HomeMy WebLinkAbout 0788.98 State Release�e
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APPLICAIIUN F-UR I RIM
REMODELING RELE
I..
state Form 26137 (5187)
M
Indiana Department of Fire and Building Secee
PLAN REVIEW DIVISION
1099 Norn Meridian Street. suite 9C0
USE ONLY
Project Numbe
Filing Date
Occupancy Classification
-
Construction Type
p Indiana a620a r n
Indiana olis, UI
.. "fRUCTIONS: See Reverse Side for Minimum Qualifications and',Filing. Procedures for an Interim Remodeling Release.
1i tj
I accep! full responsibility for removing and replacing any construction work found by plan examination or by inspection, to be in violation of the rules of the Fire
Prevention and Building Safely Commission. I further:agree not to occupy or allow occupancy until a full release has been issued by the State Building Commis
sioner and all known code violations have been corrected. I understand that failure to provide adequate plans and specifications or requested corrections
thereto Is a code violation.
or
or Floor
140
Use
Closest Intersecting Street or Road Direction MUNI Intersection to Project
Gil / IW A-L — P5L V i?(N) ❑ (E) ❑ (S) ❑ (M
ze _'`;} '';r.&H"^e£'rt'INTERI h1 RELEASE CONDITIONS{OFFICE USE ONLYJ "'>_.,a•,, i<iiT ,t' y t "
a. azu ti, .., uc ,:«.I' a ..s % r �>n� 4s:L.::
This partial release for remodeling is granted prior to full plan review and is subject to all the rules of the Fire Prevention and Building Safety Commission and
any local rules for issuance of a building permit by the local official'. As such, this release does not allow occupancy of said project until a standard release is
Issued by the State Building Commissioner. THIS PARTIAL RELEASE IS NOT A PERMIT.
&Architectural C`&Wdc� Electrical
1. Mechanical v� pa rtien�
PAF
ED Bill., INTERIM REMODELING RELEASE
Q- _ Subject to comaliance with
conditions herein and all Applicable
Rules of the' IRE PREVENTION AND
BUILDING SAFFETY COMMISSION AND
THE LOCAL AUTHORIT
.Ai'
l�i.IF�~-
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'rt I RU-N ' ( Q5 ; .
,I �I pprrProlecL9(Recei 'num
ber
IEONSTUCTIODESIGN RELEASE 95578 25595D
State Form ( 8 1 Construction type. Occupancy
„�•�� .� F.!(ST SPK �3 --
Scop_e,ol release, -
Indiana DepartmenCof Hre;and Bwlding,Services r,•-
PLAN REVIEW DIVISION ' II _ , - MFC14 EL.F.0 ARCH
Offlceiof;the State Building Commisstoner ,
402'W. Washington:St Room E245 , I Type of rel6as
e
Indianapolis,, Indiana-46204'
CANS -ON DRSItN ASSOCIATES CONSECO BUILDING D
ATTN.-SARAH 6 FORTFON All(11f.,6 MAIL OPERAT`iON5
1,1560 N MERI-D,1AN STF 104 ` S1reeladdress
CARMEL I.hJ 46032 5411 N COLLEGE DR
HAMIL
I
1. Plans and speodf,i.cationa' for the revised fire st_tppres-
si'nn System she'll he fi.lad, with the required application,
feast an"d complate details in Ae.;CO danr„a with 575 T..AC 12-5-
3(a)' 7(ii)1.-1 and 13,95 3AC 13-'rh-8. (N.F.P.A,. 412)
2. This release does nto;t i-nclud.e plumbing work. Plans and
spsr„ificati;ons• For adding or( r,amodeli;ng tihi;s, system shall: be
P'.1ed as a new project before inrnmenr_ing work in accordance
with 975 TAC 1?-6-3(a)', 6, end 7.
3, Ronf top mechar>i.cal units shall be re3adi.l.y' accessible
kn accordance: with Section 306. ;-3•gS.6 'IMC(6-75 :IAC
-4).
_i
P1a'aae be advised that if an administrative review of this
BCti,bn is claSi.red., a writteri pmt.j_ti,nn for retview ninst be
filed a,t the above addre*s w;i°th abbe Fire Prevent; ion oral
Bui3iing Safety Cnrnrn.i:ssicn idertti.fying 'i;he matter. fn,r" whi.Ch
PAGE ONE OF TWO
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l .r Y,1,�.' I -
A set of documents released by,thls offimshall Wmaintained on the constructlomsiteunhftlie "structure is occupied (6751AC 12-6-19)'._
Attachments- I Cnderreview-ntlicial2Yf I State'Rmldinn' Commissinner i
Terry Jones
Dept, of Cnrnmorsi:ty U'evelopmerit
One Civic 5gtiare
Carmel IN 4603?
