HomeMy WebLinkAbout0003.00 Contractor AffidavitAFFIDAVIT TO; INDUCE CONDITIONAL RELEASE
FOR COMMERCIAL STRUCTURES AND INTERIOR REMODELING
Date:
Building Permit No.:
i
Entity (Business or
Individunl):✓c�i/���47L
Applicant-Affiont: ✓//"�! / !OJ<G
3 ,�00c)
Project Name: f /GI I [_c
Address/Location: 570 C•
I; being duly sworn upon my oath, state the following:
1: .I am executing this Affidavit for myself or as the authorized agent of the
ef above-rerenced Entity to induce the City of Carmel/Clay Township ("DOGS") to allow me or
-the Entity to proceed with development pursuant to the Plans (defined below).
2. That this Affidavit shall bind me or said Entity and any further reference to "I"
herein shall be considered as a reference to me or such Entity.
3. I have filed with the Office of the State Building Commissioner ("SBC") of the
Indiana Department of Fire and Building Services for its review and approval, plans and
specifications (the "Plans") for development of the above -referenced project (the "Project").
I believe these Plans to be in compliance with all State of Indiana requirements including, but
not limited to, the rules of the Fire Prevention and Building Safety Commission, the Indiana
Building Code, Indiana Plumbing Code, Indiana Mechanical Code, Indiana Electric Code and the
Model Energy Code, all as amended from time to time (the "Rules"). I also verify that the
Plans I am submitting to D005 are exact duplicates of the Plans submitted to the State.
4 I have presented to OCS a copy ofthe Notice of Construction Design Release
front} the State an changes submitted to or re q iuired by the 5BC will be submitted to DOGS
in a timely fashion A final Construction Design Release will be submitted to D005 prior to
scheduling Chef final inspection and issuance of a Certificate of Occupancv (C/Ol
5. I f urther understand that application for a conditional release„will co�nly} allow me or
the Entity, after payment of the full fee to D005;1to;proceed at. my/! ts.owntrisk through
the rough -in stage of the inspection process. I ,V!wa� au!lnns i u ;
6. I understand that by proceeding on an conditional basis; I accept responsibility for
removing and replacing any construction found by plan examination or by site inspection not
to comply with the Rules and/or those rules and regulations of DOCS and/or ordinances of the
City of Carmel/Clay Township.
7. I further acknowledge that I am proceeding on an conditional basis at my/the
Entity's own risk and that I assume and accept all liability for the project and will indemnify
and hold the City of Carmel/Clay Township, its officers, employees,and agents, harmless from
any and all liability to any person or entity (including the Entity), resulting from proceeding
forward_ without a final Construction Design Release from the SBC.
8. I further agree that I will pay the City of Carmel/Clay Township for any and all
expenses, including reasonable attorneys fees, it might incur, in taking enforcement action
against the Project.
9. I further acknowledge that, in addition to the Rules, I must comply with all other
rules and regulations of the City of Carmel/Clay Township and the State of Indiana as such
relate to the Project including, but not limited to,'building codes and zoning ordinances as
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STATE OF INDIANA
COUNTY OF HAMILTON
Personally appeared before me, a Notary Public, in and for `d m&t A County, State
of Indiana, acknowledged the execution of the foregoing Affidavit and indicated that the
facts stated therein are true. The Affiant further represented that he/she has proper
authority and resolutions to execute this Affidavit on behalf of the entity.
Witness my hand and Notarial Seal this ao day of r IQ 12 , 19 q C11 •
q�' M `'p
Not ry Public
Print
Regina M. Page, Notary Public
My Commission Expires: November 24, 2000
Resident of Hamilton County, IN
Date Commission Expires
s:forms/affidavit/Rev.July 1999