HomeMy WebLinkAbout19090162 ApplicationOFFICE USE ONLY
�Aj� n'�� CITY OF CARMEL PERMIT#
- COMMERCIAL / INSTITUTIONAL / MULTI -FAMILY
PERMIT APPLICATION
�NDIAN� Please complete form and email to permitsCa�carmel.in.aov as an attachment.
ff you have any questions, please call Building & Code Services at (317) 571-2444.
BUILDER OF
NAME
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PHONE
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RECORD
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ADDRESS S71� !/IGLTJ Ciil GG7�`
BEST ME/THHOD OF
CONTACT ❑ PHONE I E-MAIL
PLUMBING
LRACTOR
NAME
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STATE OF INDIANA
LICENSE NUMBER
TY
NAME ',� lL
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PHONEI/�8O
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ADDRESS
CITY
STATE
ZIP
PROJECT
PARCEL
LOCATION
NUMBER
ADDRESS (INCLUDING
SUITE NUMBER) �b.��� f L L J NL�I S j
CITY
itJ �l�LS
STATE
IA-1
ZIP
TYPE OF
ElINSTITUTIONAL ❑ MULTI NUMBEROFUNITS:
1/0
STRUCTURE
COMMERCIAL -FAMILY
PROJECT
NAME OR DESCRIPTION _
OF PROJECT e'e cI ��E�'C �l-j��s �/� %i�a�/1!C%�Z Z_
DETAILS
❑ NEW STRUCTURE ❑ TENANT FINISH REMODEL ❑ ACCESSORY BUILDING ❑ CELL TOWER
❑ ADDITION ❑ Room ❑ Porch ❑ Deck ❑ GARAGE ❑ Attached ❑ Detached
COST OF CONSTRUCTION
(EXCLUDING LAND) $ gL'
SQUARE
FOOTAGE
STATE OF
PROJECT
NUMBER �Olfg S 3
RELEASE
DATE Zy
CONSTRUCTION
TYPE /l ,4 ,
OCCUPANCY
CLASSIFICATION
INDIANA CDR
SCOPE OF RELEASE El ❑ STIRARCH ELEC Je51 MECH
0 PLUM ❑ SPKLR ❑ HOOD ❑ OTHER
ADVANCED STRUCTURAL COMPONENTS REPORTING
is 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 i joists or lightweight roof trusses) in Class I and Class II Construction that:
ave less mass cross -sectional area than sawn lumber of equivalent proportions used in an equivalent application; and
re 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'
Fthis
nclude any Advanced Structural Components? ❑ Yes (Section Below Required) No
d Structural Component (Select all that apply) Locations) in Structure
eight I -Joists
eight Roof Trusses
Class 1 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 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 Occupancyycof Substant)'alAompletVirt has been issued by the Department of Community Services, Carmel, Indiana.
Signature of Owner or Authorized Agent
Date