HomeMy WebLinkAbout05120076-State ReleaseIndiana Department of Homeland Security
DIVISION OF FIRE SAFETY / PLAN REVIEW
402 W. Washington St., Room E245
Indianapolis, IN 46204
To: Owner / Architect ! Engineer
Architects Forum
Thomas G Jolly 19600180
5252 E 82nd St
Suite 201
Indianapolis IN 46250
Would you like to reduce your turnaround time?
ELECTRONICALLY FILE YOUR PROJECT WITH STATE OF INDIANA AT
efile24-7@dhs~state,in.us, Or VISIT OUR WEB SITE AT www,in.gov/dhs/osbc
Project number E-Filed, No hard
CONSTRUCTION DESIGN RELEASE 314520 copy will be mailed
State Form 41t91 (R9/5-98) Construction type
Report Printed on: November 23, 2005 fi-B, SPK
Scope of release
$ UUUU i Type of release
SUPPORT HOOSIER SAFETY Head and Neck Surgery Associates PC
Release date
11/2 3/0 5
Occupancy classification
*SEE BELOW
Street address
12188 N Meddian St
City County
CARMEL HAMILTON
Fax & e-maih 3178428877, mnuckols@architectsforumllc.com
The plans, specifi~aiion~ 0nd application Sut~rniJied ~r ih~ 0~ove referenced project hove bee~ reviewed for C~mpiia~e With the applic0ble rules Of
the Fire Prevention and Building Safety Commission The project is released for construction subject to. but not necessarily limited to. the conditions
listed below THIS IS NOT A BUILDING PERMIT. All required local permits and licenses must be obtained pdor to beginning construction work. All
construction work must be in full compliance with all applicable State rules. Any changes in the released plans and/or specifications must be filed with
and re eased by his Office before any work is altered ~his release may be Suspended or revoked if it is determined to be issued in error, in violation
of any ru es of he Comm ss on or f t is based oB i~Co~recl ~r i~suffi~i~t inf~r~aiion This release shall expire by lim ~ation. and become null and
void if the work authorized is not commenced with n one !i year f[~m the abo~e da e:
CONDITIONS:
Note (A1A & A1B): tn accordaBce ~vith the affidavit sworn under penalties of perjury in the application for construction design release the plans
and specifications filed in conjunction with this project shall comply with all of the applicable rules and laws of Fire Prevention and Building Safety
Corem ss on Providing false information constitutes an act of perjury which is a Class D felony punishable by a prison term and a fine up to $10.000
In accordance with Sectio,q '19 of the General Administrative Rules (675 tAC 12~6-19) a complete set or plans and specifications that conform
exactly to the design that was released by the office of the state building commissioner shall be maintained on the construction jobsite as well as a
copy of the design release.
4G0603AF Plan§and specifications for the revised fire Suppression system shall be filed with the required
application, fees, and complete details in acco[dance with 675 lAC ~2-6- 3(a), 7(h)17 and 675 lAC
13~1~8. (N.F.P.A. #13)
*B-TENANT FINISH
Please be advised that if an administrative review of this action is desired, a written petition for review must be filed at the above address with the
Fire Pre~enfion and Building Safety Commission identifying the matter for which a review is sought no later than eighteen (18) days from the above -
stated date. unless the eighteenth day falls on a Saturday. a sunday, a legal holiday under State statute, or a day in which the Department of Fire
and Building Services is closed during normal business hours In the latter case. the filing deadline will be the first working day thereaffer If you
choose to petition, and the before-mentioned procedures are followed, your petition for review Will be granted, and an administrative proceeding will
be conducted by an administrative law judge of the Fire Prevention and Building Safety Commission. If a petition for review is not filed, this Order will
be final, and you must comply with its requirements
Filed By Code review official
DENISE FITZPATRICK
Address (name.title of local official.street.city.state and ZIP code
DEPT OF COMMUNITY SERVICE
JIM BLANCHARD
ONE CIVIC SQUARE
CARMEL. IN 46032
Fax & e-mail: 3175712499. jbtanchard~arme!:in ~ov
Code E~forcemeni & Pi0n Review Bronc~ Director
State Fire Marshal 20~p~
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