HomeMy WebLinkAbout19040069 ApplicationCITY
CARMEL
OFFICE USE ONLY"
CI 1 I OF CARMEL PERMIT#�000�2
RESIDENTIAL PERMIT APPLICATION
cul as Please complete form and email toyeermits(dIcarmel.1ri as an attachment.
-" If you have any questions, please call Building & Code Services at (317) 571.2444.
BUILDER OF
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PHONE
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RECORD
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STATE
ZIP
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PHONE E-MAILIA1
FCONTACT
PLUMBING
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STATE OF INDIANA /
LICENSE NUMBER �tfl S(/o 5'N
CONTRACTOR
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UTILITIES-
NAME
SEWER
WATER
EXCAVATOR
UTILITY
UTILITY
PROPERTY
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PHONE cp
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OWNER
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317 /
STREET
ADDRESS I `��77 VVC� t11111 7?' 4,41(f(7
CITY q
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ST ATE /
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140) 2
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PROJECT
PARCEL
LOCATION
NUMBER
LOT
NUMBER 3�
SUBDIVISION J /�
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vREE
FLOOD _
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ADDRESS I'7�•//�� lqJ� 1117 I !'CIN
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DOES SUBDIVISION HAVE A
❑
HOMEOWNERS ASSOCIATION? YES (LETTER OF H.O.A. APPROVAL REQUIRED) NO
TYPE OF _.
STRUCTURE
EACH UNIT WILL REQUIRE
SINGLE FAMILY ❑ Two FAMILY ❑ TOWNHOME SEPARATE APPLICATION
.PROJECT
❑ NEW STRUCTUREqpr REMODEL ❑ ACCESSORY BUILDING
DETAILS
/
❑ ADDITION ❑ Room ❑ Porch ❑ Deck ❑ GARAGE ❑ Attached ❑ Detached
FOUNDATION BASEMENT ❑ Walkout ❑ SLAB ❑ CRAWL POSTIBEAM ElPo6T/PIER
TYPE
COST OF
CONSTRUCTION $ / / /-q J
ENERGY
CODE PRESCRIPTIVE ❑ TOTAL UA ❑ PERFORMANCE
I47 j.f"b
EXCLUDING LANDTOTAL
i /
SQUARE! %
JJ
BASEMENT IST 2ND I IpORGHES I ':GARAGES .
3 FLOOR FLOOR
FOOTAGEI 7
i I
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 R relates to the use of Advanced Structural
Components (lightweight 1 -joists 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 -
Z 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 Ore resistance under ASTM El 19"
Does this project Include any Advanced Structural Components? ❑ Yes (Section Below ReyufreUJ No
Type of Advanced Structural Component (Select all that apply) Location(s) In Structure
❑ Lightweight I -Joists ._..............__._._ .._... .�._.,.._.....__,....__.._.._.. _
❑ Lightweight Roof Trusses
Class I structure permits are subject to the State of Indiana General Administrative Rubs (GAR 675 IAC 13) regarding expiration dme frames for beginning and
completing construction.
I, the undersigned, agmthat any construction, reconstruction, enlargampnt, rilipcadon, or qr any change In the,use of land or
-
structures requested by this application will comply with and conform to all appliou1q ,ilf ;t ave of Indiana and dao' Cams* Unified bevehppmarn �. e
Ordinance (Z-826-17) and amendments, adopted under authority of I.C. de•7 t?eneAssembly of tMr State Indiana, Acts amen latory
et sec, of and'alI
thereto. l further certify that only Mtchen,bath, and floor drains are connected w ihesanitary sewer. I'further cindly that the construction will not be
used or occupied until a Certificate of Occupancy or of Substartial Com ledon gas been Issued. by the Department of Community/Services;: Central, Indiana.
Signature of Owner or Authorized Agent