HomeMy WebLinkAbout1307.98 State Release � � , . �
'^"'� Pro�ect number Receipt number Relea'
� �a p4 SF.Y� 1yyR [18 : b5 . . . �
��: :CONSTRUCTION �ESIGN RELEASE � S � 9 't:.
-S�ate Form'41191"(R9/5-98) Construction rype Occupancy'classfiratioi.
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' '°° , DI ION
� � ' Scope of release -
� Indiana�Department of Fire!and�Building Services� �
BLAN'REVIEW�.DIVISION � ' E.�L7N� 5`PR-� MEf.H� PL1.1M EC�F:C� �
O ce��.of tFe State Building Commissioner � �� •
�� 2.�.W.'�WashingtonSt:-„ Room,E245 Typebt,release � �
ianapolis;Indiana°46204� -
�� ' � . Owner/Architect/EngineeF , Projectname� � � � - . -
HURST & ASSOCI'.R'd'F..S' TOF1' filOi�D •LEXUS
ATTN .KQRF..RT R HURST R?.BSC� ��
' Sireet address - �
4954 E S6TH ST STF.. 3 .
INDIANAAflL,7'S IN 4E22f1 .
City � County �
' RM LTON
The�,plans,specifications and�applicationsubmitted,for lhe above referenced project;have been,reviewed foccompliance-with the applicable�rules of the
'Fire��Prevention antl�Builtling'Safety Com`mission. The projecfis',ieleased.forconsUuction subjecLto„but not necess�arily limited��to,the conditions listed
',below., THIS�.ISNOTA BUI6DING PERMIT. AI(�equired local permrts�and licenses musPbe obtained prior to beginnirig constniction work. .
.All,wnstruction work-must be insfull compliance.with all.applicable State rules Any,�changes,inilFi,e�released�plans and/or specifcations�must be fled �
withand.released by'this OKce befo�e`any work�is altereii: T6is release may:be suspended odrevoked if�it is deteimined to'be�issued in evor,.in�Jiolation �
of any�rules;of the,Cbmmission-or if iCis based on'incorrect.or<insuKcienFinformalion. This release.shall,expire.by,limitation,�and bec8me null and void,
� if the wo�k'authonzed is�not,commenced withiri one`(1)'yearf�om"ttie:above tlate. � , , " �� � +
CONDITIONS: � - .
7. . No t:ondi,tions . '
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y •
Piease ba advisetl that if"an administrative rewew of this action is desired,a wrdten,petition for review must be,fletl at the above adtlress witfi the Fire Prevention and Building
Safety Commission identiying the matte�for wh�ch a renew is sought no later than�eighteen'(18)days from the above-stated date;unless the eighteenth day;Falls on a Saturday,
, '� � � der,State statute;or a day m�whicFthe Depahment of F,ire'and Bwlding Services is closed during normal business hours. In the latter iase,��he`
a'Sunday a legalPoliday u 9 working Eay.lhereafter If you choose to petition,and�the before mentioneA pmceduies are followed.your petition�FOr.review vnll be granted,�and�
:(I :alo adminastrative boceedin��wdl be conducted by an atlminisiralive lawjudge of tfie Fire Prevenhon and Bwltling Safery.Commission..If a petition fo�review.isnot f�ed,this
9
� Orderwill be.final�and� ou.mustcom 1��with its�re uirements.. _ - ' "°' � �� � ' - �' '
I A se"COi documents release�y this office shallbe maintained'on the cons uclionsite until th fruclure is occupied;(675JAC 12s6-19).
' !. _ ,
�t A,achments Coc����ffciaf St B ding mission �
I' �'Address(nameififleo//ocalo//iiial;�,streef,iity,state.andZlPcodoJ � ' . -
� . ate Fire Maishal
'Rerr. y ,Tnnes � ' - � � �
De;Pt . nF Commr.mi..t�i De�elnpment.
Une Civic Sqriar,e `
Carmel IN 46'03� 1
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'°"�w - �� Project number Receipt number Release date
d/'�`—� i II4 !�Mh 'I :iiH > I'IH : fI:�! �
� CONSTRUCTION DESIGN RELEASE'._,,,;y, �; u r ; �z"'a q • �'�,q l
7� ;
i � � >. i' State�Form41191 (R94,�598) �' � ConstriuGOn�type Occupancyclassifcation - �I
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eii"� �-1 � ' .!� t , .' '_tJ _n 1�,. .. .i ���
• �• � ,� Scope of release �
Iniliana.DepartmenPofFiie�and'Building Services
PGAN�REVIEW DIVISION � EDN S9'R� �4H:(7�F1 PC,1)t1 F,I,.E'C
�Office.of�.theState-�Building Commissioner� � ��� � � �
402.W.Washington�St., Room,E245� Type ot.release �
Indianapolis,Indiana'46204„ � ,.
