HomeMy WebLinkAbout19050203 Application- OFFICE U&EON
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CITY OF CARMEL PERMIT#a��
RESIDENTIAL PERMIT APPLICATION
`��xalaxN% Please complete form and emall to permits('7D,carmel.in.gov as an attachment.
If you have any questions, please call Building 8 Code Services at (317) 8712444.
BUILDER OF
RECORD
NAME
K,; P(b 5ArV;.Gt 30 11
PHONE
31i, ?32. S 6 9j
STREET
ADDRESS 9.7r.0 Le.
CITY
��,
STATE
EMAIL'r
ADDRESS (n10� t4„ K— h
BEST METHOD �p
OF CONTACT ElPHONE �rr EMAIL
PLUMBING
NAME
rsTATE OF INDIANA
CONTRACTOR
LICENSE NUMBER
UTILITIES
EXCAVATOR
NAME
I
SEWER
UTILITY
I WATER
UTILITY
E
NAME
mC�I�
PHONEr
31� 31 "711,7
STREET /
ADDRESS J 0 b
CITY
STATE
y-'',
YlV
ZIP
I
PROJECT
PARCEL
LOCATION
NUMBER
LOT
NUMBER
SUBDIVISION
a
FLOOD
ZONE
STREET
ADDRESS �
a
CITY
Zy
DOES SUBDP/ISION HAVE A �7
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
DETAILS
❑ NEW STRUCTURE ❑ REMODEL ❑ ACCESSORY BUILDING
❑ ADDITION ❑ Room, Parch Deck ❑ GARAGE ❑ Attached ❑ Detached
FOUNDATION
TYPE ❑ BASEMENT ❑ Walkout ❑ SLAB f7CRAWL ElPOST/BEAM POSTIPIER
COST OF
CONSTRUCTION
EXCLUDING LAND I dd0
ENERGY
CODE ❑ PRESCRIPTIVE ❑ TOTALUA ED PERFORMANCE
TOTAL
SQUARE f
FOOTAGEI
;
BASEMENT IST 2ND ,
I ;FLOOR .FLOOR ! PORCHES !� i GARAGES 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 It relates to the use of Advanced Structural
Components (lightweight ]-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
appiloehon; 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 El 19'
Does this project Include any Advanced Structural Componanis7 "
❑ Yes (Bannon Below Requlred) Or -,No
Type of Advanced Structural Component (Select all that apply) 1 Looatlon(s) In Structure
❑ Llghtwelghl I -Joists
❑ Lightweight Roof Trusses
Class 1 structwe permits are subject to the Select Indiana General Administrative Rules (GAR 675 IAC 12) regarding expiration Oma 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 at seal, 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 s Certificate of Occupancy or of Substantial Completion has been issued by the Department of Community Services, Corrmal, Indiana.
Signature of Owner or Authorized Agent tf j�� Data yl /
CKW LAND SURVEYING, INC.
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119 SOUTH MAIN STREET
MANKLIN, INDIANA 44131
OFFICE U17) 796-0781
FAX (317) 736.0791
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PRIPAREO FOR;
PLOT PLAN THE SXkRT GROUP
4302 HEATHERWOOO BOULEVARD
GREENWOOD, IN 46143
$4AL11 P- IQ 10RAWN {Yt AJW PIF PE ��„ PUN 7O9 NUA4t[R
OATC:IANUARY 16, 2001 INECT I OKI 010017
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