HomeMy WebLinkAbout19090084 ApplicationOFFICE USE ONLY
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CITY OF CARMEL PERMIT#
COMMERCIAL 1 INSTITUTIONAL 1 MULTI -FAMILY
PERMIT APPLICATION
Please complete form and email to parmits0carmel.in.goy as an attachment.
If you have any questions, please Call Building & Code Services at (317) 571-2444.
BUILDER OF
RECORD
NAME /I
1`or 6,, I
s
PHONE
317- al-SS2_7
ADDRE
?�9 &,r.14
At& &
CITY
,
STATE
-:I;.
ZIP
�GtSL
E-MAIL
ADDRESS Ahl
e 4,
LL
kc-40►► f f,
BEST METHOD OF
CONTACT ❑ PHONE �� E-MAIL
PLUMBING
NAME
STATE OF INDIANA
LICENSE NUMBER
PROPERTY
NAME
LGn .� Wrir(i
PHONE
.�! 7- 757- �7r
OWNER
ADDRESS CITY
STATE
IMP
PROJECT
PARCEL
NUMBER 17- /3'07- QD -of - 0/1 ooD
LOCATION
ADDRESS JINCLUOIrNG 1 S�11■
SUITE NUMBER) 10LIAIO IV rCA; s r ta7-
CITY
�+f•+ltr.�•
STATE
a
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zip
LPtr
IGe' 2-
TYPE OF
STRUCTURE
COMMERCL ❑ INSTITtiTkONAL ❑ ERUCT! -FAMILY NUMBER OF UNITS:
� IA
PROJECT
NAME OR DESCRIPTION
OF PROJECT Killafirg A414E
DETAILS
❑ NEW STRUCTURE TENANT FINISH ❑ REMODEL ❑ ACCESSORY BUILDING ❑ CELL TOWER
❑ ADDITION ❑ Room ❑ Porch ❑ Deck ❑ GARAGE ❑ Attached ❑ Detached
COST (EXCLUDING $ . j U 0,00.10.
SQUARE
FOOTAGEPRCMEC
STATE OF
NUMBER D' f ��
DATE a�jia ! i
CONE TRUCTION
!!'�
CY
CLASSIOCCUPFICATION j i' ►s
INDIANA CDR
SCOPE OF
El ❑ STR ARCH ELEC 21 MECH
RELEASE
I�
SCE PLUM ❑ SPKLR E]' HOOD ❑ OTHER
ADVANCED STRUCTURAL COMPONENTS REPORTING
This section is requlred 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,
1. Have less mass cross-sectlonal 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 E119*
Does this project include any Advanced Structural Components? ❑ Yes {Section Below Required} NO
Type of Advanced Structural Component (Select all that apply)
LocatioNsj In Structure
_...._ .................. -- -----..._.........._....................._....
❑ Lightweight I -Joists
_....�.—......_....._...... .. _
❑ Lightweight Roof Trusses
Class I structure permits are subject to the State of Indiana General Administrative Rules (GAR 675 LAC 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 Ind lane and the Carmel Unified Development
Ordlnancs ¢-625-17j and amendments, adopted undo 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 art connected to the sanitary sewer. I further certify that the construction wlll not be
used or occupied untlI a Certificate of Occupancy or of Substantial Completion has been Issued by the Department of Community Servloes, Carmel. Indiana.
Signature of Owner or Authorized Agent ' Dater3](