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ELECTRONICALLY FILE YOUR PROJECT WITH STATE OF INDIANA at http:itwww,in.govldhs<firefbrancheslplan_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, 21107 the exhairg e-file site e fl Z e24 - 7Bdhs . in. gcsv will no foncJer be in service,
-Fr"CONSTRUCTION DESIGN RELEASE
State Form 41191 (129158)
!y Report Printed on: September 4, 2007
Indiana Department of Homeland Security INDIANA 02
DIVISION OF FIRE & BUILD NG SAFETY S 0000
PLAN REVIEW DIVISION 402 W. Washington St, Room E245
Indianapolis, IN 46204 H1MIER SAFETY
AvaINVI At Yore- Local Licks Branch
To. Ownerf Architect 1 rangineer SUPPORT HOMER SAFETY
David Powers Architect P C
David E Powers AR000304062
5816 Carrollton Ave
Indianapolis IN 46220
&e-mail: 3172554068, powers arch planaa of. corn
I-B, SPK I B. REM -
Scope of release
ARCH ELEC MECH
Type of release
Standard
Project name
Rehab Imaging MedCheck 1MACL
Street address
11911 N Meridian
CARMEL
HAMILTON
the Fire Prevention and Building Safety Commission. The project is releasers for construction subject to, but not necessarily limited to. the 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 State rules- Any changes in the released plans andlor specifications must be filed with
and released by this Office before arty work is altered. This release may be suspended or revoked if if is determined to be issued in error, in violation
of any rules of the Commission or if it is based on incorrect or insufficient informatiion- 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 date.
Nola :(A1A & Al B): In accordance with the affidavit swom under penalties of peduryin the application for oonstruction 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 pedury, 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 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.
4GO603AF Plans and specifications for the revised fife 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. #13)
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 with the
Fire Prevention and Building Safety Commission identifying 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 dosed 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 Faw 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
Address (narme,titse of local official,street,city,state and ZJP code
DEPT OF COMMUNITY SERVICE
JIM BLANCHARD
ONE CHIC SQUARE
CARME L, IN 46032
Fax& e-mail: 3175712499, jb?nchard@carrnel.in.gov
I Code Enforcement 8 Plan Review Branch Director
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