WX
J
a,
a `R�� 16 Jtlt, 1998 z P!5 „0?... ° +
m CONSTRUCTION DESIGNeRELEASE
State,Form41191 (R6'/897)
�e id
yo^
Indiana'Departmeint 61 Fi e. and Buiming.. Services
PLAN REVIEW'DIVISION. p
,Office ;of the State136ilding�Oommissioner,
.402' W. WatihingtonlSt:, Rodin,EM'
')fidianapolis,.lirdianaL46204 "
CAR.e,OM DESIGN AS OC'.;ATF..S 11
ATTM,SARAH A FORTSON IA0;01s9
11.599 N MERIDIAN STE 1.1114
ORP.MEL IN 463'i.132
city
,CONDITIONS:
MF;C4 rE,EC ARCH
CONSECO BUILDING D
a ceiview is sought no later than mightean (18) clays From tlia
•hava-statad slate, unless the 6ighteant;h d'ay F3115 nn,e Sat-
rtrda:y, a 'Suntltny, a 'legal holiday under State s'tt+tul;ar or a
day in which tYie 'Dapsrtment of 'Fires and Btti,ldi.ng Se"rvjC.es i.g
closed during normal, busdne:sis hours. In•.the lattc,r
the,, Filing deadline will be "this first wnrle'i"ng clay
thorea.fter. If you choose t'q ,petition, and the be Fore-man-
ti.onsd .procedurt,e, are Followed,, your pnt,iti.on for revimW j
will be granted, and en administrative proceeding will he .W,
conductRcl by, an atlmini"stratilwe law judga. of the Fire Prsraen`
and iluil:di ig Safety Conntisaion. I'f a petition for
review ie not Fi;Ied, this Order w:i.11 by finnl, and ynu mnr t
comply with i+ts requiremants.
PAt;c TWO OF Tti10
A set"of documents released"byithis°office;shall beimain{aimed€on the,construciion sii6,until flie structure is occ foied>.(675�IAC,12-6-,19)'.„a
"I
Derr.,, of ommurnit.n Deve,l:o rmFl , j
Dept, of �' �� I tot �/" Z.
One C;ivir- Square
CArmel. IN 46032 �'
V
d/.ds ^era Project numbers, Receipt number Release date
¢ g CONSTRUCTION DESIGN RELEASE 97083536 09MM
I -
7 Y `State Form 41191r(R945 96) „ Construction type Occupancy classification
Repprt'Pdmoa un: saptembers. 19%,12:43 PM II-N SPK F-1
Sc_opeof release - -- -
Mdiana;Depirtnl of Fire and B6ildlnlj Serviees ' ,RRCH ELEC, �•
PLAN REVIEW,DIVISION - i
PLUM MECR
Office of,the State,Building Commissioner
402!W.'Washington.St., Room;E245' Type' of release; -
"lliclianapl Indiana;46204 !� -
,, Standard
To; Owney/ Architect4, Engineer - - Project name i
1 -
CONSECO BUILDING ❑
CSO.ARCtlffECTS EtIGINEERS GENERATOR ROOM
ALA.NR TUCKER 1MSE-
I Street address. -
9100 KEYSTONE Gt2S6
W COLLEGE OR
WOLANAPOLIS IN 45204 City Count
4WILTON
The.olans.'soedficationsrand application submitted for bielabove'referenced'Droieci:have been reviewed for;comoliancewith-the'.aonlicahle: mles.nf,the
'CONDITIONS: i
!dote 4A1A 5 A18): In ac; orllance wIN the all swomyunder penalties ofpenury In the application Tor construl llon r eslgn,retease.lhe
plans and speclicatlons filed'ln-conjunationwitn this'project shall comply ui3h all of the abplls2DIP rules and laws of Fire Pre'renliorki
Building Safety Commission, ProvIdIng,tal^etrd0rmatl0n ,1 on616uIPs arl.aot of perury, whtan ls;a Claso'D felony puhllle ishi by a prison
term ano a tine up to bio,lwrt.
