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ELEClRONlCALL Y FILE YOUR PROJECT WITH STATE OF INDIANA AT
efile24-7@dhs.state.ln.us, Or VISIT OUR WEB SITE ATwww.in.goYfdhslosbc
Project number
E-FiI ed, No hard
320416 copy wi II be mailed 08/28/06
Construction type Occupancy classification i
II-B B
Rei ease date
CONSTRUCTION DESIGN RELEASE
State Form 41191 (R915-98)
Report Printed on August 28. 2006
Scope of release
Indiana Department of Homeland Security
DIVISION OF FIRE SAFETY I PLAN REVIEW
402 W. Washington St., Room E245
Indianapolis, IN 46204
, INDIANA 02
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,.!'!.~OOSIER SAFETY .~
Available At Your local licence Branch
SUPPORT HOOSIER SAFETY
ARCH ELEC
PLUM
T~e of release
Standard
MECH
"
To: Owner I Architect I Engineer
Studio 3 Design Inc
Timothy W Cover 910110
6406 Castleway Ct
Ste 100
Indianapolis IN 46250
ax & e-mail: 3177122916, kcoppedge@Studi03design.nel
The plans, specifications and application submitted for the above referenced project hal/e been reviewed for compliance with the applicable rules of
the Fire p.revention and Building safety. CommJssion. The project is released for construction sUbjec.tt. 0.' but not neCeSSarilY. Iimit.ed to, the c. ond. itiOn. s. I
listed below. THIS IS NOT A BUILDINGPERMIT. All reqUired local permits and licenses must be obtained prior to beginning constructIon work. All
constructlOn work must be in full compliance with all applicable State rules. Any changes in the released plans and/or specificatJons must be filed with
and released by this Office before any work is altered. This release may be suspended or revoked If It IS determined to befssued in error, In ViolatIOn
of any rules of the Commission or if it is based on incorrect or insuffiCfent information. This release shall expIre by limitation, and become null and
void, if the work authorized is not commenced within one (1) year from the Etlove date.
CON DITI ON S
Project name
Dr Bunch Orthodontist Office
Street address
5875 146th St East
City
Carmel
County
HAMILTON
Note :{A1A & A1B)' In accordance with the affidavit sworn under penalties of perjury in the application for construction design release the plans
and specifications filed in conjunction with this project shall comply with all of the applicable rules and laws of Fire Prevention and Building Safety
Commission. Providing false information constitutes an act of perjury, which is a Class D felony punishable by a prison term and a fine up to $10,000.
In accordance with Section 19 of the General Administrative Rules (675 lAC 12-6.19) a complete set of plans and specifications that conform
exactly to the design that was released by the office of the state building commissioner shall be maintained on the construction jobsite as well as a
copy of the deSIgn release.
3B
THIS PROJECT HAS BEEN REVIEWED UNDER THE 2003 INDIANA BUILDING CODE.
'Please be advised that if an administrative review of this action is desired, a -written petition for review must be filed at the above cddress Wlth the
Fire Prevention and Building Safety Commission fdentifying the matter for which a review is sought no later than eighteen (18) days from the above-.
stated date, unless the eighteenth day falls on a Saturday, a Sunday, a legal holiday under State statute, or a day in which the Department of Fire
and Building Services is closed during normal business hours. in the latter case, the filing deadline will be the first working day thereafter. If you
choose to petition, and the before-mentioned procedures are followed, your petition for review will be granted, and an administrative proceeding will
be conducted by an administrative law judge of the Fire Prevention and Building Safety Commission. If a petition for review is not filed, this Order will
be final. and you must comply with its requirements. '
Filed By Code review official Code Enforcement & Plan Review Branch Director
FRED BENNETT ..(}~d /.5~
Address (name.title of local official,street,city,state and ZIP code
DEPT OF COMMUNITY SERVICE State Fire Marshal V1?-O~
JIM BLANCHARD
ONE aVlc SQUARE
CARMEL. IN 46032
Fax & e~mail: 3175712499 iblanchard@carmel.ln,(]ov
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