HomeMy WebLinkAbout19090109 ApplicationOFFICE USE ONLY
CITY OF LIAR G L PERMIT #
RESIDENTIAL PERMIT APPLICATION
�lVETIi►Kp Please complete form and email to permitsl(aokarmel.in.clov as an attachment.
If you have any questions, please call Building & Code Services at (317) 571-2444.
BUILDER OF
NAME
5a��k Cv�Strvcd,�
S�rvlces, Inc.
PHONE
'317-- 8K14- Olt 676
RECORD
STREET
ADDRESS L�7 rtCSCy S*-P"t
-`t1Q7Lf
CITYw
f"65t-eld
STATE ZIP
Z
E-MAIL
ADDRESS'jam & 50 beZ4k-Cons f-r rct- o11-to
BEST METHOD
OF CONTACT
;�r PHONE ❑ E-MAIL
PLUMBING
CONTRACTOR
NAME
°wpm cnna S D�t S lV+'n61
STATE OF INDIANA
LICENSE NUMBER
f O b ^V t� f 1
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UTILITIES
EXCAVATOR
NAME
0*_V&44't E�rcwru i-�'o
SEWER
UTILITY Tr,,C,0
WATER
UTILITY
PROPERTY
OWNER
NAME
Ari4o^ ok^dt, wryJhAvr
PHONE
'1jl7— (,Z7-- 7Z° Z
STREET �^ L
ADDRESS 110 Z Q f l NLBGir 1-n
CITY
cf rvv f t1
STATE
114 1
ZIP
412032
PROJECT
PARCEL
i r71 ^ Db — 0'1— Q 1 -- t? 0 `� O ba
LOCATION
NUMBER .
LOT
NUMBER �!!
UBDIVISION �^'
T-Jr-or-dourlwood] �j�G� 7
FLOOD
ZONE 1 `�f
IA
STREETTY
ADDRESS l I0Z) r1 MbQ_t a n
CI G,tone,I
STATE
Zq �D Z
DOES SUBDIVISION HAVE A
❑ YES OF H.O.A. APPROVAL REQUIRED) NO
HOMEOWNERS ASSOCIATION? (LETTER
TYPE OF
EACH UNIT WILL REQUIRE
FAMILY ❑ TWO FAMILY ❑ TOWNHOME
STRUCTURE
SINGLE SEPARATE APPLICATION
PROJECT
NEW STRUCTURE ❑ REMODEL ❑ ACCESSORY BUILDING
DETAILS
❑ ADDITION ❑ Room ❑ Porch ❑ Deck ❑ GARAGE ❑ Attached ❑ Detached
FOUNDATION TYPE 3< BASEMENT 7-1WalkoutElSLAB ElCRAWL ❑ POST/BEAM ❑ POST/PIER
COST OF
CONSTRUCTION �QD
JENERGY
CODE ❑ PRESCRIPTIVE ❑ TOTAL UA PERFORMANCE
X
Q O
EXCLUDING LAND) VV C�
TOTAL
SQUARE , 5 1
ISTf +
BASEMENT Z 8 FLOOR t�$ FLOOR 'PORCHES 3 { GARAGES
t
FOOTAGE
ADVANCED STRUCTURAL COMPONENTS REPORTING
his 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
Fl.
Components (lightweight 1-joists or lightweight roof trusses) in Class I and Class Il Construction that:
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 1 hour of fire resistance under ASTM El19"
Does this project include any Advanced Structural Components? Yes (Section Below Required) ❑ No
Type of Advanced Structural Component (Select all that apply) Location(s) in Structure
_.._.................. ---- ------- -------
Lightweight I-Joists!(j0 s`f i GiIY�
❑ Lightweight Roof Trusses
Class 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.
1, 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 et 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 or Authorized Agent
Date l ` / -� /11