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Home My WebLink Aboutconst design release.pdfAPPLICATION FOR CONSTRUCTION DESIGN RELEASE STANDARD / PARTIAL FOUNDATION REQUEST State Form 37318 (R13 / 8-99) Approved by State Board Of Accounts 1999 Return to: INDIANA DEPARTMENT OF FIRE AND BUILDING SERVICES PLAN REVIEW DIVISION OFFICE OF THE STATE BUILDING COMMISSIONER INDIANA GOVERNMENT CENTER SOUTH 402 W WASHINGTON ST RM E245 INDIANAPOLIS IN 46204-2739 www.state.in.us/sema PLEASE PRINT CLEARLY PROJECT LOCATION (Must Be Complete and Accurate) Name of Project ORCHARD SOFTWARE Closest intersecting street or road City Center Drive Address (site location, number and street) 701 CONGRESSIONAL BLVD SUITE 270 Suite or Floor First Floor Direction FROM intersection TO project North X South East West City CARMEL County HAMILTON Is project within city limits? X Yes No OWNER’S CERTIFICATE (Must Be Executed) As owner of the project for which this application is being filed, I hereby certify: 1. The description of use and information contained on this application are correct: 2. The project will be constructed in accordance with the released documents and applicable rules of the Fire Prevention and Building Safety Commission: 3. Any changes to the released documents will be filed with the Office of the State Building Commissioner. Authorized signature Name of owner or business Name (typed or printed) Address (number and street) Title City, State, Zip Code Telephone Number: Fax Number: E-Mail: Facility use: OFFICE I agree to take full responsibility for removing and replacing any construction found by plan examination or by inspection, to be in violation of the Foundation Requested building codes. I further agree not to proceed with above grade construction until the complete building plans and specifications have been reviewed and released by the Indiana Department of Fire and Building Services. DESIGN PROFESSIONAL CERTIFICATE (Must Be Executed for all new buildings or additions exceeding 30,000 Gross Cubic feet or any alteration affecting Structural Safety) As the design professional for the project for which this application and plans are being filed, I hereby certify: 1. I am qualified and competent to design such buildings, structures, and systems; 2. the plans filed in conjunction with this application were created by me and / or by persons under my immediate personal supervision and will comply with all applicable building laws and rules of the Commission; 3. the project data contained on this application is correct and corresponds with the plans that are being filed in conjunction with this application: 4. the design professional identified below or a designee will inspect the construction covered by this application at appropriate intervals to determine general compliance with the released documents and applicable rules of the Commission and will cause all noted deviations from released documents and code violations to be corrected or notify ` the owner and authorities having jurisdiction of all specific deviations and code violations: and 5. I affirm under penalty of perjury that the representations contained herein are true and I further understand that providing false information constitutes an act of perjury, which is a Class D felony punishable by a prison term and a fine of up to $10,000. PROJECT DATA (to be completed by submitter) Please answer all pertinent questions FOR OFFICE USE ONLY SBC project number Filing date DOCUMENTS REQUIRED FOR FILING 1. One Application for Construction Design Release, together with correct filing fees. (See Fee Schedule) 2. One complete filing ( paper, disk, or e-mail ). This filing will not be returned to the applicant. A set of drawings identical to those released by the Office of the State Building Commissioner shall be maintained on the project site. Weight limit of each submitted package is 30 pounds. A. Site plan showing dimensioned location of building to all property lines and to all existing buildings on the property, as well as width of any streets , access roadways or easements bordering the property. B. Foundation and basement plans and details. C. Dimensioned floor plans for all floors. D. Fire and life safety plan showing graphically or by legend the location and rating of building elements such as area separation walls, smoke