HomeMy WebLinkAbout19020073 ApplicationCITY OF CARMEL PERMIT
1 RESIDENTIAL PERMIT APPLICATION
�ao�Aa'f Please complete form and email to permits@carmeLin.Gov as an attachment
If you have any questions, please call Building & Code Services at (311f) 571-2444.
BUILDER OF
NAME 1� /
Ma (-1
PHONE
3 j Soo 0,��
RECORD
(i O CO C
DDRES
AS 7 1 2(j'o/� w 34 ?L
O.�"n
`Sq
61M
�Ib
LW
ADDRESSMG l\C [�i0��1�nC �,�(, (�6,1 OFCONTACTp ❑ PHONE JW EMAIL
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PLUMBING
NAME
STATE OF INDIANA
CONTRACTOR
...NAME
I
LICENSE NUMBER
UTILITIES
SEWER
WATER
EXCAVATOR
UTILITY
UTILITY
futME
phwc E' l
PHONE
165 63 665
i o , vc� �c
E
1 ADDRESS�(0 EILL s STREET
�� L4v
PROJECT
PARCEL
04 003, (j 0,9
LOCATION
LoTI,
ki+\
SUB N.
f
FLOOD
TONE
�'lqa
ti
y�2��
DOES SUBDIVISION HAVE A
HOMEOWNERS ASSOCIATION? ❑ YES (LETTER OF KOA APPROVAL RE ED) ❑. NO
TYPE OF
STRUCTURE
EACH
❑ SINGLEFAMILY to TWO FAMILY ❑ TOWNHOME SEPARAfEAPLICATIOE
SEPARATE APPLICATION
PROJECT
0 NEW STRUCTURE C4 REMODEL ❑ ACCESSORY BUILDING
DETAILS
❑ Aw1moN ❑ Room ❑ Parch ❑ Deck ❑ GARAGE ❑ Adaenea ❑ Detached
FOUNDATION SASEIIIENT ElWallout ElOS SLAB ❑ CRAWL ❑ POSTIBEAM ❑ PMER
TYPE
COSTor l� $ I GUO
{
CODE Y ❑ PRESCRIPTIVE ❑TOTALUA ❑PERFORMANCE
.FOOTAGE
TOTAL r
�2, r 00
.,
2ND i
EASEMENT ISTFLOOR FLOOR PORCHES :GARAGES.
ADVANCED STRUCTURAL COMPONENTS REPORTING
Ties secoon is regaled in order to conyly wkh the requirements d IC 22-11-21 (PdAe Law 104, 2018) as it relates to the use of Advanced Swicaxal
Componems (6gMweight I-jdsm a 8 t and mases) in Class I and Class 8 Conswaion Own;
1. Have less mffisaces-serAorW auea Ilan sarin Wmber W egivalrnnt pmportiona wed man equw4dent appGcabon, and
2 Are assembled from combus" or noncemhus" matenwa, a both
`ills doss not tnckWe a stnxxural assembly, joist a Miss *.I pmvides at least 1 hour of Tve resistance under ASPM El IW
Does 4t project innckIde any Advanced Structural Components? ❑ Yes (Section BdowR"Wned) �, No
Type of Advanced Structtrral Component (SeWal dud appy) 1 Locations) In Structure
❑ uotweigle F.lo m t
❑ Lighhve#* RoofTnwes
CWasiaouWrre Waft aresub)eatothe Stag of lodiarIa General.AdmW4sCaHve Rules (GAR 87BM 12) isgwd" wWaftathneframes1w beSM Ing and
mmpMflrgcon}truotlon.. ..