HomeMy WebLinkAbout19020103 ApplicationOFFICE USE ONLY
OF nCITY OF CARMEL PERMIT#
COMMERCIAL 1 INSTITUTIONAL 1 MULTI -FAMILY
PERMIT APPLICATION
IHUTANA Please complete form and email to perrmitsCcDcarmel.in.dov as an attachment.
If you have any questions, please call Building & Code Services at (317) 571-2444.
BUILDER OF
RECORD
NAM
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l�LZ�;
PHONE
..1
ADDRESS
CITY
STA�TF
ZIP
E-MAIL - / I
ADDRESS �� �'�� f �C �tiS r a^ J C/`��/1 ,
BEST METHOD OF
CONTACT ❑ PHONE L;---1J-MAIL
PLUMBING
NAME
/
'�
[STATE OF INDIANA
LICENSE NUMBER � „ .
c
CONTRACTOR
v
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S (r
e
PROPERTY
OWNER)
NAME
ILLC_�-?f
PHONE
/t+7 - �ZG' a -
ADDRESS
CITY
STATE
ZIP
PROJECT
LOCATION
PARCEL
NUMBER
ADDRESS (INCLUDING y
SUITE NUMBER) �l C' S/a? Zr
CITY
= ti
STATE_ Zit'/�
y ` V ��jf%j7L
TYPE OF
STRUCTURE
COMMERCIAL ❑ INSTITUTIONAL ❑ MULTI -FAMILY NUMBER OF UNITS:
PROJECT
DETAILS
NAME OR DESCRIPTION '
OF PROJECT�L�r, '
❑ NEW STRUCTURE ❑ TENANT FINISH L' REMODEL ❑ ACCESSORY BUILDING ❑ CELL TOWER
❑ ADDITION ❑ Room ❑ Porch ❑ Deck ❑ GARAGE ❑ Attached ❑ Detached
COST OF CONSTRUCTION
(EXCLUDING LAND) $ r �j � ,
SQUARE
FOOTAGE ?,' —3
STATE OF
INDIANA CDR
PROJECT
NUMBER Ll S ��s
RELEASE J
DATE 1z�! /C
CONSTRUCTION
TYPE �r�
OCCUPANCY
CLASSIFICATION. �J!
�/
SCOPE OF ❑ FDN ❑ STR C1�ARCH IK ELEC &,-6ECH
ul�RELEASE
PLUM D SPKLR ❑ HOOD ❑ OTHER
ADVANCED STRUCTURAL COMPONENTS REPORTING
This section is required in order to comply with the requirements of IC 22-11-21 (Public Law 104, 2018) as it relates to the use of Advanced Structural
Th
F1,
Components (lightweight I -joists or lightweight roof trusses) in Class I and Class li Construction that:
Have less mass cross -sectional area than sawn lumber of equivalent proportions used in an equivalent application; and
2. Are assembled from combustible or noncombustible materials, or both
'This does not include a structural assembly, joist or truss that provides at least 1 hour of fire resistance under ASTM El 19'
Does this project include any Advanced Structural Components? ❑ Yes iSection Below Require(f) Iq No
Type of Advanced Structural Component (Select all that apply) Location(s) in Structure
❑ Lightweight I -Joists
❑ Lightweight Roof Trusses
Class t structure permits are subject to the State of Indiana General Administrative Rules (GAR 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply with and conform to all applicable laws of the State of Indiana and the Carmel Unified Development
Ordinance (Z-625-17) and amendments, adopted under authority of I.C. 36-7 at Seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. 1 further certify that the construction will not be
used or occupied until a Certificate of Occupancy or of Substantial Completion has been issued by the Department of Community Services, Carmel, Indiana.
Signature of Owner or Authorized Agent ' 7' �', ' Date