HomeMy WebLinkAbout17100001 Accessibility FormCITY OF CARMEL
Accessibility for Public Accommodations and Commercial Facilities Certification
Registered Design Professionals who are the designer of record of any commercial,
institutional, industrial or other building or structure that is required to be accessible by the
State of Indiana in accordance with the Indiana Building Code Chapter 11: Accessibility must
complete and seal this form. l--':-6'EA°76j�=Ie,,J- Tl0A( fs ��E-7
Permit Number: Date:
Name of Project:2'%Gf�flQ_—
T
Address of Project: ?72- 75-6 A/ Wl6�lxZ
I W6the Registered Design Professional of the
(Name)
above subject property have personally prepared the drawings and personally or my qualified
representative,
(Name of Qualified Representative)
have/has performed a physical inspection at the above subject project and attest that all the
requirements of the Indiana Building Code Chapter 11: Accessibility for Public Accommodations
and Commercial Facilities ode compliant.
Signature of De -sigh Prorn
G 3/, 2-01q
Date