIVIC ASSOCIATION REVIEW AND APPROVAL MAY BE
REQUIRED BY DEED. APPLICANT IS RESPONSIBLE FOR COMPLIANCE
WITH ALL APPLICABLE RESTRICTIVE COVENANTS AND DEED
RESTRICTIONS REQUIRED BY TITLE.
BASEMENT FINISH not for Separate RENTAL RESIDENTIAL USE
Home business requires a Home Occupation Permit. Contact
Greg Jones 410-4647.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 80.00 .00 .00 80.00
Plan Check Total .00 .00 .00 .00
Grand Total 80.00 .00 .00 80.00
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.
r
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 Application No. l?? '?? Jl J? J`???
Job Address L "I Z' ? ?fZ7*KlRE $ 1 Parcel No. 2-13 - 0 09 5U 3
Subdivision 540 1)9 (:CSIJ??iZS Lot No. 2--
Owner Name AV.1Iou.? .? ILACRt.?'a-i LO_ WATY Telephone -1 C) Z'
Contractor Name ISC--
Contractor Address
Residential:
Sq. Ft. /'[? 1 I::71 l ,? ?w
$50-.A8-Minimutn plus $39.04for each additionalSq Ft. or
elacement units, minimum fee)
$50,09-REPLACEMENT LINITS: GAS EL
Commercial:
Telephone
Dublin Registration No
New/Addition Sq. Ft. Alteration
New/Addition: $58:68 Minimum plus $2&.90 for eath additional 1000 Sq. Ft. or fraction thereof over 1000 Sq. Ft.
Alteration: $50:00 Minimum plus $1U.99 for each additional 1000 Sq. Ft. or fraction thereof over 1000 Sq. Ft.
3% State of Ohio Surcharge (commercial only)
Total $ JG?
JOB DESCRIPTION
fi
This permit is granted on the express oondition that the said work shall in all respects, conform to the ordinances of the City of Dublin and all
the laws of the State regulating construction, installation, pair and alteration, and may be revoked at any time upon violation of any
provisions of said laws. / i ,
Signature of licensed contractor or homeowner
Division of Building Standards
w
CITY OF DUBLIN
Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
Application Number ..... 08-00200068 Date 2/04/08
Property Address ...... 6192 PIRTHSHIRE ST
Parcel Number: 273-009543
Alternate Address: SANDY CORNERS 1#23
Tenant nbr, name ...... BASEMENT FINISH
Application type description RES REMODEL
Property owner ....... HOLOWATY ANDREW A JR & KATHLEE
Contractor . . . . . . . . . HOMEOWNER/OWNER
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . NOT APPLICABLE
Occupancy Type . . . . . . NOT APPLICABLE
----------------------------------------------------------------------------
Permit ...... RES HEATING, VENTILATING, A.C.
Additional desc . .
Permit Fee .... 90.00 Plan Check Fee .. .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/02/08
Qty Unit Charge Per Extension
BASE FEE 60.00
1.00 30.0000 RES HVAC 30.00
----------------------------------------------------------------------------
Special Notes and Comments
NOTICE TO APPLICANT
SEPARATE OWNER/CIVIC ASSOCIATION REVIEW AND APPROVAL MAY BE
REQUIRED BY DEED. APPLICANT IS RESPONSIBLE FOR COMPLIANCE
WITH ALL APPLICABLE RESTRICTIVE COVENANTS AND DEED
RESTRICTIONS REQUIRED BY TITLE.
BASEMENT FINISH not for Separate RENTAL RESIDENTIAL USE
Home business requires a Home Occupation Permit. Contact
Greg Jones 410-4647.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90.00 .00 .00 90.00
Plan Check Total .00 .00 .00 .00
Grand Total 90.00 .00 .00 90.00
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.
w
CITY OF DUBLIN
Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
vate 1 1-MOT5
Application No. 06. ??oo("'?s
APPLICATION FOR ELECTRICAL PERMIT
Job Address (eiRZ Pm_t F?SN 1eE ST Parcel No -2 -7 3- 0 0q3' 1-13
Subdivision 5u) p`y Ry gS Lot No. 2_3
Owner Name ?mw? ? IZ.tt' I'tq H74?k)a ! v Telephone 7151' f?5-79:2"
Contractor Name Telephone -
Contractor Address
Residential:
New Sq. Ft. AlteraUont
Temporary Service $40.00........................................................
