HomeMy WebLinkAboutProject Data*NOTE: use separate sheet if additional space is required.
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FOR OFFICE USE ONLY ? wp`,
3. PROJECT DATA
sac Proje�j �. j r / / Filing Dae+
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:. F' ' ` :P_ ROJECT'DWRIPTroN (alfest,bl tem Ntlt�j .. ,s
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AREAS .
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Scope of Work
Total Existing (1l applicable)��
❑ New Building Additlon Remodeling ElChange of Occupancy I Use
Sq. Ft
Building Permit to be Issued by
Sewer
Addition(s)(1I applicable) Additions (If applicable)
City / Town ❑ County ❑ NonePublic
El Private C3 None
7 Sq. Ft. $
Fire Suppression System In Building
Detailed Suppressions System Pians and Spec's
Remodeled (If applicable) Remodeling (it applicable)
C3Full ElPartial ,� None
ElProvided ❑ To Follow
'� Sq. Ft. S A 140
If Partial, Specify Where'
Located In Flood Plan (e County Plan Commission)
T tal Building Area Sq. Ft. Total Proltict Cost
[]Yes No
i
Building TyQe and Occupancy*
Building Height (Stories)' No.
(Describe
of Building's this submittal
it necessary)'
VolumeCu. Ft. (Fee Category E only)
�j_
)
Serving Fire Department and Address C* City Townshi
clrt 1 b. Io 1trn SW
Does project include: (check If yes)
❑ Elevation or lift ❑ Combusts Fireworks storage ❑ ExplosivQs. gtoraga �>V ;.
❑ High e ❑ Boiler or pressure vessel ❑ Hazardous or flammable' materials storage •�. ;rs
Describe proposed use of facility in DETAIL,ly as of malsrla: stored or handled, it,�aa^^ny.. (F��"/nmaDility? Activities pursed?')
�d 1..
c.
Describe previous or current use of facility In DETAIL (if existing facility)' r *.��•,'• \�
t
No. of Persons Employed
•.i:,\,.'r
(MexlShift) {-
L
General Comments'
No. of Persons (Public)
GENERAL INFORMATION ?�
�. •'777
Has Other Work at this location ever been filed
Whet Year and Month
Previous SBC Project No.
❑Yes ❑ No of known
Does project Include use of aseparately
Manufacturer Name
Master or Modular No.
filed Master or Modular Plan
I
❑Yes No
Has Construction Started
It Yes, has a Notice of Violation or Investigation been issued
If No, Prob le C structio Sig[.' Dale
❑ Yes No
❑ Yes ❑ No
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ENERGY DESIGN DATA
Indiana Climate I Zone
Type of Heaiing Fuel
No. of T nants
No of Electric
No. of Gas Meters
Calculated Uo Values
El North Central El South
S
'
Meters
I-
`
BTU!HR,SFIDeq F
Walls (Adjusted
for openings) O16 uo
Does prof ct contain skylights, greenhouse, —
solarium, or large glass areas It yes, OTTV OTTV
❑ Yes No of roof = of walls
Roof I Ceiling C
o
Energy Calculations Provided
Potabl Hot Water Provided? Is it recirculated?
❑ Yes No
Yes ❑ f+o ❑ Yes W.No
Assembly 1 v Uo
Floors (Unheated ems+
Air Infiltration Rate Per Tabre 5-3
Total Non - Residential 1.gh ing Power Budget
Thermostat Range
O O
Yes ❑No
r K. W. I
Heating Cooling 718
Below) Uo
Slab at Grade r R
G
General Commentd*
Crawl Space Walls— R
HANDICAPPED ACCESS1131LITY
Have handicapped parking Does
access within building
Do toilet rooms and equipment
Does access to building meet
Is building designed for
spaces and signs en comply
with to 33-A. I. B. C.
meet Handicapp Accessibility
I
Handicapped c ssibilitx
access age to ility
provided Yes ❑ No
Yes ❑ No
Code Yes ❑ No
Code Yes (J No
Yes ❑ No
General Comment -
SEISMIC DESIGN
Is this project classified as an ESSENTIAL FACILITY, GROUP Et or HIGHRISE? /See IBC Chapter 23) ❑ Yes We
Have seismic design procedures been followed per code requirements? Yes ❑ No
HEALTH CARE FACILITIES
Type of Facility (As Licensed by State Board of Health) If
Nursin H
❑ Residential Custodial Care ❑ Nursl ng Home ❑ O Hospital ❑
Intermediate Care ❑ Skilled Care
Admitting and Discharge Policy Pians S eating Area
Emergency Power Service
Provided
l _ o ❑Yes ❑ No
❑ Generator ❑ Battery ❑ None ❑ Other (specify)'
*NOTE: use separate sheet if additional space is required.
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