HomeMy WebLinkAbout19040009 Application
CCIITTYY OOFF CCAARRMMEELL
RREESSIIDDEENNTTIIAALL 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
STREET
ADDRESS
CITY STATE ZIP
E-MAIL
ADDRESS
BEST METHOD
OF CONTACT ࡕࡕ PHONE ࡕࡕ E-MAIL
PLUMBING
CONTRACTOR
NAME STATE OF INDIANA
LICENSE NUMBER
UTILITIES
EXCAVATOR
NAME SEWER
UTILITY
WATER
UTILITY
PROPERTY
OWNER
NAME PHONE
STREET
ADDRESS
CITY STATE ZIP
PROJECT
LOCATION
PARCEL
NUMBER
LOT
NUMBER
SUBDIVISION FLOOD
ZONE
STREET
ADDRESS
CITY STATE ZIP
DOES SUBDIVISION HAVE A
HOMEOWNERS ASSOCIATION? ࡕࡕ YES (LETTER OF H.O.A. APPROVAL REQUIRED) ࡕࡕ NO
TYPE OF
STRUCTURE ࡕࡕ SINGLE FAMILY ࡕࡕ TWO FAMILY ࡕࡕ TOWNHOME EACH UNIT WILL REQUIRE
SEPARATE APPLICATION
PROJECT
DETAILS ࡕࡕ NEW STRUCTURE ࡕࡕ REMODEL ࡕࡕ ACCESSORY BUILDING
ࡕࡕ ADDITION ࡕࡕ Room ࡕࡕ Porch ࡕࡕ Deck ࡕࡕ GARAGE ࡕࡕ Attached ࡕࡕ Detached
FOUNDATION
TYPE ࡕࡕ BASEMENT ࡕࡕ Walkout ࡕࡕ SLAB ࡕࡕ CRAWL ࡕࡕ POST/BEAM ࡕࡕ POST/PIER
COST OF
CONSTRUCTION
(EXCLUDING LAND) $ ENERGY
CODE ࡕࡕ PRESCRIPTIVE ࡕࡕ TOTAL UA ࡕࡕ PERFORMANCE
TOTAL
SQUARE
FOOTAGE
BASEMENT 1ST
FLOOR 2ND
FLOOR PORCHES GARAGES
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? ࡕࡕ Yes (Section Below Required) ࡕࡕ No
Type of Advanced Structural Component (Select all that apply) Location(s) in Structure
ࡕࡕ Lightweight I-Joists
ࡕࡕ 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__________________________________
19040009
SURROUNDINGS by NatureWorks+ 317.900.3410
200 S. Rangeline Roard #102A Carmel IN 46032
bill@choosesurroundings.com n
N/A
N/A Carmel Carmel
Raileen Peterson 765-744-1709
13078 Deerstyne Green Street Carmel IN 46032
17-09-28-00-46-037.000
479 Village of Westclay
13078 Deerstyne Green Street Carmel IN 46032
n
n
n
n
18,000
196 196
n
04.01.2019 Bill Bernard
05/20/19
Mike Sheeks