HomeMy WebLinkAbout19090211 ApplicationOFFICE USE ONLY
�'�TsFf CITY OF CA RM E L PERMIT #
RESIDENTIAL PERMIT APPLICATION
Please complete form and email to permits(&carmel .in.gov as an attachment_
If you have any questions, please call Building & Code Services at (317) 571-2444.
BUILDER OF
RECORD
NAM PHONE
f E f �� 1 �,c%�V,4 [ t o N 3 J?- 3 7-/- G�
srREET 12 ' fie'%STATE
ADDRESS %�
crnr j2/�Ll
14�32-
E-MAIL
BEST METHOD
ADDRESS r (�(F�-� ft
!
TACT PRONE ElE-MAIL
PLUMBING
NAME
STATE OF INDIANA
CONTRACTOR
jWt h 11— 746- �
_
LICENSE NUMBER ` �_5
UTILITIES
NAME
SEWER
WATER
EXCAVATOR
UTILITY
UTILITY
PROPERTY
OWNER
NAME
C�915 C Amwlu
PHONE �7 r
7 C {
STREET CITY
ADDRESS 136 „�1��Tcs� �'c e4lk�l��-
STATE
%IV
ZIP
�`�]3Z
PROJECT
PARCEL
LOCATION
NUMBER
LOT
NUMBER 7/
SUBDIVISION
FLOOD
STREET
ADDRESS / 9 (
CITY _
STATE
q63
DOES SUBDIVISION HAVE A �r
HOMEOWNERS ASSOCIATION? I+ 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
r
ADDITION 1KRoom ❑ Porch ❑ Deck ❑ GARAGE ❑ Attached ❑ Detached
FOUNDATION TYPE El Elwajkout El SLAB CRAWL ❑ POSTIBEAM ❑ POSTMIER
COST OF
CONSTRUCTION j
$
ENERGY
CODE ❑ PRESCRIPTIVE ❑ TOTAL UA ❑ PERFORMANCE
(EXCLUDING LAND i2
TOTAL
SQUFOOTAAGE 7 h G.,
FLOOR L BASEMENT 1ST �6 FLOOR N6 : PORCHES GARAGES
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 1-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 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 Ell 19*
Does this project include any Advanced Structural Components? ❑ Yes (Section Below Required) X� No
Type of Advanced Structural Component (Select all that apply) Location(s) in Structure
❑ Lightweight t-.!Diets
❑ Lightweight Roof Trusses
Class I structure permits are subject to the Stag 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 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 saq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains arc connected to Issusewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupant a epartrnent of Community Services, Carmel, Indiana.