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ELECTRONICALLY FILE YOUR PROJECT WITH STATE OF INDIANA at http:ltw .in.govldhsifirelbranchesfplan_reviewlindex.html.
This on-line filing is through a secure site, you can use it to submit your project information, pay the fees and upload your project plans.
As of July 1, 2007 the existing a-file site efi 1e24- 7%dhs. in, gov will no longer be in service.
Project number Release date
CONSTRUCTION DESIGN RELEASE
'3,? __,N•,.: S State Form 41191 (R915-98) 327682 6$/62/67
w'? Iz Construction type Occupancy classification
Report Printed on: August 2. 2007 II-B, SPK, EXST B, REM
_?, _..1",•A
a re a Scope of release
Indiana Department of Homeland Security INDIANA 02 ARCH FLEC MECH
le,
DIVISION OF FIRE & BUILDING SAFETY C 0000 PLUM
PLAN REVIEW DIVISION J Type of release
402 W. Washington St., Room E245 Standard
Indianapolis, IN 46204 ,00siER saFErf
Available At Your Local Licence Branch Project name
To: Owner I Architect I Engineer SUPPORT HOOSIER SAFETY Dr. McKown Dental Office
Architects Forum
Thomas G Jolly AR196000180 street address
301 Pennsylvania Parkway 12188 North Meridian Street
Suite 155 3rd Floor
Indianapolis IN 45280 city county
Fax & e-mail: 3178428877,ljolly@architecisforumlic.com Carmel HAMILTON
i
The olans,,specifications and application. submitted for the above referenced project have been reviewed for compliance with the applicable rules of
the Fire Prevention and Building Safety Commission. The project is released for construction subject to, but not necessarily limited to, he conditions
listed below. THIS IS NOT A BUILDING PERMIT. All required local permits and licenses must be obtained prior to beginning, construction work,. All
construction work must be in full compliance with all applicable Slate rules. Any changes in the released plans and/or specificationsmust be riled with
and released by this Office before any work is aPered.yThis release may be suspended or revoked if it is deterrnined,to be issued in. error, in violation
of any rules of the Commission or if it is based, on incorrect or insufficient 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 above dale.
CONDITIONS: ?
Note :(A1A & A76): 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 vAth all of the applicableirules 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 IAC 1211-19) 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 jcbsite as well as a
copy of the design release.
14GO603AF Plan's and.specificatlons for the revised fire suppression system shall.be filed with the required
application, fees, and complete details in accordance with 675 IAC 12-6- 3(a), 7(h)17 and 675 IAC
13=1-8. (N.F.P.A. #113)
:Please be advised that if an administrative review of this action is desired, a written petition for review must be filed at the above address wdth the
j Fire Prevention and Building Safety Commission identifying the matter for which a review is sought no laier than eighteen (18) days from the above -
lstated"date, unless the eighteenth day falls on a Saturday, a Sunday, alegal holiday under State statute, or a day in which the Department of Fire
iand Building Services is closed during normal business hours. In the latjer case; the filing deadline will he the nr<_t working day thereafter. If you
.chgose to petition, and the before-mentioned procedures are followed, your petition for review will be granted, and an administrative proceeding will
: e conducted by an administrative law judge or the Fire Prevention and Building' Safely Commission- 11 a'patition for review is not filed, this Order will
be final, and you must comply with its requirement=_.
Filed By Code review official
TONY BRADSH Code Enforement & Plan Review Branch Director
Address (name,title of local officialstreel,citystate are 21P code
DEPT OF COMMUNITY SERVICE
JIM B CHARD
Satz Fire Marshal /? ^ (I f
ONE CIVIC SQUAR=
CA.RMEL, IN 46032
Fax & e-mail: 3175712499,jblanchardroh)carmel.in.gov
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