HomeMy WebLinkAbout14050020 Resubmittal Info n �,9y I
';� REVISION / PLAN AMENDMENT or ADDENDUM to STATE RELEASE I
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;`;✓�g For Commercial, Instirirtional, Industrial, orMulti-Family Projects i
°� `°�' City of Carmel;Department of Community Services
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Yermit.has been issued: Ycs No. If ycs, PERi�(IT#:
BUILDERof NAME' IJ NO� I�J CiJj \vw� �W .-�+i� II� PHONE: ���- (�y� - � � I � FAX:
RECORD: � v
STREET ADDftE55: � 3 7 3 S +-�i�\ �.-�� Uf CIN: ��S��V STATE: \,/�� ZIP: �(6'�j �Q
BUILDERS EMAIL ADDRE55: BEST METHOD OF CONTACT: �'/I1�...y �
�<r+o� ;� 7zr @ y�k�G � �z�
LOCATION PRO]EQ NAME: LOT k and SU9D[VISfON NAME(If appfiCahfe)
& PRO]ECT 5 T /�/�a^^� w•�d� /✓(a r (e �1. �� <.Q�
INFO: ADDRE55 OF CONSTRUCTION: I`L � 7 y 5 �e iL boY�..� r�e��,( C;,u;.,.,,_� �N
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NEW�SQUARE'FOOTAGEOR � 9��'� S,Vn} NEWESTIMATEDCOST y!K NEWfOUNDATION�TVPE O SLAB !J CRAWLSPACE
AREA AFFECTED BYBEVIS[ON: OF CONSTRUC?ION: O pOST&BEAM r�pSEMENT (Walkout KV_N)
SrATE COMMERCIAL 7�'� � 2 y z DATE OF AMENDED RELEASE NEW�SCOPE(S)OF L: FON .= STR _ ARCH :i MKH :� PLUM
DES[GN RELEASE N: �
RELEASE: :� ELEC •-; SPKLR OTHER(5):
#�of Floors: Z , Elevator/LiP: � YES �• NO BLDG.CONSTRUCTION TYPE: � I'-� OCNPANCYiLA55IFICATtON: `} _ 3
DESCRIPTION OF AMENDMENT/REVISION, AND/OR STATE RELEASEADDENDUM/UPDATE INFORMATION:
dd� u �� sh� Fe � � �-- �
Cl:�ss I st�uc[ure penni[s am subjecc�o the General Admi�iis[ra[ive Rules of the 5[�[e of fndiana(See 67.5 IAC 12)regn�ding expirntion�ime Er.imes for
bcginning and complecing�wns[ruction.
1,the undersiened,agree diaumy�mnsmicclan,recons[ructinq enlargement,reloc�[ion,or;ilce�anon of u sc�ucmre,o�any change in che usc of land or
senic[u�es cequeseed 6y ehis appliui[ion«�II mmply��,idi,:ind conFnrm ca,all�pplicabic la«�s of[he Srure nE Indi:ma,and[he"Zoning Ordin:mce o[Curmel
Indian�i 19�J3"(Z-�89)and amendmen[s,adop[ed undeuwchoriq�oF I.C.36-7 e[seq,Generul Assembly oF�heSrace of Indianu,and a11 dccs xmenducory
chere[o I also eer[ifvthu[nnly kitchen,b:i[h,and tloo�drains ure cnnnected ca ehe suni[ary�e�ver- I furdier ceaiEy,widcr die pen;ilt[es oP Perjury(Indi;ma i
Cocle8�--04-2-1)rhat:dlbl the infornmtion 1 have provided in[his Application and other dacumennitiun is�rue nnd ueeurate m die besc of iny
knowlcdge and belief,and chut I have no[knowingly oninren[ionally pmvided or omittcd any information diac would[end[o hide,obscum,or
othenvise inisle.idthe�Uept.of Community Serviccs rcgxrding che truth uL[he matters addressed. I also agree dia�che conscn�c[ion will not be used
ur uccupied until n Crrtifir.rtrofOccup:ri:cyhas been issucd by ehe Depnrtmene of Cummunity�Services,Carmel,Indiana. '
/�— 1 � - Ntn v ss.� �c i-I ,� �, S/i 3 /1 y
Signature of Owner arAUthorized Agent Print �Date
OFFICE USE ONLY: ********�**��****************x***�************r************�***********�
NEW INSPECTIONS REQUIRED: p�,qN AMENDMENT/REVISION FEE:
Upper Footing Lower Footing UnderSlab ADDITIONAL SQUARE FOOTAGE:
NEW INSPECTIONS REQUIRED:
Rough In Metel'Ba52 Flna� Site (If additional inspections other than what already remain on the existing�permit are required.)
�.I�IrpmYw�ln! SI i4I iQ- TOTAL: �
Reviewed/Appr ved: Dept.of Community Services� (Date) L( �� � ��—� � � �y
S:Permits(fwms/%an Amend Commerci�l,I�,(nR,-MUIn Fee ReC21vCd. y: a[