HomeMy WebLinkAbout14060010 Resubmittal Info C�q
�.� �°'� REVISION / PLAN AMENDMENT
� '�'��+,� For New Single Family or "Other" Residential type permit projects
��s+"'' City of Cnrmel; Deparbnent of Co�rimurrity Services
Permit has been issued: l'es Yo. �IGyes, PEIL�II'P#: ���7 f>QQ � �
BUILDER of NAME: � PMONE: FAX:
RECORD: ' 7`33 `�� 3 � 3 �
STR�ADDRESS: CITY: SfATE: P� ��
. � N �U �
BUiIDER'S EMAIL AD�RE55: BEST METHOD OF CONTACT:
� � C 33 - ,
LOCATION LOT#', SUBDNISION NAME SECTION:
& PROJECT C
INFO: A�E55OF CONSTR�N: � ��
e� i civ
NEW SQUARE FOOTAGE OR ,, / NEW ESTIMATED COS',T�!( —���� NE pOST&BEAMN TYPE:BASEMENTA(Walko��VyL SPN;E
�AREA AFFECiED BY REVISION: /� / �— OP CONSTRl1CTI0N:L.G J�
! `F
�IF�PLANSFOR,REVISION/AMENDMENT ARE PART OF THE MASTER PERMIT PROGRAM; NAME OF MODEL AND REFERENCE#�ID OF
PCAN�SBECIFICATIONS FOR THIS WORK:
DESCRIPTION OFREVISION: � �/ �
1^ «�
I �C-t����v
NEW DESIGNATION OF AREA OF WORK SOUARE FOOTAGE:
BASEMENT 1" Floor 2nd Floor 3rd Floor Front Rear Porch Total Sq. Ft. TOTAL
(Finished and Porch or of Garages
Unfinished Sunroom
�4-1 � � �
Fo(Single Family and Two Fn�iiily devcllines,addicions,remodcls,and/or acccs'sory strucmres,[his permic is valid only i[mnstnic[iun commences
wi[hin 180 dxys of the dn�e of issuance of[he building permit,and mus'[be comple[ed(Cer[ificate of Occupancy issucd)within 18 mun[hs ol[he
issuance date. Class I strucmre permics are subjec[m[he General Administrn[ive Rules o[[he 5[ate af Indiana(See 675 IAC 12)regarding e�cpiratiun
time Frnmcs Por 6eginning and mmple[ing mnstruccion.
I .[he nndersianed,agree[hat unp conscruc[ion,remnsmiction,enlargement,reloca[ion,or alteracion of a s[memre,ar any chunge in thz u;z of land or
scruco.ves rer{ues[ed hy chis application will comply��i[h,und conform m,all applicabte la�vs of che Stace nf Indiana,and ehe Zoning Ordinance oE Carmet
Indiaw-199i"(Z-269)und amendmen[s,udop[ed under uuehoriry o[LC.36-7 c[sey,Genzral Assembly oE[he Scare of[�diuna,and ull Accs ame�damry
[hececo. I also certify[haronly Iuechen,bach,and flaor drains are conntc[ed m�hz sani[ary�se�ver. I further certify,under the pen:ileics oC Perjury Qndiana
Code 35-4{-2-I) chac all of the informacion 1 have pmvided in[his Applica[ion and ocher documentacion is tnie and uccurace co[he besc of my
knowlcdge:md belief,and thac I haye no[knowingly or in[en[ion:illy provided or umit[ed xny informa[ion ehac would[end co hide,obscurc,or
ocherrvise misle2d che Depc.of Communiry Services�regarding che cruch of[he m:i[[ers addressed I also agree that[hc constniccion will no[be used
�nr occu un[il a Certificare o(Occupancyhns been issuect by[he Dcparcmen[af Co munity Se iccs,Carme�
/L /�-L- �1� l�l/� i��� -5� �-Z3
Signature of�Owner or authorized Agent Print Date
OFFICE USE ONLY; e#********»x**s*a**s*****�*****x*******x*********s*»****s****x*rr*+xss**
NEW INSPECTIONS REQUIRED: PLAN AMENDMENT/REVISION FEE:
Upper Footing Lower Foating Under Slab ADDITIONAL SQUARE FOOTAGE:
Rough In Meter Base Final Site
NEW INSPECTIONS REQUIRED:
Qf adtli[ional inspeQions o[her than what already remaln on the exis[ing permi[are required.)
TOTAL:
Reviewed/Approved: Dep[. of Communicy Services (Date) oa[e
5',Permi6/FOrms/Plan Amentl ResiGen[ial F2P$EC¢N2d by: