HomeMy WebLinkAboutCarmel Revison-Amendment Form°��y°`�cA�9��r�, CITY OF CARMEL
RESIDENTIAL REVISION / AMENDMENT TO EXISTING PERMIT
�xpiq�ta Please compfete form and email to permitsla�carmel in aov.
If you have any questions, please call Building & Code Services at (317) 571-2444.
PERMIT HAS BEEN ISSUED: Q"ves ❑ No IF YES, PERMIT #:
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BUILDER OF
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STATE OF INDIANA
LICENSE NUMBER
This section is required in order to comply with the requirements of �C 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-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 no; include a structural assembly, joist or truss that provides at least ? hour of fire resistance under ASTM E119`
Does this project include any Advanced Structural Components?
Type of Advanced Structural Component (Select all that apply)
_ _ _ __
_ ...
❑ Lightweight I-Joists
_ ..__...........
❑ Lightweight Roof Trusses
❑ Yes (Section Below Required) �( Na
Location(s) in Structure
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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
compieting construction.
I, the undersigned, agree that any construction, reconstruction, eniargement, relocation, or alteretion of a structure, or any change in the use of tand or
structures requested by this application will comply with and conform to all appficable laws of the State of Indiana and the Carmel Unified Development
Ordinance (Z-625.17) and amendments, adopted under authority of I.C. 38-7 et seq, Generel Assembly of the State of Indiana, and all Acts amendatory
thereto. I 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 besn issued by the Department of Community Services, Carmel, Indiana.
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Signature of Owner or Authorized Agent '"' / %' � ,� /
Date_ �/ `��!
I ADVANCED STRUCTURAL COMPONENTS REPORTING