HomeMy WebLinkAbout1312.98 Contractor Affidavit AFFIDAVIT TO INDUCE INTERIM REMODELING RELEASE
AND/OR EARLY FOUNDATION RELEASE
CITY OF CARMEL/CLAY TOWNSHIP J �
Date: (�G�o�J�/' ��, �lp� �l�`g�
�/ �
Building Permit No.: �� U � "(l(p �
Entiiy (Business or /� /
Individual): ,1�c1�� L-O/J./�7i/1/IG�j�/�J
Applicant-Affiant: L�1��� � /GhQ1'�SO/�I
Project Name: ���"Gi`//cl c� Ca. T�c°c yz4;i,� Sc����
Address/Location: S DO �, �j(� � S�/��� , "C���„�e� �jZ/ c���j3�
I, being duly sworn upon my oath, state the following:
1. I am executing this Affidavit for myself or as the authorized agent of the
above-referenced Entity to induce the Ciry of Carmel/Ctay Township ("DOCS") to allow me or the
Entity to proceed with development pursuant to the Plans (defined below).
2. That this Affidavit shall bind me or said Entity and any further reference to "I" herein shall
be considered as a reference to me or such Entity.
3. I have filed with the Office of the State Building Commissioner ("SBC") of the Indiana
Department of Fre and Building Services for its review and approval, plans and specifications (the
"Plans") for development of the above-referenced project (the "ProjecY'), which I believe to be in
compliance with all State of Indiana requirements including, but not limited to, the rules of the Fre
Prevention and Building Safety Commission, the Uniform Building Code, the National Electric Code,
the National Plumbing Code and the Model Energy Code, all as amended from time to time (the
"Rules").
4. I have presented to DOCS a copy of the Plans, and that any changes submitted to or
required,by tne SdC.will be submitted to DOCS in a timely fashion and that the Plans sYamped with-
a fina;'approval:ac;d:accompanied by a Full Design Release will be submitted to DOCS prior to
sched�ling the_final.inspection and issuance of a Certificate of Occupancy (C/O).
: -
- :: 5. �; I;further.uncerstand that application for an interim remodeling release anU/or early
fourdation �elease�wilhanly allow me or the Entity, after payment of the full fee to DOCS, to proceed
� -,_ .
at my!its'o�vn�isk: ��"',�
6. I understand that by proceeding on an interim basis, I accept responsibility for removing
and replacing any construction found by plan examination or by �ite inspection not to compiy with
the Ruies and/or those rules and regulations of DOCS and/or ordinances of the City of Carmel/Clay
Township.
7. I further acknowledge that I am proceeding on an interim basis at my/the Entityr's own
risk and that I assume and accept all liability for the project and will indemnify and hold the City of
Carmel/Ciay Township, its officers, employees and agents, harmless from any and all liability to any
person or entiry (including the Entity), resulting from proceeding forward without a stamped set of
Plans and a Full Design Release from the SBC.
8. I furtheragree that I will pay the Ciiy of CarmeUClay Township for any and all expenses,
including reasonable attomeys fees, it might incur in taking enfarcement action against the Project.
9. I further aeknowledge that, in addition to the Rules, I must comply with all other rules
and regulations of the City of CarmeVClay Township and the State of Indiana as such relate to the
Project including, but not limited to, building codes and zoning ordinances as amended from Ume to
time.
DATED: i `� 2" S S Y �
'', ��
�� Signature
� Ati� ,.� 1� � �� ^y-�s��.
Printed Name
��
STATE OF INDIANA )
)SS:
COUNTY OF HAMILTON )
Personally appeared before me, a Notary Public, in and for ��� County� State of
Indiana, acknowledged the execution of the foregoing Affidavit and dicated that the facts stated
therein are true. The Affiant further represented that he/she has proper authority and resolulions
to execute this Affidavit on behalf of the entity
Witness my hand and Notariai Seal this � �day of �/ �'7U 19 �'�,
Notary �ublic �
� �1��-. �I.r-�-��� �:c�
Printed �• " -
:` -,._-
_ • _� ' ._
_ � : . ; _
My commission expires: � _ -_ ',- ; , � =
l ` i
c:96docnum.1002.ghs/pg2
dg/tj/ghs
March 1996