I
4G0003AF Plans -and specifications toritherevised 'tire suppression system ehalf be,tiled witn,the regmretiappfiomi t
fees, and complete details 6z000rdance WIn 6751l 12-6r 3(a), 7(n)17.and 75 tAC 13-1-8. (N.F.P.A #13) :-
4G06D3AQ This felease'.does not, in whe tank Installation work; Plans and apeclticatlons'.for adding or remodeling the tank
and plping system MajlDejfilkd as new project _before commlar ing work hi-acoordance Mh;65 IAC 12•6-
3(a),.6:and
9:
Papa 1/1
i
Xsetrofedocuments releaseOy this office shall tie maintained on the constructionSiteiuntil the structure is: occupied (675JA6 12-6,19):;
S•
DEPT OF COMMUNITY AEVELOPMFEVT
ONE CIVIC SdUARE:
CARMEL. IN 46W2
2.-. CERTIFICATE OF COMPLIANCE
1 to oe completed by.submitter)
.SBC.prof ect�umgpr. ' n Filing date
Pleas&indicale how you wish to receive the design release and plans. M
We.w Il mall to lne,design professional (owner lino design professional) ❑ MAIL
We,wtll call the tleslgri professional (owner iLno design prolessionaQ CALL FOR PICK-UP
Name atipr'oleci' Closest intersecting street or road
� ur�rl v MsY � D ohls Go
Aacress (site jocaflon, numoer andstreetl
Suite or floor tit applicable)
Direction FROM intersection TO project
HO —
gI North ❑ South ❑ East ❑ West
Cnyantl cCurly, Is project Within city limits?
G�2MYes ❑ No
As owner of the project for wnicn Ins apphCaeonis.being filed. I hereby candy
1. thedescription of use and information contained on this application are correct;
2- the project will be constructed in accordance with the released documents and applicable rules of the Commission;
3. any changes to the rejeased documents will be filed with the Office of the State Building Commissioner.
Awnon ad signa ur `
Name of owneror business
oN�v�G
Name.( ed or ponied)
Adtlrea (nurn and street)
2,fEl!A,
II'' 11
1.4
'Title
City. '. stale, ZIP cone
i Ni 4fLe0� 2
Telephone number Facility use
(51-7 61 7 - 2-10b
it
As me designprofessional for the project for which this. application. plans and specifications are being hied I hereby certify:
I . I am qualified and competent to design such, buildings, structures. and systems and have attached a copy of my current registration card;
2, the plans andspecifications filed in conjunction with this application were created:by me and 1 or by my persons under my immediate personal
supervision and will comply with all applicable building laws and rules of the Commission;
3, the project data contained on this application are correct and correspond with the plans andspecifications to be filed in conjunction with this application;
a. the design professional identified below will inspect Ine construction covered by this applicatiom,al appropriate intervals to determine general compliance
with the released documents and applicable rules of the Commission and will cause at noted deviations from released documents and code violations
to be corrected or notify the owner and authorities having jurisdiction of all specific deviations and code violations; and
5. 1 affirm under penalty of perjury that the representations contained herein are true and I further understand that providing false information constitutes
an act of perjury, which is a.Class D Felony punishable by a -prison term and a fine of up to $10,000.
Responsibility is for the following systems: S
❑ite ❑ ❑ Foundation Structural� Architectural (� Mechanical
�{
❑ Plumici l lllllliryp,.rElectrical ❑ All Above ❑ Other specify)
TT'
/G Signature Name of firm (if applicable)
S- PEG u"TFgF `/v%
L 'Nam pod cr printed) Address (number and sheet)
9600168 = 5AO, �! 0 F I 115 c N-
(
_
Indiana. reglstralion numoer Architect City Sear ZIP code
STATE`OF p -
-. -
zI O ❑ Engineer ., -. Ir-I
��/
•.• /NDIAPoA ,. ' \j NOTE. Seat and signature affixed before reproduc:iomsmall appear. on each page'ot. alfdr wings antl Telephone number
/j ... �� the title page of all specifications.
p
//�r Q „-r x� All. correspondence will be to design Arc hitectiEngjneer,`d noneihen.to
�ltf) s,onal (typed
pealF> or prinreo)
NOTARY CERTIFICATE 1111111 Ili``• _
STATE OF _
Indiana registration numoer'' Architect COUNTY OF } 'SS:
❑"Engineer Bel e me ee a arsigned. a Notary Public.for said County and State; personally appeared
Name Of brie yl 3dpi,cacle) - -
.,who under the penalty of Pe,jury acknowledges the
_ tostatements as true this
'-
Adcress"tnumber and. street)
Signature of 'y'P
City gale, ZIP code
My commission expires.- County of d ai
,� s.p ..�.�.y.r..•apeonogr v.eaa.ona.a a•rnryarrry onus r:rnuwauurr er
poce4 submit an additlonal page Z,with the ap*.9Prjafe information
3. PROJECT DATA
(To be completed by submitter) Please answer all pertinent q' uestions.., SBD project number Piling date
Scope of work
Total existing (If applioable)
❑ New ouildin ❑ Addition Remodelih
Sq. Ft.
