HomeMy WebLinkAbout19060095 ApplicationOFF]FUSE ONLY
CITY OF CARMEL PERMIT# `�0�oo�
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RESIDENTIAL PERMIT APPLICATION
kutnar Please complete form and email to nermitsCd carmel.in.Qov as an attachment,
If you have any questions, please call Building & Code Services at (317) 671-2444,
BUILDER OF
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OF CONTACT PHONE ❑ EMAIL
PLUMBING
CONTRACTOR
NAME a fr�\
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STATE OF INDIANA
LICENSE NUMBER
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UTILITIES
EXCAVATOR
NAME-r�
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SEWER
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PROPERTY
OWNERSTREET
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PROJECT
LOCATION
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NUMBER .i?��'h
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DOES SUBDIVISION HAVE A
HOMEOWNERS ASSOCIATION? YES)&TTEA OF H.O,A. APPROVAL REQUIRED) NO
TYPE
STRUCTURE
SINGLE FAMILY El TWO FAMILY 13TOWNHOME EACH UNIT WILL REQUIRE
� SEPARATE APPLICATION
PROJECT
DETAILS
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❑ NEW STRUCTURE REMODEL ❑ ACCESSORY BUILDING
❑ ADDITION Room ❑ Porch ❑ Deck ❑ GARAGE Attached ❑ Detached
FFO�UE DATION ❑ BASEMENT 11Walkout SLAB CRAWL El POSTIBEAM ElPOSTIPIER
COSTOF�
CONSTRUCTION $' o,oulo i
ENERGY
CODE ElPRESCRI)'TI E�„❑ TOTAL UA El PERFORMANCE
EXCLUDING LAND
TOTALj
SQUARE BASEMENT -1ST OR LOOK �I ;PORCHES-. GARAGES
FOOTAGE x
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ADVANCED STRUCTURAL COMPONENTS REPORTING
This section is required In order to Comply with the requirements of IC 2211.21 (Public Law 104, 2018) as h relates to the use of Advanced Structural
Components (lightweight hjolsts or lightweight roof trusses) In Class 1 and Class Il 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 i hour of Ore 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 that apply) Locations) In Structure
❑ Lightweight? Joists _
❑ Ughlweighl Roof Trusses
Class I structure permits are subject to the State of Indiana General Administrative Rules (OAR 6761AC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any constmctlon, reconstruction, enlargement, relocation, or alteration of a structure, or any change In the use of land a
structures requested bythis appiloation will eompiywitb and conform to all applicable laws of the State of Indiana and the Carmel Unmed Development
Ordinance (ZC26.17) and amendments, adopted under authority of I.C. 36.7 at 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 Occupancyor�,b`sttanntiallll�)1Completion has been issued by the Department of Community services, Carmel, Indiana.
Signature of Owner or Authorized Agent (1✓"'c i Date