$40.00 Minimum plus $20.00 for each additional 500 Sq. Ft.
Low Voltage Systems: Square Feet
$40.00 Minimum plus $10.00 for each additiona1500 Sq. Ft.
Dublin Registration No
on Sq. Ft, 1130
:ticn thereof over 1000 Sq. Ft. & o
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.
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 $ ?
JOB DESCRIPTION?&6"".'T
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 an=61JUt1_. s of said laws.
Signature of licensed contractor or homeowner _
Division of Building Standards
. Q
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 ..... 08-00200068 Date 2/04/08
Property Address ...... 6192 PIRTHSHIRE ST
Parcel Number: 273-009543
Alternate Address: SANDY CORNERS 1#23
Tenant nbr, name ...... BASEMENT FINISH
Application type description RES REMODEL
Property owner ....... HOLOWATY ANDREW A JR & KATHLEE
Contractor . . . . . . . . . HOMEOWNER/OWNER
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . NOT APPLICABLE
Occupancy Type . . . . . . NOT APPLICABLE
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee .... 60.00 Plan Check Fee .. .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/02/08
Qty Unit Charge Per Extension
BASE FEE 40.00
1.00 20.0000 RES ELECTRICAL SERVICE 20.00
----------------------------------------------------------------------------
Special Notes and Comments
NOTICE TO APPLICANT
SEPARATE OWNER/CIVIC ASSOCIATION REVIEW AND APPROVAL MAY BE
REQUIRED BY DEED. APPLICANT IS RESPONSIBLE FOR COMPLIANCE
WITH ALL APPLICABLE RESTRICTIVE COVENANTS AND DEED
RESTRICTIONS REQUIRED BY TITLE.
BASEMENT FINISH not for Separate RENTAL RESIDENTIAL USE
Home business requires a Home Occupation Permit. Contact
Greg Jones 410-4647.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60.00 .00 .00 60.00
Plan Check Total .00 .00 .00 .00
Grand Total 60.00 .00 .00 60.00
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
Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
Application Number ..... 08-00200068 Date 1/30/08
Property Address ...... 6192 PIRTHSHIRE ST
Parcel Number: 273-009543
Alternate Address: SANDY CORNERS 1#23
Tenant nbr, name ...... BASEMENT FINISH
Application type description RES REMODEL
Property owner ....... HOLOWATY ANDREW A JR & KATHLEE
Contractor . . . . . . . . . HOMEOWNER/OWNER
--------------------- Structure Information 000 000 ---------- ------------
Construction Type . . . . . NOT APPLICABLE
Occupancy Type . . . . . . NOT APPLICABLE
--------------------------------------------------
------------
--------------
Permit . . . . . . RESIDENTIAL BUILDING PERMIT
Additional desc . .
Permit Fee .... 100.00 Plan Check Fee .. .00
Issue Date . . . . k• ?Sk.d? Valuation . . . . 0
Expiration Date . . 7/28/08
Qty Unit Charge Per Extension
BASE FEE 100.00
.00 40.0000 RES BLDG PLAN REVIEW
----------------------------- .00
------------
-----------------------------------
Special Notes and Comments
NOTICE TO APPLICANT
SEPARATE OWNER/CIVIC ASSOCIATION REVIEW AND APPROVAL MAY B E
REQUIRED BY DEED. APPLICANT IS RESPONSIBLE FOR COMPLIANCE
WITH ALL APPLICABLE RESTRICTIVE COVENANTS AND DEED
RESTRICTIONS REQUIRED BY TITLE.
BASEMENT FINISH not for Separate RENTAL RESIDENTIAL USE
Home business requires a Home Occupation Permit. Contact
Greg Jones 410-4647.
