HomeMy WebLinkAbout19080038 Application,�...` OFFICE usE ONLY
CITY OF CARMEL PERMIT# �
RESIDENTIAL PERMIT APPLICATION
M
xmaxp Please complete form and email to Pormits(dcarmel.in.Qov as an attachment.
If you have any questions, please call Building $ Code Services at (317) 571.2444.
BUILDER RECORD OF
NAME
Inc
PHONELandscaping
PHONE317-896-9180
ADDR SS17377 Little Eagle Creek Ave =
°I -f
STATE IN
"P46074
E-MAIL
ADDRESSOffICe@kdlafldSCapinglflC.COf11
BEST METHOD
OF CONTACT R PHONE ❑ E-MAIL
PLUMBING
NAME
STATE OF INDIANA
CONTRACTOR
LICENSE NUMBER
UTILITIES
NAME
SEWER
I WATER
EXCAVATOR
I
UTILITY
UTILITY
PROPERTY
DINNER
NAME
Ryan & Carrie Hulzebos
PHONE
1 859-559-9350 �(Qrs33
ET
ADDR 14470 Smickle Lane
CITY
STATE STATE IN
LP
PROJECT.
LOCATION `
PARCEL
NUMBER 1-7--1 q-- 13, Wo
LOTNUMBER SUBDIVISION n FLNED� )< g
'
STREET 14470 Smickle Lane
ADDRESS
CITY
STATE STATE IN
ZIP
%74 -
DOES SUBDIVISION HAVE A ([
HOMEOWNERS ASSOCIATION? El YES (LETTER OF H.O.A. APPROVAL REQUIRED) ❑ NO 4033
TYPE OF '
STRUCTURE I
EACH UNIT WILL REQUIRE
R SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOME SEPARATE APPLICATION
PROJECT `
DETAILS
❑ NEW STRUCTURE ❑ REMODEL ❑ ACCESSORY BUILDING
ADDITION ❑ Room ❑ Porch R Deck ❑ GARAGE ❑ Attached ❑ Detached
FOUNDATION
TYPE El ElWalkout ElSLAB ❑ CRAWL ElPOSTIBEAM ElPOSTIPIER
-.
COST OF
CONSTRUCTION $I /l i`lo
ENERGY
CODE ❑ PRESCRIPTIVE ❑ TOTAL UA ❑ PERFORMANCE
-.
EXCLUDING LAND IJI,J
^/
FOOTOTAL
TAGE i��`
QQ
BASEMENT ;FLOOR FLOOR i J22 I PORCHES j 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 (Ilghtwelghl I-Jolsts 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 noncombustlble materials, or both
'This does not Include a structural assembly, Jolst ortmss that provides at least 1 hour of fire resistance under ASTM El 19*
Does this project Include any Advanced Structural Components? ❑ Yes (Sec(lon Below Required) ❑ No
Type of Advanced Structural Component (Select all that apply) Location(s) In Structure
❑ Lightweight [-Joists
................ ............... —..-___..—..
❑ Lightweight Roof Trusses
-.- Class I structure permits aro subject to the State of Indiana General Adminh
completing construction. _.
1, the undersigned, agree that any constriction, reconstruction, enlargem in
structures requested by this application will comply with and conform to all
`P1M euye,r,.f. v,wauwunua,.wq,p,vuun
Signature of Owner or Authorized Agent C
3AR 675 IAC 12) regarding expiration time, frames for beginning and
alteration of s atruchure, or any change in the use of land or
s of the State of Indiana and the Carmel Unified Development
VUR4+194 °08/05/2019 I