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HomeMy WebLinkAbout19040024 Application�a CARMEL + p �/� OFFICE USH ONLY �'�a,'"aa,M``f CITY Y OF 4DA�,�:11, EL. PERMIT #—I RESIDENTIAL PERMIT APPLICATION rxbunk Please complete form and email to permitsOcarmel.in,nov as an attachment. If you have any questions, please call Building & Code Services at (317) 571-2444. PUILDERDF NAME PHONE RECORD STREETADDRESS .` 1 X39 0080/+� CITY ry STn, /,j � ZIP ) q� plrl AD REWAIESSJ1t�lC'M"IYt't()(O>X: Y ✓ 1 BEST OF CONTACTTD ❑ PHONE Lel E-MAIL PLUMBING ., NAME STATE OF INDIANA NTRACTR :+, EO O LICENSE NUMBER UTILITIES NAME SEWER WATER EXf�AVATOR e, UTILITY UTILITY PROPERTY; . NAME �p_ PHONE OWNER Pll T ET ADDRESS X719 CITY /� ' STATE /P . ,UL PROJECT PARCEL ©O NUMBERLOT LOCATION _ NUMBER SUBDIVIS ON Ty., I IFLOOD ZONE /L,.r•V C' �j�'CITY . STREET ADDRESS ,/Ex � (r STAT A) 1I 66,3Z, DOES SUBDIVISION HAVE A 91 ❑ HOMEOWNERS ASSOCIATION? YES (LETTER OF H.O,A APPROVAL REQUIRED) NO TYOE,OF STRUCTURE 11d' SINGLE FAMILY El TWO FAMILY 1:1TOWNHOME EACH UNIT WILL REQUIRE SEPARATE APPLICATION PROJECT DETAILS ❑ NEW STRUCTURE ❑ REMODEL ❑ ACCESSORY BUILDING / 171ADDITION ElRoom Ili Porch ❑ Deck ❑ GARAGE ❑ Attached ❑ Detached ' FOUNDATION ❑ BASEMENT ❑ Walkout ❑ SLAB ❑ CRAWL ❑ POST/BEAM ❑ POSTIPIER TYPE . COST OF!��. �/// ,-.,, ✓ CONSTRUCTION $ 5(/3 Lf� ENERGY CODE ❑ PRESCRIPTIVE ❑ TOTAL UA ❑ PERFORMANCE EXCLUDING LAND I TOTAL SQUARE BASEMENT IST FLOOR PORCHES/ GARAGES :' FOOTAGE .FLOOR ADVANCED STRUCTURAL COMPONENTS REPORTING This section Is required in order to comply with the requirements of IC 22-19-21 (Public Law 104, 2018) as It relates to the use of Advanced Structural Components (Ilghtwelght I-jolsts or lightweight roof trusses) in Class I and Class II Construction that: 1. Have less mass cross-secllonal area than sawn lumber of equivalent proportions used In an equivalent application; and 2. Are assembled from combustible or nonwmbustible materials, or both 'This does not Include a structural assembly, joist or trues that provides at least 1 hour of fire resistance under ASTM El 19* Does this project Include any Advanced Structural Components? ❑ Yes (Section Below Required) No Type of Advanced Structural Component (Select all (hel apply)Locat[on(s) in Structure ❑ Llghtweighl Woists ❑ Lightweight RoofTrusses fit es I altuo(ara permits are -subject to the State otlndla a General AdrmnlslreliJo Rules (GAR 3751AC t]) regarding gxplratlon lime frames for tiagln°ning and -bompleli,a 99nstrucdoti. - A the 6nderitgned, agree that any eonstructioh, reconstruction, enlargement, relocation, ort ellerdclon of a slruature,'or any change,in the rise of land or ` requea`ted by this applloation will comply With and oonforin to all appllceblelaWs of the Sttie of Indiana and the Cennel,Unifled Dgiolc atient _alrpctures '4rdfnanee (Z-328=17) and amendments, adapted under authority of I.C, 38 7 of seq, General Aiso lyaf the'Sudsof fndlana, and ell Acta amendaigry, .thoraco. Ifunnarcertifythatonly kitchen; bath, and floor drains are connectedto the sanitary sew r. lfurthercer4fythotthebonstfuotlon will aogbe g =Used o} pfcupled until a Certificate of Occupancy or of Completion has tiaen Ipaued by the Department oT Communjfy,garvlces; Carmel, Indiana./21 Signature of Owner or Authorized Agent AU d� Date