HomeMy WebLinkAbout19040116 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 ¯¯ PHONE ¯¯ 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? ¯¯ YES (LETTER OF H.O.A. APPROVAL REQUIRED) ¯¯ NO
TYPE OF
STRUCTURE ¯¯ SINGLE FAMILY ¯¯ TWO FAMILY ¯¯ TOWNHOME EACH UNIT WILL REQUIRE
SEPARATE
APPLICATION
PROJECT
DETAILS ¯¯ NEW STRUCTURE ¯¯ REMODEL ¯¯ ACCESSORY BUILDING
¯¯ ADDITION ¯¯ Room ¯¯ Porch ¯¯ Deck ¯¯ GARAGE ¯¯ Attached ¯¯ Detached
FOUNDATION
TYPE ¯¯ BASEMENT ¯¯ Walkout ¯¯ SLAB ¯¯ CRAWL ¯¯ POST/BEAM ¯¯ POST/PIER
COST OF
CONSTRUCTION
(EXCLUDING LAND) $ENERGY
CODE ¯¯ PRESCRIPTIVE ¯¯ TOTAL UA ¯¯ 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? ¯¯ Yes (Section Below Required) ¯¯ No
Type of Advanced Structural Component (Select all that apply) Location(s) in Structure
¯¯ Lightweight I-Joists
¯¯ Lightweight Roof Trusses
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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__________________________________
SURROUNDINGS by NatureWorks+ 317.900.3410
200 S. Rangeline Road Suite 120A Carmel IN 4603
bill@choosesurroundings.com
N/A
N/A Carmel Carmel
Mike and Jenni Engledow 317.777.1674
13748 Adios Pass Carmel IN 4603
17-09-24-03-01-047.000
21 Village of Mount Carmel
13748 Adios Pass Carmel IN 4603
30,000
224 224
04.12.19
Bill Bernard
19040116
05/16/19
Mike Sheeks