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7o:�OwnenFArcM1iled�/Engineer " - �� Projecfname �
H11R:�'P ,N H:3SOt'1:R'P�:ti 'POM filOU� LE:Xf.fS
A'P'�I'P� . k(7FIF:k`I' k . HtiR$'I' F1'lHSii �-
49.`.i4 F: SF'1'H :�'P S'PF. :i :r
Streetaddress - � '
7NIi1'RN�FOI.,'I:� 1,t4 4f�221i .�i
Cily -- County�
� ' uaMr .rt�caN
The�plans,specifcations�and application su6mitted fo�thea6ove referenced p�ojecNhave been reviewed for,compliance�:with�the applicable.iules.of,the
Fiie;Prevention:anii Building Safety Commission. The project is'released for construction su6jectto,buCnol necessarily limited�to�,the conditions listed
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lielow. TNIS°IS.NOTA�BUILDING PERMIT:�,All;iequired,local permits��.and,licenses must bg;oblained priortobeginning'constructibn work._ _ _�_ �_ __ ._
__. ... _ .. . . _ .. :., _ _ . , _
All construction'wo�k musl be:in�full compliance,with all apphca61e��5tate:rules: Any changesin�.the�eleased pians�and/orspecificatibns must be fled�
��with'and,released tiy tliis'Office,6efore any;,work,isaltered. This release��.may be suspendeiibr revoked��'if ifis determined�to�be issued in error,in'violation
of;any rulesof ihe;Commissiori��or if it�.isbasetl on'incorrechor msufficieriCinformation ThiSrelease shall expi�e by limitation,andbecome_null and void,
�if4he work authorized is not commenced�within one'�(7):yearlrom the���above�date. � �
CONDITIONS: �
1. . IJn Cc�ndi.'iinns . .
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P,lease be advisetl lhal if an atlministralive review.of Ihis action is.desired a written.pebtion for review mustbe.fled at ihe above atldress 1vit6lhe'Fire PreJenhon and Building
� Safety Commission iCenUfying ttie�matler for which a�rewew ii sought no later than eighleen(18)days fmm the above stated date unless the eighteenth'day lalls on a SaWiday,
. a��5unday alegal�,hoLdayunderState��.staWte.ora�.daym�which.theDepaAmentoCFveand,BuiltlingSemie'siscloseddurinj-normalbusinesshours Inthelaltercase,ihe�.
filing deadline will be the frst working�tlay lhereafter:�If you choos'e.lo petihon,and�lhe before=menhoned�.procedures are.followed�.your petition for review willbe granted,antl
an administratrve-� wceeding aill tie conductetlby�an ailminisUative lawjudge oLIM1e Fire Prevenlion and BuildingSa(ety Commission. IL-apetihon for�review is nof fledt,tliis
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.�Orderwiil.tie�fnal;and oumustcoml wilfi�its�re�uiremenis:� � '� ' ��17 '� � -
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. A sel'of'documents releasetl�liylhis office shall be maintained on the con�ructwn site until t�sfiucture is-;occupied (675 IAC 12-6-19).
Attachments� - � Coderev,iewqfficial � SlateBu'ding6ommissiooe'
Address;(name;title'.-o1/ocal.oHiWal;,shaet,city,sfale.andZlPcode) � ��� 1 � �
U 5lete,Fire,Marshal - / � J / �
`I'yrr,i ,7nne:s .J � / //
D�lit. . nF Cnmmr.ini.i:�� 17AVe�InLimr�nt. ' !� i •/��C�-� ,..
Ona Ci.vir,. .�rluare '� • 1 f
Crrme'I 7'Ft 4Fif1;3'7 f ' �,
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3. PROJECT DATA �
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(To be compfeted by submitte�J Please answer all pertine�t ques�ions. SB r � ct mqer � Filing d �
;� �UG 17 7998
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I Scope ot cvoB Total existing(I7 applicaWe)
❑ New builCin. � Addition ❑ Remodelin S . Ft.
Is;his consimr.ion;he result of lire or natural oisaster? Sewer ❑Existing Q Proposed� Addition(II applicable/ Atldition(If applicable)
❑ Yes� No I Public ❑ Private � None S . FL $
Fire suopression system in h�iltling Detailetl suppression system plans antl specs Remodeled pl applicable) Remodeling p!applicable)
❑ Full ❑ Partial None ❑ Provided ❑ To follow S . Ft. $
If panial,specify where' I Locatetl inYlootl plain(✓counry Total builtling area square teet Total project cost
Ip/an cammission/❑ .
