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CONSTRUCTION DESIGN RELEASE
State Form 4t191 (R9/5-98)
Report Printed on: July 14~ 2005
INDIANA
Indiana Department of Homeland Security]
402 W. Washington St., Room E245 ]
Indianapolis, IN 46204 ~ E
Avaltable At Your Local Licence Bcanch
TO: Owner / Architect I Engineer SUPPORT HOOSIER SAFETY
A RCHFFECTS FORUM
THOMAS G JOLLY 00180
5252 E 82ND ST STE 201
INDIANAPOLIS IN 46250
Fax & e-mail: 3t 78428877, kre xing@architects for um IIc.com
Project number E-Filed, No hard Release date
311378 copywillbe,mailed . 07/13/05 _
Construction type Occupancy classification
It-B, SPK B, RBvl
Scope of release
ARCH B_EC ME'CH
PLUM
Type of release
Standard
Project name
COMMUNITY CAREAMBULATORY SURGERY CBNTER
Street address
12188 N ME~JDIA N ST
City County
CA RMB_ HAMILTON
Ti3e plans, specifications and application submitted for the above referenced project have been review ed for compliance w ith the applicable rules
of the Fire Pre~enti0n and Building Safety Commission. The project is released 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 beginnieg construction
work. All construction work must be in fu!! cQ~liaece ~ ~~ all Cppliq~ble 8~te [tJles, ShY changes in the released plens ~¢/or specifications must
be filed with and released by this Office ~f~ cn~ ~prk ~ altered; ~le ~lea~e ~be suspended or revok~ if ~ is 8~J~rnined to be issued in
error, in violation of any rules of the Co~n ~ if ~is b~e~ od ine~rre~t ~[ibs~f[~i~nt information. This re,ese ~h~l! ~pire by limitation, and
become null and void, if the work authorized B nO~ 8o~ce8 Within dhe(1) ~ar ~rom the above date.
CONDITIONS:
Note :(AIA & A1B of perjury in the application for construction design release the plans
and specifications filed in with this project shall corrCly w ith all of !~ applicable rules and law s of Fire Prevention and Building Safety
Comcnission. Pcovidle( ;f~ constitutes an act of perjury, whiCh is a Cass D felony punishable by a prison term and a fine up to $10,000.
In accordance with S Rules (675 IAC 12~6-19) a complete set of plans ehd specif~ations that conform
exactly to the desk by the office of the state building C0mrnisslener shell be maintained onthe construction jobsite as w ell as a
copy
3B0907A1 Cstem Shall be designed as Specified in Section 907; IFC (675 lAC 22-2.3) and
. ~;(675 lAC 2222;2~17) in accordancew th Sect on 907 BC (675 lAC 13;2.4).
;9P0703A pipes Sha!l be sized ir) accordance with Section 703.0; IPC (675 lAC 16-1.3).
Please of this action is desired, a written petition for review must be filed at the above address with the
Fire hich e review is sought no later than eighteen (18) days fromthe above
-stated d~ie, unless the eighteenth day f~ll$ 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 w ill be the first working day thereafter, if you
Choose to petition, and the before-rrentlened procedures are follow ed, your petition for review w ill be granted, and an ad~nletrative proceeding
w ill be conducted by an administrative law judge of the Fire Prevention and Building Safety commission. ~ a petition for review is not filed, this
Order w ill be final, and you must comply with its requirements.
code Enforcement & Ran Review Branch Director
Filed By Code review official
Address (name,title of bcal officlel,street,city,state and ZiP code
JEFF KENDALL
ONE CfVIO SQUARE
CAP, MB_, IN 46032
Fax & e-ma j!; ~ ! 757 ~ ~4~ jkend~]J~c Lc~E~!,in,~
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