HomeMy WebLinkAbout19050194 Application
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PPEERRMMIITT AAPPPPLLIICCAATTIIOONN
Please complete form and email to permits@carmel.in.gov as an attachment.
If you have any questions, please call Building & Code Services at (317) 571-2444.
BUILDER OF
RECORD
NAME PHONE
ADDRESS CITY STATE ZIP
E-MAIL
ADDRESS
BEST METHOD OF
CONTACT PHONE E-MAIL
PLUMBING
CONTRACTOR
NAME STATE OF INDIANA
LICENSE NUMBER
PROPERTY
OWNER
NAME PHONE
ADDRESS CITY STATE ZIP
PROJECT
LOCATION
PARCEL
NUMBER
ADDRESS (INCLUDING
SUITE NUMBER)
CITY STATE ZIP
TYPE OF
STRUCTURE COMMERCIAL INSTITUTIONAL MULTI-FAMILY NUMBER OF UNITS:______________
PROJECT
DETAILS
NAME OR DESCRIPTION
OF PROJECT
NEW STRUCTURE TENANT FINISH REMODEL ACCESSORY BUILDING CELL TOWER
ADDITION Room Porch Deck GARAGE Attached Detached
COST OF CONSTRUCTION
(EXCLUDING LAND) $ SQUARE
FOOTAGE
STATE OF
INDIANA CDR
PROJECT
NUMBER
RELEASE
DATE
CONSTRUCTION
TYPE
OCCUPANCY
CLASSIFICATION
SCOPE OF
RELEASE FDN STR ARCH ELEC MECH
PLUM 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
Components (lightweight I-joists or lightweight roof trusses) in Class I and Class II Construction that:
1. 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 E119*
Does this project include any Advanced Structural Components? Yes (Section Below Required)No
Type of Advanced Structural Component (Select all that apply) Location(s) in Structure
Lightweight I-Joists
Lightweight Roof Trusses
OFFICE USE ONLY
PERMIT #____________
Class I 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 et 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. I 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 _______________________________________________________________ Date__________________________________
19050194
Burnside Builders, LLC 3175078336
5261 N. Tacoma Ave., Suite A
Indianapolis IN 46220
jb@burnsidebuilders.com
North Mechanical Services PLC8601048
Rubenstein Partners 215-563-3558
2929 Arch Street, 28th Floor
Philadelphia PA 19104
600 E. 96th Street, Suite 400 Indianapolis IN 46240
ONI
90,000 4,000
406879 4/1/19 I-B, SPK B, REM
John B. Smith II 5/24/19