07201716 Permit FileCITY OF DUBLIN
Division of Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
RESID
This is to certi
described below and
PERMIT
d the residence
)r occupancy.
ADDRESS: pERMIT NO.:
?-- --?
By. F1NAL 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)
Date '¢/IS /, S
Application No.0 7- 2-6 /7/ u°
? New L5"Remodel 0 Residential ? 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 907/ Al/ ?
Subdivision/Project Name
Owner's Name rei ll 4- V?
Contractor's Name
Contractor's Address ( v ? ?
Parcel No
Lot No
Telephone 339 4'4"44
Telephone 48 4 +P 4g
on Number
nt pipes consist? PyG
*INDICATE NAME OF CERTIFIED BACKFLOW TESfiER
This form must be properly filled out and returned to the office of the City of Dublin at least four days prior to the date of the FIRST INSPECTION,
accompanied by a fee calculated upon the following basis:
WA7ER TANK REPLACEMENT FEE $35.00
RESIDENTIAL COMMERCIAL
Application for permit & first fixture ................................ $50.00 Application for permit & first fixture.............................. $60.00
? Number of remaining fixtures X$10.00 =$ z? Number of remaining fixtures X$12.00 =$-
v oe
Total Inspection Fee .................................::.................. $? Total Inspection Fee ....................................................$ _
Re-inspection fee (based upon disapproved Inspection and collected by the Franklin County Board of Health ONLY) $45.00
Qty. Qty.
Air Admittance Valve i
*Backflow Preventers
Bath Tubs
Bed Pan Washers
Bidet
Dental Cuspidors
Dilution Sum
Dish Washers
Drinkin Fountain
Floor Drains
Garage Catch Basin
Garbage Disposal
Gas Water Heater
Electric Water Heater
Kitchen Sink
Laundry Trays
Lavatories ?
Mop Sinks
Outside Faucets
Roof Drains
Rough-in Openings for Future
Sewage Ejectors
Qty.
Showers 1
Sterilizers
Sump Pum
Tra Primer
Urinal
Wash Fountain
Washing Machine
Water Closets
Water Lines
Water Stora e Tank
Other
GRAND TOTAL
Division of Building Standards
CITY OF DUBLIN
., - Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
Application Number ..... 07-00201716 Date 4/15/08
Property Address ...... 8071 ALIMOORE GREEN
Parcel Number: 273-011273
Alternate Address: BELVEDERE SEC 4#153
Tenant nbr, name ...... BASEMENT FINISH
Application type description RES REMODEL
Property owner . . . . . . . Will Kuyvenhoven
Contractor . . . . . . . . . HOMEOWNER/OWNER
--------------------- Structure Information 000 000 ----------- -----------
Construction Type . . . . . NOT APPLICABLE
Occupancy Type . . . . . . NOT APPLICABLE
-----------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT -----------
Additional desc . .
Permit Fee .... 70.00 Plan Check Fee .. .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/08/11
Qty Unit Charge Per Extension
BASE FEE 50.00
2.00 10.0000 EA RES PLUMBING >1 FIXTURE 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.
EGRESS WINDOW WELL CANNOT ENCROACH INTO REQUIRED SIX FOOT
SIDEYARD.
-----------------------------------------------------------------
Fee summary Charged Paid Credited D
----------------- ---------- ---------- ---- -----------
ue
------ -----
Permit Fee Total 70.00 .00 .00 -----
70.00
Plan Check Total .00 .00 .00 .00
Grand Total 70.00 .00 .00 70.00
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.
,? x CITY OF DUBLIN
Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
Date ? ?C.fM C
Application No. 0 4 ' D-0 1 _?_ k ?0
APPLICATION FOR ELECTRICAL PERMIT
Job Address ?( I?QO2(? Cye&j Parcel No
Subdivision ? C-1 U ? D W F Lot No.
Owner Name km U ouH? ?f 4) Telephone
Contractor Name Telephone -
Contractor Address
Residential:
New Sq. Ft. tllterati
Temporary Service $40.00...................................................
$40.00 Minimum plus $20.00 for each additiona1500 Sq.
Low Voltage Systems: Square Feet
$40.00 Minimum plus $10.00 for each additional 500 Sq. Ft.
ftireof over 1000 Sq. Ft.
CommerciaL•
over 1000 Sq. Ft.
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
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 reg lati g con uction, installation, repair and alteration,
and may be revoked at any time upon violation of any prpxigien?of? id law?
Signature of licensed contractor or homeowner
Division of Building Standards
Dublin Registration No
ion Sq. Ft.
?x -
Date: 1/1/2001
r. ?
CITY OF DUBLIN
Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
Application Number . . . .
Property Address . . . . .
Parcel Number:
Alternate Address:
Tenant nbr, name . . . . .
Application type description
Property owner . . . . . .
Contractor . . . . . . . .
