HomeMy WebLinkAbout14050140 Application � •
�' .� � 3/7 G. r-S' ��33
��'�` SWIl��IING POOL / SPA CONSTRUCTION
. For Commercial,.InstituHonal;tor Residendal Projects � �
�xoux� City of Carmel;Department of Cnmmunity Services PERMIT#:
BUIGDER of NAME: PHONE: FAX:
RECORD: h,�`�°n � S� �34 3oq9 � i�7 �3 4'�� �
STREET ADORESS: / � / STATE: ZIP:
q. L �^�� J /fi2�i-� il/ �G/G�
BUILDER'S EMA[L ADDRESS: BEST MEfHOD OF CONTACT:
�,�� 3�7 83 � 3 o t'
PROPERTY NAME: PHONE: FAX:
OWNER, �� U� 3�7 SZ�i /�57
INFO: STREEfADDRE55: � CiTV: /� STATE: IIP:
/OSOS /'u ��i .r,l C�/�yn�' .1i✓ /J3 Z
PROJEC7' ADDRESSOFCONSTRUCfION: Ir� II Il// �a, L^ , ��02�
LOCATION /OSd� o� i iJ F'��"•+•�'v r� �
INFO: PROJEC?NAME:(If applirable) Mqy 21 Zp14 oT UB��/N��Vltla�licable)
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ESTIMATED COST � FOOTAGE RE TYPE,
OF GONSTRUCTION: '�,� 'Z Z [nclu m � � IF APPLICABLE:
SUMP PUMP: ❑ YE$ N0. pOOL COLOR: �J IS T OF PROPERiY WITHIN
(If YE$—INDICATE DRAINAGE�ON SITE��PLAN) .�J� ��� SPECIAL FLOOD�HAZARD AREA: ❑ YES �NO
STATE COMMERCIAL CLA55 OF POOL ��Q?f yj % ��
DESIGN RELEASE# IF COMMERCIAL: Q�p R � p��R(,'� , POOL COVER: f� YES ❑ NO
IFAPPLiCABLE: C` ta .dry� ./�/ �
AUTO FICTER: YES O NO SEPTIC SYSTEM: �sq, d�o � (�lr °k ❑ YES f�iNO
IF HEATED: ❑ GAS ❑ ELECTRIC SLIDE: ❑ YES / NG BBR�RD: ❑ YES �NO
POOL BUICDERS WILL BE RESPONSIBLE FOR: Notification to pool ow�ers that � � c � n� ��, and also wil]relate the various wdes
a�plicable. Pool'builders.shall coordinate with owners.fo�thrinspector's aceess to�site on days ins�iections a �Jp � d. Under[he Curmel /Clay "Loning
Ordinnnce,,Chapter 29.0,Sea 19.06.08: "Late Fees shal/��6e assessed on missed inspec[ians,including.occup without a C/O".
This permit is valid only"if construction commences within 180 days of the date.of issuance of this�permit and must be comPleted�havin�the
Cer[ificate oPOccupancy issued�within 1 S months:of the�.date bf issuance. Class 1 Structure Pe�miis ate su6ject to the State of Indiana General
Adminis[rative Rules(GAR 675 fAC 12�regarding expiralion time frames for beginning and comPleting�mnstruction.
I,the undersigned,agrce that any construction,rewnstructioq enlargement,relocation,or alteration of a structure,or any change in the use of land or structures
requested by this apPlieation will comply with and.mnForm to all applirable laws of the$tzte of Indiana and e6e"Zoning Ordinance of Carmd.Indiaoa—1993"(Z-289)and
amendmentr;adopted under authority of LC. 36-7'et seq,General Assembly of the State of Indiana,.and�all Acts amenda[ory thereto. 1(wther certify that only kitcheq
bath,and Roor drains are conneaed to�the sanitary sewer. I fwther certify that the constru�tion will not he used or occupied until a Cenificatc of Occupancy has bee,n
issued by the Departmcnt of Community Services,Carmel,Indiana.
I also certify,under�he.penaltiesof Peijury(Indiana Code 35-44-2-1)thac all of the information Chave provided in this A�pIication and other
documentation-is�true and accurate to the best oEmy knowledge and belief,and thatl.have�no�knowingly or intenrioaall}�provided or omitted
any infocmation�ha�wquld tend to�hide;obscure;o�otherwise mislead the Depc.of Community Services regarding the truth of the matters
addresse��-(i� � � -
� �'C/ .5`Z%��
Sigvnmreof0 rnt� Prin4dName Dam
OFFICE USE`ONLY:.xe+wxww,e,ex>xx+.���xx��r.r.���:e:e:ess���x�x�x+.+:+�+::+:�xv��ww�wwr,-.v�i�+++++:i.���xx�xt��re,e:e�:e+�+������,r��x+�x�rxr���+:e�z:ex
INSPECTIONS REOUIRED: '�—� � C��
PERMIT FEE (Flat Rate + Sq. Ft. fee): �oL < <J
� Sn BONDING / GROUNDING n I �
' � 2"dBONDING / GROUNDING INSPECTION FEES: �'"l V�• �C�
� FINAL- Bldg _FINAL- FORESTRY CERTIFICATE OF OCCUPANCY: ��• �
' � TOTAL:� . �
FINAL—Carmel Fire Department
i�o..�`� ,� 1
,� � Fee eceived'�by: Date
ReviewedJApp�oved: Dept.-�unity.5ervices (Date)