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- Project number
CONSTRUCTION DESIGN RELEASE
State Form 41191 (R9!5-98)
Report Printed on: April 10, 2007
325066
Construction type
II-B. SPK
I Release date
I 04/10/07
Occupancy classification
M. ADD. REM
Indiana Department of Homeland Security
DIVISION OF FIRE SAFETY I PLAN REVIEW
402 W. Washington St., Room E245
Indianapolis. IN 46204
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A~iib~-Loeal Licence Branch
Scope of release
ARCH
STR
FDN
Type of release
Standard
Project name
Old Navy
To: Owner I Architect / Engineer
Simmons Architects LLC
Frederick A Simmons 3135
l305 E New York St
Indianapolis IN 46204
, ax & .-mail: 3176S63S01. ccartwright@Simmonsarchit.cts.n.t I ~:~MEL -.---.---.1 ~::~ON __.._J
The plans, specifications and application submitted for the above referenced project have been reviewed for compliance with the applicable rules of
the Fire Prevention and Building Safely Commission. The project is released for construction subject to, but not necessarily limited to, the conditions
listed below. THIS IS NOT A BUILDING PERMIT. AU required local permits and licenses must be obtained prior to beginning construction work. All
construction 'Nark must be in full compliance with all applicable State rules. Any changes in the released plans and/or specifications must be filed with
and released by this Office before anyworX is altered. This release may be,~uspended or revoked if it is determined to be issued in error, in violation
of any rules of the Commission or if it IS based or:t incorrect or insufficient information. This release shall expire by limitation, and become null and
void, jf the work authorized is not commenced.within one (1) year from the abov~'date.
CONDITIONS:
SUPPORT HOOSIER SAFETY
Street address
14250 Clay Terrace Blvd
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 Safely
Commission. Providing false information constitutes an act of peljury, which is a Class D felony punishable by a prison term and a fine up to $10.000.
In accordance with Secti.on 19.0!,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.
4G0603AA 1 This project release is for the building shell only and does not include the finish of one or more
tena'rli spaces. Tenant space finish shall be filed as a new project in accordance with 675 lAC 12-6-
6 before commencing work.
4G0603AE Detailed plans and specifications of the fire suppression system shall be filed with the required
application and appropriate fees in accordance with 675 lAC 12-6-3(a) and 675 lAC 13-1-8.
(N.F.P.A.13)
3C0502H2 For a slab-on-grade floor, the perimeter insulation shall extend downward from the top of the slab to
the bottom of the slab and then horizontally for a minimum total distance of forty-eight (48) inches in
accordance with Section 502.3.1.4, IECC (675 lAC 19-3-1).
Please be advised that if an administrative review of this action is desired. a written petitioll for review must be filed at the above address with the
Fire Prevention and Building Safely Commission identifying the matler for which a review is sought no laler lhan eighteen (18) days from the above-
slated date, unless the eighteenth day faUs 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.
Code review official
ROBIN PHILLIPS
Code Enforcement & Plan Review Branch Director
Filed By
Address (name,title of local official,street,city,state and ZIP code
DEPT OF COMMUNITY SERVICE
JIM BLANCHARD
ONE CIViC SQUARE
CARMEL. IN 46032
State Fire Marshal
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Fax & e-mail: 3175712499,jblanchard@carmeUn.gov
Page 1/1
SIMMONS
'IRCHITECTS, LLC
ARClJfn.:crs. rLVi\EK:;
AFFIDAVIT OF AUTHENTICITY
I, Frederick A, Simmons, AlA do hereby attest and affirm the following:
A. I am a Licensed Architect in the State of Indiana (Registered #3135).
B. I am the Project Architect for the Project known as Old Navv - Clay Terrace (PARTIAL
SUBMITTAL).
C. The Original Drawings dated 03/13/07 are the same drawings submitted to the Indiana
Department of Fire & Building Services for obtaining a Design Release dated 04/10/07
(SBC #325066)
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Indiana Registered Architect
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