No $
Buiiding cons ruction type antl occupancy classitication Builtling height Num6er of builtlings this submittal Volume cubic leet
� �jZ (S(ories) ' 1 (Oescribe il necessaryJ ' (Fee category E only)
Intliana habilitalion stantlard(Rule�used? Evaluation aocuments pmvitletl? Use ot conversion mle(Flule 1�proposed?
❑ Yes ❑ No ❑Yes ❑ No � ❑ Yes ❑ Na
Does pmject include:(ChecN i!Yes) . .
❑ Elevator or lift ❑ Comoustible fibers storage ❑ Fireworks srorage ❑ Explosives srorage .
❑ Hi h ile 5ora e ❑ Boiler or �essure vessel ❑ Hazardous or flammable materials stora e
Describe proposed use of laciliry IN DETAIL:including,ypes oi flammable or combusti6le�malerials storetl or handled'
_..��..��._�_f�....�r.._f�[�(l�._(��°c���.....
Describe previous or cunen[use of facilirylN DETAIL(l7 existing faciliry�.'
� ����
—�--....._.__... i__ .._ . . _ Number af parsons employetl
-_. � ' . . , . (Mas/shiR) . /�.� .
_�
General comments' .
� -����- -� . , " Num6er ot persons(public)
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v
Has other work at tnis loca�ion ever been liled? Does pmject inclutle�use ol:.a:master plan tlesigdrelease ora lacrory built moCular or mobile s;ructure"+
Yes ❑ Mo ❑ Unknown ❑ Ye5 No
Uha�(t yIfe/�ar��n7tl�m1o1n1th Previous SBC pmject number Name of manulaclurer(r/lacrory builfj Master plan/Modular tile num6er or motlular/mobile
I"1 NVw� . � . sealnumber
Has consWCtion started? If Yes,has a notice ol violation or investigation been issuetl? If No,probable construction starting date?
❑ Yes ❑ No ❑ Yes .❑ No
. � . ,
Indiana climaie/mne �7ype of h�ng'luel NumOer�f tenants No.ot eleclric meters No.of gas me!ers BTU/HR/SFIDeq.F walls
��� I (Adjus(edloropeningsJ
❑ Nonh Central ❑ South �T� � uo
Does pmject contain skylights,greenhouse,solarium,ar If Yas,OTTV of rool OTT/of Walls FooVceiling assembty
� larqe glass area?
❑ Yes � No �a
Energy cylculations provided? Po�ahle hol waier provitled? Is it radreulated? pir in(ileretion rate per Table 502.42 Floors(Unheated below)
❑ Yes No ❑ Yes No ❑ Yes ❑ No ❑ Yes ❑ No Uo
Total Non-residential lightingpower hudget Thermoslat range heating Thermostat range cooling Slab at grade
KW
R
Generel comments' � Crawl spaca walls
R
ACCESSIBILITY• , �.SEISMIC DESIGN
❑ Yes ❑ No Have accessible parking spaces and signage teen provided? Is this pro'ect classified as an ESSENTIAL FACILII'Y,
❑ Yes� ❑ No Does access within builtling comply with Table 33-A I.B.C. ? GROUP�7 or HIGHRISE? � Yes ❑ No
❑ Yes (See IBC Chapfei 23J
❑ No Do toilet rooms and equipment meet accessibiiiry code?
❑ Yes Have seismic design procedures
❑ No Does access ro building meet accessibiliry code? been foliowed'per code ❑ Yes ❑ No
❑ Yes ❑ No Is.buildin desi ned.for.access adaptabilit ? requirement? �
��,Type of laciliry(as licensed by GCiana DeAartment ol HealthJ If wrsing home -
❑�Resitlential cus�odial care ❑ Nursin home ❑ Outoatient sur e ❑ Hos ital ❑ Intermediate care ❑ Skilled care �
Acmining and dischargepoliry provitletl Plans�show criiicaLheaiing area Emergency power ❑ Genera�or❑ Battery ❑ None
❑ Yes ❑ No service
❑ Yes ❑ No ❑ Other(Specily/'
'�NOTE:USE SEPARATE SHEET/FAOOITIONAL SPACE�IS REQUIRED .
Page 3
2. CERTIFICATE OF COMPLIANCE • • • •
(fo be completed by Submifter) SBC pmject number Filing:date
. - ,�sb33�j auc � 7 issa
Please indicate how you wish to receive Ihe design release ar,d plans.
