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OFFICE 11SE ONLY
CITY �F CARMEL PERMIT#
COMMERClAL ! INSTITUTIONAL ! MULTf-FAMILY
PERMIT APPLICATION
Please complete form and email to nermitsa(2carmel.in.aov as an attachment.
fi you have any quest�ans, pleaae cal! Building 8 Code 5ervices at (317j 579-2444.
PROJECT N�� DR IJESCRIPTfON
RETAILS �F PROJECT
❑ NEW STRiJCTURE ❑ TENANT FINISH �REAhODEL ❑ ACCE5SORY BUILDING ❑ CELL TOWER
❑ ADDiTIQN ❑ Room ❑ Porch ❑ Deck ❑ GAitAGE ❑ ABached ❑ Detached
COST OF CONSTRUCTION &QUARE
(EXCLU�ING LAND) .� �` FOOTAGE ��.�f�t
v
STATE OF PROJECT RELEASE CONSTRVCTION DCCUPANGY
INDIANA GDR NUMBER �' DATE TYPE �� _ CLASSIFiGATION �
SGOPE OF � FDN ❑ STR � ARCH ELEC ❑ MECH
RELEASE
PLUM ❑ 5PKLR ❑ HOOD ❑ DTFIER
ADVANCED STRUCTiJRAL COMPONENTS REPORTiNG
This section is required in order to comply with the reqUiremenis of IC 22-� 1-21 (Public Law 144. 2018) as it relates to lhe use of Advanced Structuraf
Components [ligh4weight I joists or lightweighi roof trusses} in Class I and Class !I Gonstruction thai:
1. Have less mass cross-sectional area lhan sativn lumber of equi�alent proportions used in an equi�afent app[ication; and
2. Are assembled from combustible or noncombustible materials, or bo3h
'This does not include a structural assembly. joisi or truss 4hat provides at least 1 hour oi fire resistance under ASTM E119'
Does this projed indude any Advanced Structural Camponents?
Type af Advanoed Structural Component (Seiecf all lhat apply)
❑ Lighlweight I�lofsts
❑ Lightweight Roof 7russes
❑ Yes (Seclion Se1ow Required) �No
. ,
Location�s) in Structure
Class I structure permits are subject to the State of Indiana General Administrative Rules (GAR 675 IAC 12j regarding expiration time fremes for beginning and
completing construction.
I, the undersigned, agree that any construcllon, reconstructian, enlargement, relocation, ar alteration af a struclure, ur any change in the use nf land ar
slructures req�esied by thls applita6o wi a ly with and confortn ta all apptica6le laws of the StaFe of Indiana and the Carmel Unified �e�elopment
Ordinance (Z�25-97) and amendments adopt d nder hority of I.C. 3B-7 eE seq, Genaral Assembly of #he State of indiana, and ait Acts amendatory
thereto. l further ceriiiy that on�y kitch n, bath, a d r dr�s a�ed to ihe sanitary sawer. I furthar certiiy that the tonsVuct3on will not ba
used or octupied until a Cerkificate of ccupa of Subs ial Com lon has been issued by the Depar[ment of Community Services, Carmel, Indiarta.
Signature of Owner or Authorized
Date�i� '�,�/ ' (�v
TYPE OF
STRU�TURE � COMMERCIAL ❑ INSTITUTIQNAL ❑ iVIULTI-FAMILY NUNEBER OF UNffS: