HomeMy WebLinkAbout19050153 ApplicationOFFICE ?ISE ONLY c'��
CITY OF CARMEL PERMIT#_�J®�
RESIDENTIAL PERMIT APPLICATION
rrealnelh Please complete form and email to p@rmitsOcarmo Qom as an attachment
If you have any questions, please call Building & Code Services at (317)571.2444.
BUILDER OF
NAME SERVICEMASTER/MARK CROUCH 1
PHONE317-652-8889
RECORD
STREET BROOKVILLE WAY SUITE B
a
O11YINDIANAPOLIS
6TATEIN
2l'46239
E-MAIL BEST METHOD
ADDRES$markecrOUCh@yahOO.COm Of CONTACT ❑ PHONE H EMAIL
PLUMBING
NAME
STATE OF INDIANA
CONTRACTOR
LICENSE NUMBER
UTILITIES
NAME
SEWER
WATER
EXCAVATOR
UTILITY
UTILITY
PROPERTY
NAME
PHONEBUHR PHONE
317-669-2037
OWNER
STREET PREVAIL DR W
CITY
STATEsTATEIN
21P46033
PROJECT
NUMSER 17-10-20-00-05-008.000
LOCATION
LOT
NUMBER 15
]SION
FLOOD
ZONE
ADDRESS14276 PREVAIL DR W
C17YCARMEL
sTATEIN 1
2IP46033
DOES SUBDIVISION HAVE
HOMEOWNERS ASSOCIATION? ❑ YES (LETTER OF H.O,A. APPROVAL REQUIRED) ❑ NO
TYPE OF
STRUCTURE
8SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHtlME EACH UNIT WILL REQUIRE
SEPARATE APPLICATION
PROJECT
❑ NEWSTRUCTURE 8 REMODEL ❑ ACCESSORY BUILDING
DETAILS
❑ ADDITION ❑ Room ❑ Porch ❑ Deck ❑ GARAGE ❑ Attached ❑ Detached
FOUNDATION M BASEMENT El 11 SLAB ❑ CRAWL ❑ POSTIBEAM ❑ ROSTIPIER
TYPE
COST OFENERGY
CONSTRUCTION g pgpg�
CODE PRESCRIPTIVE ❑ TOTAL UA ❑ PERFORMANCE
EXCLUDING LAND
TOTAL
SQUARE '' i00
.1ST -2ND
BASEMENT FLOOR :.FLOOR PORCHES -GARAGES
FOOTAGE l
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 lgoists or lightweight roof trusses) in Class I and Class II Construction that:
1. Have less mass dross sectional area than sawn lumber of equivalent propomons used in an equivalent applkadon; and
2. Are assembled from combustible of noncombustible materials, of beth
"This does not Include a structural assembly, joist or truss that provides at least I hour of fire resistance under ASTM El 18`
Does this project Include any Advanced Structural Components? a [j Yes (Section Solo. Required) ® No "
Type of Advanced Structural Component (Select ail Thal apply) ' Lacation(s) in Structure
❑ Lightwelghtl4olse
❑ Llghlweight Roof Trusses
Class I structure permits are subject to the State of Indiana General Administrative Rules (GAR 676 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargemeh4 reoc rflon, 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 (Z426.17) and amendments, adopted under authority of I.C. 76.7 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 Occupancy or of
/Substantial Completion has been Issued by the Department of Community Services, Carmel, Indiana.
Signature of Owner a Authorized Agent1"'" (�..+-'-' Date 5-16-19