barriers, fire-resistive corridor walls, stair enclosures, shaft enclosures and horizontal exists. E. Wall elevations of all exterior walls including adjacent ground elevation. F. Sections and details of walls, floors and roof, showing dimensions, materials. G. Structural plans and elevations showing size and location of all members, truss designs showing all connection details, and stress calculations. H. Room finish schedule showing finishes for walls, ceilings and floors in all rooms, stairways, hallways and corridors. I. Door schedule showing material, size, thickness and fire-resistive rating for all doors. J. Electrical plans, diagrams, details and grounding of service entrance and power or lighting information required for energy conservation. K. Plumbing plans showing location of fixtures, risers, drains, and piping isometrics. L. Mechanical plans showing location and size of ductwork, equipment, fire dampers, smoke dampers and equipment schedules showing capacity. M. Fire protection plans showing type of system, location of sprinkler heads, standpipes, hose connections, fire pumps, riser and hanger details. PROJECT DESCRIPTION (Must Be Complete) FLOOR AREAS ESTIMATED COSTS Scope of work: New building Addition X Remodeling Total existing (if applicable) 11,446 Sq. ft. Is this construction the result of fire or Natural disaster? Yes X No Sewer : X Existing Proposed Public Private None Addition (if applicable) --- Sq. ft. Addition (if applicable) $ Fire suppression system in building X Full Partial None Detailed suppression system plans/specs Provided To follow Remodeled (if applicable) 11,446 Sq. ft. Remodeling (if applicable) $ If partial, specify where* Located in flood plain (check county plan commission) Yes X No Total building area square feet Total project cost $ Building construction type and occupancy classification II B Building height (stories)* 1 Number of buildings this submittal (Describe if necessary)* Volume cubic feet (Fee category E only) Indiana rehabilitation standard (Rule 8) used? Evaluation documents provided? Yes No Yes No Use of conversion rule (Rule 13) proposed? Yes No Does project include: (Check if yes) Elevator or lift Combustible fibers storage Fireworks storage Explosives storage High-piled storage Boiler or pressure vessel Hazardous or flammable materials storage Describe proposed use of facility IN DETAIL including types of flammable or combustible materials stored or handled * OFFICE Describe IN DETAIL previous or current use of facility (if existing facility)* OFFICE Number of persons employed (max/shift) General comments* Number of persons (public) GENERAL INFORMATION Has work at this location ever been filed? Yes No X Unknown Does project include use of a master plan design release or a factory built modular or mobile structure? Yes X No What year and month? Previous SBC Project Number Name of Manufacturer Master Plan / Modular Number Has construction started? Yes X No If yes, has notice of violation or investigation been issued? Yes No If no, probable construction starting date? Upon project release HEALTH CARE FACILITIES Type of facility (as licensed by Indiana Department of Health) π Residential Custodial Care π Nursing Home π Outpatient Surgery π Hospital If Nursing Home π Intermediate Care π Skilled Care Admitting and discharge policy provided? π Yes π No Plans show critical heating area? π Yes π No Emergency power π Generator π Battery π None Service π Other (specify) Responsibility is for the following systems: Site Foundation Structural X Architectural X Mechanical X Plumbing X Electrical Fire Suppression All Above Other (specify) _____________________________ Signature Name of firm (if applicable) Name (typed or printed) Kevin H. Boyle Address (number and street) 7805 Pineview Court Indiana Registration Number: X Architect AR 10700017 Engineer City, State, Zip Code Indianapolis, IN 46250 Telephone Number: 317-578-3091 E-Mail: ronc@d2pindy.com Fax Number: 317-572-1213 Designated Inspecting Design Professional: Kevin H. Boyle Indiana Registration Number: AR 10700017 Telephone Number: 317-578-3091 STANDARD FILING FEE PROCESSING PARTIAL FOUNDATION INSPECTION LATE FILING TOTAL $75.00 $75.00 $150.00 IF MULTIPLE DESIGN PROFESSIONALS ARE INVOLVED IN THE CERTIFICATION PROCESS, SUBMIT AN ADDITIONAL PAGE 1 WITH THE APPROPRIATE INFORMATION. Page 1