--------------------- Structure
. 07-00201716 Date 1/08/08
. 8071 ALIMOORE GREEN
273-011273
BELVEDERE SEC 4
. BASEMENT
RES REMODEL
. Will Kuyvenhoven
. HOMEOWNER/OWNER
Information 000 000
#153
FINISH
Construction Type . . . . . NOT APPLICABLE
Occupancy Type . . . . . . NOT APPLICABLE
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee .... 40.00 Plan Check Fee .. .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/06/08
Qty Unit Charge Per Extension
BASE FEE 40.00
----------------------------------------------------------------------------
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.
EGRESS WINDOW WELL CANNOT ENCROACH INTO REQUIRED SIX FOOT
SIDEYARD.
Fee summary Charged
----------------- ----------
Permit Fee Total 40.00
Plan Check Total .00
Grand Total 40.00
Paid Credited Due
.00 .00 40.00
.00 .00 .00
.00 .00 40.00
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
Division of Building Standards • 5800 Shier-Rings Road • Dublin, Ohio 43016
Phone: (614) 410-4670 • Inspection Line: (614) 410-4680
Date ?-
Application No. o"c ° a 0 `-4 ` Qo
ACCESSORY/REMODEL APPLICATION FOR BUILDING PERMIT
?A ,,,.,C
JobAddress 6_6?-_t ?t'lt>/?/?R7?+e.e- cJI?N Parcel No
Subdivision IPZI Az vP, 1) Ga Lot No.-
Owner Name 1A) ??? KXX\J IL EA I HL V 4V Telephone /L1 2
Contractor Name _
Contractor Address
Telephone
n Number
1,000 SF
7' `
The owner of this building and unders)gned, do hereby covenant and agree to comply with all the laws of the State of Ohio and the
ordinances of this jurisdiction, pertaining to by?'ding and buildings, and to construct the proposed building or structure or make the proposed
change or alteration in accordance with the pla?s and specifications submitted herewith, and certify that the information and statements given on
this application, drawings and specifications ast to the best of their knoyvledge, fue and correct.
Signature of licensed contractor or
_ r_ ?
Division of Building Standards Issue Date \ v c)
Separate Permits: Separate permits are required for electric wiring, heating and ventilating, plumbing, moving, wrecking, shoring,
use of public property, and tents.
ENGTNTYRI;e{:CnWI.lAN('F; .,,=-.?s?,?? r!?':?;• ?i.,.??,??::
jUILqINUGUMruANCt city or Durfx;n , :,?, :... . . .?
APFROVED AS NOTFD ?
APPHOVEDASNOTED
CITYOFDUBUN,OH 0 2'0
? ?_?..?g ??
?? f4? 7/07 10/01 WHITE-FILE YELLOW-FINANCE PINK-BIA GOLDENROD-CONTRACTOR
Division of Bailding 5tandards
5800 Shier Rings Road
Dublin, Ohio 43016
CITY OF DLTBLIN rnone: V/TDD 614/410-4670
Inspection Line: 614/410-4680
HOMEOWNER AF'FIDAVIT
Homeowner:
Address:
Phone Number: /3/C/r L -[; I
r < < T
By signing this affidavit, I do hereby sweaz and/or affirm that I am the Owner and occupant of the
single-family dwelling located at the above address. I am making application for a Permit. If
granted I WILL PERSONALLY PERFORM THE WORK ASSOCIATED WITH THIS
PROJECT, OR CONTRACT ONLY WITH A CONTRACTOR REGISTERED WITH THE
CITY OF DUBLIN. I understand I am personally responsible to assure all work performed under
the pernut is compliant with all related building codes and ordinances of the City of Dublin.
I UNDERSTAND VIOLATION OF THE TERMS OF THIS AFFIDAVIT ARE A BASIS FOR
REVOKING THE PERMIT, AND PROSECUTION OF ANY PARTY INVOLVED.
Sworn to and subscribed before me this
Homeowne
day of ? e v , 200?.
s ? .
r r t Nota
IFVVL/
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F)MM K BROCK
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,-
Combustion air requirements
Finishing a basement may restrict the amount of combustion air for gas utilizing equipment
located in the basement. Walls and ceilings may block air flow to the equipment resulting in
incomplete fuel combustion which greatly increases the risk of carbon monoxide discharge.
Therefore it is extremely important adequate combustion air is provided for the equipment.
Below are three common methods for calculating combustion air. Refer to the current
code book for other approved methods of calculating combustion air.
All air from inside building
Minimum number of openings required
*Free opening sq in. area per btu h
Minimum dimension of openings
Location of openings
1 / 1000
3 inches
Within 12 inches of the ceiling
and within 12 inches of the floor
of the room
All air from the outdoors
Minimum number of openings required
*Free opening sq. in. area per btu h 1/3000
Minimum dimension of opening 3 inches. Not less than the sum of the area
of all vent connectors in the space
Location of opening Within 12 inches of the top of the
enclosure. Equipment shall have
clearance at side 1 in. & front 6 in.
OR
Minimum number of openings required 2
*Free opening sq.in. area per btu h 1/4000
Minimum dimension of openings 3 inches
Location of openings Within 12 inches of the ceiling and one
within 12 inches of the floor of the room.
* Unless the free area through a design of louver or grill or screen is known it shall be assumed wood
louvers will have 25% free area and metal louvers and griils will have 75% free area.
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