HomeMy WebLinkAbout19080058 ApplicationS4 of � � � �� OFFICE USE ONLY
OF CARMEL PERMIT # _
COMMERCIAL 1 INSTITUTIONAL r MULTI -FAMILY
1
PERMIT APPLICATION
��ty°tAta�' Please complete farm and email to ermits oarm8t.i v as an attachment.
If you have any questions, please call Building & Code Services at (317) 571-2444.
13UILDER OF NAME PHONE
RECORD I��t �d:�
ADDRESS /� 1 �J
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ADDRESS L BEST METHOD] F
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PLUM13ING NAME STATE OF INDIANA
CONTRACTOR I I LICENSE NUMBER
PROPERTY
OWNER
NAME �+
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PH NE
3
ADDRESS Z S Al,I�� J
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Zip
PROJECT
PARCEL.
LOCATION
NUMBER 2 - oo - 00 - o/S.,
ING
SUiDTEENUMB RjNCLUD f Yf?oa A� f�f.' CITY
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STATE
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ofUCTURECOMMERGiAL
FTYE
❑ INSTITUTIONAL
❑ MULTI -FAMILY
NUMBER OF UNITS:
PROJECT
NAME OR DESCRIPTION
DETAILS
rf-
OF PROJECT S _;(V,0Gx-
❑ NEW STRUCTURE: 0 T! NANT FINISH ❑
REMODEL ❑ ACCESSORY BUILDING ❑
CELL TOWER
❑ ADDITION ❑ Room ❑ Porch ❑
Deck ❑ GARAGE
❑ Attached ❑
Detached
COST OF CONSTRUCTION
(EXCLUDING LAND))
SQUARE
FOOTAGE ' �o
STATE OF
INDIANA CDR
IPROJECT RELEASE
NUMBER �O 9 �� DATE q
CONSTRUCTION
r� -�
OCCUPANCY
CLASSIFICATION
SCOPE OF Cl ❑ STR
RELEASE
rTTYYPE
.�J ARCH j2"f ELEC r MECH
PLUM ❑ SPKLR
❑ HOOD ❑
OTHER
ADVANCED STRUCTURAL COMPONENTS REPORTING
This section is required in order to compiy with the requirements of IC 22-11-21 (Public Law 104, 2018) as it relates to tha use of Advanced structural
Components (I ghtwelght 1-joists or lightweight roof trusses) in Class I and C'ass I 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 !east 1 hour of fire resistance under ASTM E119*
DI%00 this project ind-do any Ad" mod Structural Components? ❑ Yey (5ectioir Below Required) NO
Type of Advanced Structural Component (Select all that apply) Location(s) in structure
_...._... __ _....._... _..........
❑ Lightweight I -Joists
❑ Lightweight Roof Trusses
close 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 uae of land or
structures requosted bythla application wlII comply with and conform to all appticable laws of the State of Indiana and the Carmel Unified Development
Ordinance (Z-525.17) and amendments, adopted under authority of I.C. 36.7 at seq, General Assembly of the State of Indiana, and all Acts aman datory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction wlII not lue
used or occupied untlI a Certificate of Occupancy or of Substantial Completion has been Issued by the Ds Part alent of Community Services, Carmel, Indiana.
Signature of [ Ymor of Authorized Agent Data �L/a b