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ELECTRONICALLY FILE YOUR PROJECT VVlTH STATE OF INDIANA AT
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Project number '
CONSTRUCTION DESIGN RELEASE 312804 Retaase data
State Form 41191 (R9/5-98) ~ :~ __ 09/12/05
,~ons,rucrlon type Occupancy classification
Report Printed on; September 13 2005
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EXST. SPA
Scope of release
~ INDIAN~I
Indiana Department of Homeland Security ~j,' ARCH ELEC MECH
DIVISIONOFFIRESAFETY/PLANREVIEW I ~F nnnn PLUM
402 W, Washington St. Room E246 ~ S UUUU Type of r' -~elease
Indianapolis, I~ 46204 ~.~e~ '~00$1E~ SA~.~,¥ Standard
Available At Yeur Lecal I. icence Branchr Project nam e
To: Owner I Architect I Engineer SUPPORT HOOSlE~ SAFETY CLAY TEP, RACE PUBLIC RESTROOMS
SIMMONS ARCHITECTS LLC
FREDERICK A SIMMONS 3135 Street address
305 EAST NEW YORK S~ 14300 CLAY TERRACE BOULEVARD
INDIANAPOLIS IN 46204
City County
Fax & e-mag: 3t 76563561. ccartw right,sim m onsarchitects.net CARMEL HAMILTON
The plans, specifications and application submitted for the above referenced aroject have been review ed for compliance w ith the app~cable rules
of the FEe Preventior and Building Safety Commission. The project is released for construction subject to, bu[ not necessarily limited to, the
conditions listed below. THIS IS NOTA BULDING PEP, MIT. Ali required local permits and licenses must be obtained prior to beginning construction
Work. All construction work must be in f u]!,cqqlpllance~ ~, alLeppli~bla State rules. Any changes in the released plans and/or specifications must
error, in violation of any rules of the Co~ol~ if ~ is b~s~ o~ii~6rre~;t bK~ins~iffio~ent information, This rel~as~ shall~xpire by limita on and
become null and void, if the work autbofiz~d is nc~t ~o~mer~ e~ w i~hin ~n~(l ) ~a~rom ~he above date.
~t~; : n for construction desi n reiease the ,ans
Note (A1A & AIB) g p
and s of Fire Prevention and Building Safety
perjury, w hioh is a Oas s D felony punishable by a preen term and a fine up to $10,000
AC t2-6-19) a complete set of piens and specifications that conform
the office of the state building comrr~ssioner shall be maintained on the constructio~ jobsite as w ell as a
ssion system shall be filed with the required
in accordance with 675 lAC 12-6- 3(a), 7(h)17 and 675 lAC 13-
is desired, a w r~en petition for review must be filed at the above address with the
;ion identifying the matter for which a review is sought no later than eighteen (18) days from the above
/. a legal holiday under State statute, or a day in which the Department of Fire
granted and an administrative proceeding
an administrative aw judge of the Fire Prevention and Building Safety Commission. if a petition for review is not filed, this
Orde~ w ill be final, and you must comply w Eh its reou~ements.
Filed By Code review official
DENISE FITZPATRICK
Address (name,title of local of ficial,street,city,stata and ZiP code
DE]=3. OF COMMUNFI'Y SERVICES
JEfF KENDALL
ONE CIVIC SQUARE
CARMEL. IN 46032
Fax ~ -, il: 317571 4 6
SIMMONS
.~ICHITECTS. LLC
ARCHITECTS, PLANNERS
.AFFIDAVIT OF~AUTHENTIClT¥
Frederick A. Simmons, AIA do hereby attest and affirm the following:
A. I am a Licensed Architect in the State of Indiana (Registered #3135).
I am the Project Architect for the Project known as ~e - Public Restrooms.
The Original Drawings dated 08/30/05 are the same drawings submitted to the Indiana
Depar{ment of Fire & Building Services for obtaining a Design Release dated 09/12/05
(sac ~
Indiana Registered Architect
Simmons Archnects. LLC · 305 East New York Street · Indianapolis. indiana 46204 ,, Phone 317-656-3500 Fax 3t 7-656-3501