Is. this construction the resull ol, fire or natuial'rd,iiSter?
Sewer 'RE)usltng ❑ Proposed
Addition (If applicable)
Addition Ill applicable)
❑ `Yes ' No
❑ Public ❑ Private ❑' None
/A Sq. Ft.
S �1/A
e'uppressloo system In building'
Fidemai.
Detailed suppression system plans and specs
Remodeled (it applicable)
Remodeling (It apolicable1
Full ❑ Partial ❑ None
❑ Provided To fallow
S . Ft.It
specify where' Located in flood plain (✓county
Total building area square feet
Total project cost
p/an commission/
El� No
ff,,'
S N/A
Building construction type and occupancy classification Building height
Number of buildings this submittal
-
Volume cubic feet
'. (Stories) '
(Describe it necessary)'
(Fee categor; E only)
Indiana rehabilitalion standard (Rule 8) used? valuation documents providetl?.
Use of conversion rule (Rule 131 proposed?
❑ Yes EL No ❑ Yes F,1No
❑ Yes Nn
u apu)c . nnwuu . Ir. er.n n rtli/ __
❑ Elevator or lift ❑ Combustible fibers storage ❑ Fireworks storage ❑ Explosives storage
❑ High oilestorage ❑ Boiler or pressure vessel ❑ Hazardous or flammable materials storage
Describe proposed use of facility IN DETAIL, including types of flammable or combustible materials stored or handled -
or current use of facility
comments'
persons fpuorcf
Ed
Has rolher.-workat this location ever been filed?
Daisprojectinclude use of a master plan design release or a factory built modular or mobile struccurE
❑ Yes l ❑ No CS& Unknown
ElYes No
What year and month
Previous SBC project number
Name of manufacturer (it factory build Master plan ; Modular file number or modular mcove
WA,
seal number W/6r
Has construction Started? It Yes, has a notice of violation of investigation been issued?
It No, probable construction sfaning date?
❑ Yes R. No ❑ Yes. _ ❑ No _A,
J� ENERGY r
Indiana climate/zone Type of heating fuel 'Number of tenants
No. of electric meters No. of gas meters BTUiHR/SF-Deq. F walls
❑ North ❑. Central ❑ South
(Adjusted for openings)
Uc
Does project comain skylights, greenhouse, solarium; or
If Yes, OTTV of tool
OTTV of Walls
Roof nailing assemblylarge
glass areal
❑ Yes _❑ No
Uc
Energy calculations provided?
Potable hot water provided?
Is it recirculated?
Air infiltration rate per Table 502A 2
Floors (Unhealed below)
El Yes El No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Uo
Total Nonresidential lighting power budget.
Thermostat range heating
Thermostat range cooling
Slab at grade
KW
R
General comments'
Crawl space walls
R
ACCESSIBILITY' 1.6--
_
SEISMIC'' DESIGN
❑ Yes ❑ No Have accessible parking spaces and -. signage..been provideci?
Is this project classified as an ESSENTIAL FACILITY.
❑ Yes ❑ No Does access within building comply with Table 33 A. j. B.;C. ?
GROUP E I, or HIGHRISE? ❑ Yes L. ! No
❑ Yes ❑ No Do toilet rooms and equipment meet accessiblhty code?
(See tBC Chapter 23J
❑ Yes ❑ No Does access to building meet, accessibility code?
Have seismic design procedures
been followed per code ❑ Yes ❑ No
❑ Yes ❑ No Is duildin g,desi ned for access ado I bilit ?
requirement?
Type of facility (as licensed by' Indiana. Department of Health)
If nursing home
❑ Residential custodial care:. ❑ Nursing home ❑ Outpatient surgea
Hospital 1 ❑ Intermediate care ❑ Skilled care
Admitting and discharge policy, provided
Plans show critical heating area
Emergency power
❑ Generator ❑ Battery ❑ None
❑. Yes ❑ No.
❑ Yes ❑ No
service
❑, Other (Specify)'
'NOTE: USE SEPARATE SHEET IFADDITIONAL SPACE 1S REQUIRED
Paga.