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3. PROJECT DATA
Sec Pro)ect o.
66 C7
Hung Date
� ^7
PROJECT DESCRIPTION (Must be complete)
FLOOR ARE"
ESTIMATED COSTS
Scope of Work
Total Existing (H applicable)
❑ New Building Addition ❑ Remodeling ❑ Change of Occupancy / Use
Sq. Ft.
Building Permit to be Issued by
Sewer
Addition(s)(/f applicable)
Additions (11 applicable)
City / Town ❑ County ❑ None
Publlc ❑ Private ❑ None
�y Sq. Ft.
$ C)
Fire Suppression System In Building
Detailed Suppressions System Plans and Spec's
Remodeled (It applicable)
Remodeling (It applicable)
❑ Full ❑ Partial one
El Provided ElTo Follow
Sq. Ft.
$
If Partial, Specify Where*
Located In Flood Pian (r county Plan Commission)
Total Building Area Sq. Ft.
Total Project Cost
❑ Yea No
o
a Ov
Building Type and Occupancy'
Building Height (stories),
No. of Building's this submittal
Volume Cu. Ft. (Fee Category E only)
-57Z-1It
ry
(Describe it necessary)
G N
Serving Fire Department and Address City Township
GA LrL 010 io/✓ GAIZ — 46
Does project include: (check if yes)
❑ Elevation or lift ❑ Combustible fibers storage ❑ Fireworks storage El Explosives storage
❑ High pile storage ❑ Boller or pressure vessel ❑ Hazardous or flammable materials storage
Describa proposed use uf facility In DETAIL, types of materials stored or handled, if any. (Flammability? Activities pursed?—.)—
s L e—' G6r — C— _
Describe p:avlouz or cc -rent use of facility In DETAIL (If existing facility)' _ _ .. . •. - ,
No. of Persons Employed
(Max / Shift) /
General Comments*
No. of Persons (Public)
2
;dENERAL'INFORIaArATtON '
Has Other Work at this location ever been filed
What Year and Month
Previous SBC Project No.
XYes ❑ No ❑ Not known
I V 4 -
Does project Include use of a separately
Manufacturer Name
Master or Modular No.
filed Master or Modular Plan
❑Yea NNO
Has Construction Started
If Yes, has a Notice of Violation or Investigation been issued
If No, Probable Construction Starting Date
❑Yes �JdO
❑ Yea ❑ No
1p jb —j7
ENERGY DESIGN DATA'::;
Indiana Climate I Zone
Type of 1-13ating Fuel
No. of Tenants
No. c! Electric
No. of Gas Met s;ra
Calculated Uo Values
❑ North Central C1 South
/�/p Al C;
IC1d N!S
Meters
�/
NON' L.'
BTU/ H R / SF / De F
q�
Walla (Adjusted
for openings) Uo
Does project contain skylights, greenhouse,
solarium, or large glass areas „ .,-•, OTTV OTTV
i Roof / Ceiling
Energy Calculations Provided
Potable Hot Water Provided? Is it recirculated?
�
Yes NO
ElIp.
fl Yes Nn ❑ .v cr No
11 Assembly Uo
Floors (Unheated
Air Infiltration Rate Per Table 5.3
Total Non • Residenilal Lighting Power Budget
Thermostat Range
❑Yes ElNo
K. W.
Heating Cooling
Below) Uo
Slab at Grade R
General Comments'
UNHc.T�%d/L/1G �v�c D� c
Crawl Space Walls R
HANDICAPPED ACCESSIBILITY
Have handicapped parking
Does access within building
Do toilet rooms and equipment
Does access to building meet
is building designed for
spaces and signs bee
comply with table 33-A. I. B. C.
meet Handicapped Accessibility
Handicapped A,cS�easlbilit
access adaptability
provided LJ Yes KN.
❑ Yes []No
Code ❑Yea ❑ No
Code LI Yes No
❑ Yea ❑ No
General Comments'
SEISMIC DESIQN
Is this project classified as an ESSENTIAL FACILITY, GROUP Et orHIGHRISE? (See IBC Chapter 23) ❑ Yes P.No
Have seismic design procedures been followed per code requirements? >AYes ❑ No
HEALTH CARE FACILITIES A,, -r P®.
Type of Facility (As Licensed by orate Board of Health)
If Nursing Home:
❑ Residential Custodial Care ❑ Nursing Home ❑ Outpatient Surgery ❑ Hospital I
❑ Intermediate Care ❑ Skilled Care
Admitting and Discharge Policy
Plans Shows Critical Heating Area
Emergency Power Service
Provided
Eles ❑ No
I ❑Yea ❑ No
I ❑Generator ❑Battery ❑None ❑Other (Specify),
'NOTE use separate shoot If additional spats is required.
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