----------------------------------------------
------------
------------------
Fee summary Charged Paid Credited
- ---------- ---------- ---------- ---- Due
------
----------------
Permit Fee Total 100.00 .00 .00 100.00
Plan Check Total .00 .00 .00 .00
Grand Total 100.00 .00 .00 100.00
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.
CTTY OF DLBllV.
Application For Residential
Building Permit
Building Staijdards
5800 Shier Rings Road
Dublin Ohio 43016-1236
Phone: (614) 410-4G70
Fax: (614)410-6566
Auditors Taxing District ra-p ts) K.1,1 Iv Pazcel Number a-13 ()09 Sk 3` 0 0
?
a
Subdivision Lot Number _
2?j
0
a'
Address of Properri ?IqZ PIZ11-IStl?1zr Si
Applicant Name: Phone: '13 1 `9 79 Z-
E-Mait: ?0/0
?:?t?`?u.UJ??",? • ?1
? Owner Name• ? A QWh Phone:
a Owner Address: (S? ?1 Z ArZ:T1r6ftL (r?
?
Coniractor Name: Phone:
Contractor Address:
Typc of Improvement: O New House O Addition ? Remodel D Deck ? Shed 0 Pooi 0 Hot Tub
0 Screened Porch 96ther fi Y115V) tllLSprA eh 1`
Description ot Work:
c
0
:.
Ctl
a
Estimated Cost of Construction: .
HVAC System
Electric
.°
a 1.
0
Type: 0 New .xisting
D Less than 200 Amp
k+?00 Amp to less than 400 Amp
? Number of Bcdrooms: Fuel Type: ? Oil ? 400 Amp to less than 600 Amp
a UKatural Gas
a ?
Number of Baths: D L.P
Gas Watcr
Building Heigl?t: .
0 Electric Q? Public Water
? Solar 0 Private Water ,
Fire Sprinkler: O Yes ? O Other Sewcr
"?
Public Sewer
9-
If yes, NFPA Ref. Na No. of Gas Appliances/Unit 11 Private Sewer
The owner of this building and thc undcrsigned, do hcreby covenant and agrce to comply with atl the laws of the State of Ohio and the
Ordinances of this jurisdiction, pertaining to the buitding and the buildings, and to conswct the proposed building or structure or make
L the proposed change or alteration in accordance with the plans and specifications submitted hercwith, and certify that the information and
? statements given on this application, drawings and specifications are to the bes of their knowledge
true and correct.
R
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Applicant's Printed Name Applicant's Signatu re
Area: Application Number: Date Received:
Basement: D
ls? Floor: ?a' ?????o? RECEI V ED
?
:D 2°d Floor: Issuing Authority:
a? JAN 2 3 ZOOS
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Garage: Issuing Date:
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CITY OF DUBLIN
Division of Buiiding Standards
5800 Shier Rings Road
Dublin, Ohio 43016
Phone: VlTDD 614/410-4670
Inspection Line: 614/410-4680
HOMEOWNER AFFIDAVIT
Homeowner: ? Gt`L ? (,IGt, PLone Number;
Address: ??c7 Z.- p1 12 % H..5/?1?1?. Srt ?JU6LI/U ??r`(Q
By signing this affidavit, I do hereby swear and/or affitm that I am the Owner and occupant of the
single-family dwelling located at the above address. I am maicing application for a Permit. If
granted I WILL PERSONALLY PERFpRM THE WORK ASSOCIATED WITH THIS
PROJECT, OR CONTRACT O1vI,y WITg A CONTRACTOR REGISTERED WITH THE
CITY OF DUBLIN. I understand I am personally responsible to assure all work performed under
the permit is compliant with all related building codes and ordinances of the City of Dublin.
I UNDER,STAND VIOLATION OF THE TERMS OF THIS AFFIDAVIT ARE A BASIS TOR
REVOKING THE PERMIT, AND PROSECUTION OF ANY PARTy I1VyOLVED.
.. ? ,.-L.
Sworn to and sabscribcd beforc me tliis day of j ? ' %?l' G , 200L_,
Homcowner`? ?C
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Notary? __ - ? .?,!?
; __,_'';?'1''1' , ? . (' .?Q??-
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Abt" Aft sw of
.'' My Comm?ipn ?
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