We will mail lo ihe design pro(essional(owner i(no design prolessionaQ ❑'MAIL
We will calLthe design professional (owner il no oesi5n prolessionaq [� CAIL FOq PICK-UP
• . . .
Name ot project . ! Closest irtersecting street or road
7`p'1�1,( (,t)DOf� I�EXU� I �y5T01JE 1tU� .
Atldress(site bcation,nu er and s7reetJ Suite or Noor(i!applicabie) Oireccion FROM intersection TO project
3��0 �� �CP��. ❑ North ❑ South ❑ East West
Ciry a!nd�pconun�ry ' I�,�,, r � Is roject within ciry limits? '
C/ � T,.`��' � TYVYI��T�N Yes ❑ No
.
As owner o(;he projec['or whictrthis appliwtion is being liled I hereby cenify
t. Ihe descripiion of use and information contained on Ihis application are correct
� 2 �the project will be constructed in accordance with the released documents and applicable rules of the Commission;
'I 3. any chanqes to the released documents wili be filed with the Ottice of the S[ate Building Commissioner.
Authorized 5ignaWre Name of owner or buSlnesS
EXJ
Nama(rypedorprinredJ Atltlress(numberandstreeQ �-
E oo E. 9L �'� S�
Title Ciry.state,ZIP code . .
l�- Tvoi�MAPoL%s l�, S�62Yo
7elephone number Faciliry use � -
c3i7� 57y-0/Y3 /�u7o /Jcfj[E�SHi/�
. • - . . .
, ,,,
As;he tlesign prcfessional lor Ne project for which this application,plans and specifications are being filed.I hereby cerily:
i. i am qualified and competenl �o design such buildings,structures, and systems and have attached a�copy of my�current registration card:
2. the plans and specifications tiled in conjunction with this application were created by me and/or by my persons under my immediate personal
supervision and will comply with all applicable building laws�and rules of Ihe Commission;
3. the project data cornained on this application are correct and correspond.with Ihe plans and specifications ro be filed in conjunction with this appiication:
a. the design p:ofessionat identified below will inspect the construction covered 6y this application at appropriate intervals to determine general compliance
with the released documents and applicahle rules of the Commission ard�will cause all noted deviations from released documents and code violations
to be corrected or notity the owner and authorities having jurisdiction of all specific deviations.and code violations;and '
5. I aRirm under penaity of perjury ihat the representations contained herein are true and i further understand�hat providing false information constitutes�
an act of perjury,which is a Ctass D Fel punishable by a prison term and a fine of up lo$10,000. -
Responsibiliry is toriha tollowing sysre . Site Foundation Structural
❑ ❑ ❑ ❑ nrchitecture� ❑ Mechanica�
❑ Pluml�ygnin��� Elect �cal I A6ove �❑ Other(speci/yJ
�`�L.. �• Y/A� .c�' �. ;�r . I / _ � Na eoiiirm{i/aplicablej .
:�o:: ''' .'`� ' .:`��: �. �lr¢r�,txt�tT��
Name(ryPed orprin OJ Adtlress(numDer and stree
_ : rao. 28�0 `: - (�O'P� fZ. T ��1- �. S�*�"�T �cT� 3
� >������ , Intl�ia1na�regisntration.number ArchiteCt Ciry,shtate,ZIP code q�
••��• �'�'OIpNP� :•• � G�N O Engineer .- I J�JV - I/v �ZZD
'�� ' , • ? ,j NOTE: Seal antl siqnaNre attixetl before repmtluaion shall appear on each page ot all tlrawings and Telephone number
., 9 ,;;' - r � �� the Iitle page of all specitications. /�./
�� '�li' '•t-v �� All wrrespondence will be to design ArchltecVEngineer,it none Ihen to Ihe ownec (���) �j/,l'
name�aetly pmtessional(rypetlorprintedj NOTARY CERTIFICATE
STATEOF IN���N14'
Intliana reglslration number ' � ArChiteCt
counnvoF /YiAR�D�L/ } Ss:
❑ Engineer getore me the undersigned, a Notary Public for said County and State, personally appeared
Name ol lirm(il aoplicable)
o ber 1- �. �-{t(2 S f who under Ihe penalty of perjury acknowledges the
foregoing statements as irue this _/�da of
nddress(numberand srreep Y �� ' � '
Signature of Noiary Puhlic � '�./ �/+�,. �
City,sta�e.ZIP code � �- �Z'/'-""�M1� � .
My commission expires: ' , hC� County of residen<e����
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