HomeMy WebLinkAbout19090020 ApplicationOFFICE USE ONLY
ofF. CITY OF CARMEL PERMIT#
RESIDENTIAL PERMIT APPLICATION
Please complete form and email to vermitst&
carmellin.gp_y as an attachment.
°�hNR If you have any questions, please call Building &Code Services at (317) 571-2444.
BUILDER OF
NAME 1 (� -'
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PHONE
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RECORD
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CITY
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ZIP
E-MAIL
ADDRESS
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BEST METHOD
OF CONTACT ❑ PHONE E-MAIL
PLUMBING
NAME
STATE OF INDIANA
CONTRACTOR
LICENSE NUMBER
UTILITIES
NAME
SEWER
WATER
EXCAVATOR
UTILITY
UTILITY
PROPERTY
OWNER
NAME
C �aC'LJ S
PHONE I /
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STREET %
ADDRESS 5 1
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CITY
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STATE �/
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PROJECT
PARCEL �
NUMBER O abO DUa� � ®®o
LOCATION
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LOT
NUMBER vh
SUBDIVISION
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FLOOD
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STREET
C�ITYJ
STATE
ZIP
ADDRESS
DOES SUBDIVISION HAVE A
HOMEOWNERS ASSOCIATION? ❑ YES (LETTER OF H.O.A. APPROVAL REQUIRED) ❑ NO
PEOF
F
EACH UNIT WILL REQUIRE
❑ ❑
RUCTURE
SINGLE FAMILY TWO FAMILY TOWNHOME SEPARATE APPLICATION
PROJECT
❑ NEW STRUCTURE ❑ REMODEL ❑ ACCESSORY BUILDING
DETAILS
❑ ADDITION ❑ Room ❑ Porch Deck ❑ GARAGE ❑ Attached ❑ Detached
FOUNDATION ❑ BASEMENT ❑ Walkout ❑ SLAB ❑ CRAWL ❑ POST/BEAM ❑ POST/PIER
TYPE
COST OF \
CONSTRUCTION $ 5 oOb
ENERGY
CODE ❑ PRESCRIPTIVE ❑ TOTALUA ❑ PERFORMANCE
EXCLUDING LAND I
TOTAL j�
SQUARE =�+tl� o
BASEMENT FLOOR FLOOR PORCHES GARAGES
FOOTAGE- llvv
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 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 kJoists
---—........ --- ...... _ — -
❑ 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.
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 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 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 I q r I I