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RECORD
PLUMBING
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UTI LITIES
EXCAVATOR
PROP�}�TY
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C I TY 4 F CA R M E L QFFICE 11SE ONLY
RESlDENTIAL PERMfT APPLICATION PERMIT #
Please complete form and ernail to ermits@carmel.in. ov as an attachment.
lf ypu have any questjons, please call Buiiding & Code Ser�ices at (3�7) 571-2444.
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BES7 METHOD OF
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STATE 4F INDIANA
LICENSE NUMBEFt A 4/j�
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PRDJECT PAace�
LOCATiON Nl1MBER � '� -dq - � � _ C�C� .- i �- [�C� , UL�C�
LpT SUBDIVISION FLQOD
NUMBER 3�t� ��� \ 1� /'_���� ZONE ��
1 C\� L_
STREEi CITY
ADDRESS `!..` � � �
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AOES SUBDIVISION HAVE A HOMEOWNEFtS {IF YES, LETTER OF kl.O.A.
ASSOCIATION? � YES APpROVAL FtEQUIREDj
WAS SUBDIVISION OR LOT GRANTED A VARIANGE? •+�F'YES (�F YES, LETTER OF GRANT(5}
•�a REQUIRED}
WILL ANY EQUfPMENT THE SIZE OF A BDBCqT OR
LARGER B� USE�? ❑ YES
�fl�C3 �y
❑ NO
�NO )
�, NO
TY�E OF
�. SINGLE FAMILY ❑ TWO FAMlLY ❑ TOWNHOME EACH 11NIT WILL REQUIRE
__ SEPARATE APPLICATION
PROJEC7 ❑ NEW STRUCTURE ❑ REMODEL ❑ ACCESSORY STRUCTURE
DETAILS ❑ DEMOLITION
❑ AQDITION ❑ Room ❑ Porch � Deck ❑ GARAGE ❑ Attached ,�. Defached
FOUNDATION
-fypE ❑ BASEMENT [] Walkout � SLAB � CRAWL � POSTIBEAM � POSTIPIER
CpNS RUCTIpN Q•� f�/�/'',/1 ENERGY CqDE � pRESCRIP7IVE � TOTAL UA � PERFORMANCE
{EXCLiJDfNG LANa} w f���1vv�� ELECTRICAL
GO�E ❑ 2�20 INDIANA RESIdENTiAi. COdE � 2009 INpIANA ELECTRICAL CppE
TOTAL
SQUARE �C� / � BASEMENT ,` ' �ST ' 2N� PORCNES :'7 �� , GARAGES :
Fpp7AGE t•� FLpOR FLOOR T-a
ADVANCED �TRUCTURAL COMPONENTS REPORTING
This section is required in order to comply wfth �he rcgu:rements of IC 22-� 3-21 [Public Law 104, 2018} as il relaies lo [he use o( Ad�anced S#ruc[ural
Cpmponents (lightweighi I joisis or lightweigh# toof frusses) in Class I and Glass II Cons�ructiRn that:
1. Have less mass cross�sectional area than sawn lumber of equivaleni proportions used in an equivaEenf application; ancl
2. Are assern6Eed From combustible or noncombustible ma[erials, or bpth
'Thfs does not include a s[ructural assembly, joist or truss thal provides at least 1 hour of fire resistance under ASTM E119'
Does this project indude any Advanced Struct�ral Components? ,�
❑ Yes ;'�e,:.r-�;r •�elow RequiredJ .� No
Type of Ad�anced Struclural Component (Select ail that apply) ' Locat9on(s) in Sfructure
_ _ ......
__ ... __,., _ , _ _,.,........
_ ,..,.... � _..,. . . _ _
ightweigh[ I-Jois�s - ------ --
_ ..... _ _
__ _ _
ightweight Rnof Trusses -
Glass t structur�e permits are subject to the State pf Indiana General Administrative Rules [GpR R'S IAC 12] regarding expiration tfine frames for 6eginning and completing consiruction.
t, the undersigned, agree that any construction, recpnstruction, eniargement, relocation, or alteration of a structure, or any change in the use of €and or structures requested py this application
wilE comply with and cnn€orm to alf applica6le laws of the Stake oF Indiana and the Carmel Unified Revelopment Qrdinance {Z-625-17} and amendmenks, adopted under authority of I.C. 36-7 et seq,
Generel Assembly of [he State of Ind{ana, and all Acts amendaSory thereto, I further certity that only kitchen, 6ath, and Flopr drains are connected to the sanitary�sewer. I further certiiy that ihe
constructlon will not be used or occ�pied until a Certificate of Occupancy or of Substantial Completfon has been issued hy the Oepartmeni of Community Services, Carmel, Indiana.
5ignature of Owner or Authorized Agent