HomeMy WebLinkAbout0004.01 Sq. Ft."A Better INpy 10 Duy o Hon¢"
E5t.1951
,UILDER:
�UIJLDERS ADDRESS:
®NTACT JPERS®N:
DAVIS HOMES, LLC
3755 E. 82nd Street, Suite 120, Indianapolis, IN 46240
Sue Jackson rr 317/ 595-2825
®ADJUNIT : Ema� lr 5 t
JEClI I®N:
uOT NUMBER:
3UYERS NAME:
EXISTING ADDR
CURRENT PHON
ESIIIOJ[AT>yD COST OF CONSTRUCTION: $ ate.
SQUARE FOOTAGE BREAEDOWN:
First Floor
Second Floor /5 a
Basement 3
Garage
Front ]Porch _ 1 (9_
Rear Porch
Screen Poach Yes /
Deck
Patio 80
3755 EAST 82ND 5T.
SUITE 120
INDIANAPOUS,
INDIANA 46240
I CERTIFY THAT ALL OF THE ABOVE LISTED INFORMATION IS SHOWN COMPLETELY AND ACCURATELY ON THE
ATTACHED PLOT OR SITE PLAN AS SUBMITTED WITH,A BUILDING PERMIT APPLICATION TO THE CARMEL-CLAY
DEPARTMENT OF COMMUNITY SERVICES. I FURTHER CERTIFY THAT THE JOINING OF WATER SUPPLY PIPING
SHALL BE MADE WITH LEAD-FREE SOLDERS AND FLUXES. FAILURE TO COMPLY WILL RESULT IN A REPLACEMENT
OF THE SYSTEM. PLUMBING CODE P-509-5.
Under the penalties of perjury (Indiana Code 35-44-2-1), I hereby affirm under oath that all of the
information I have provided in the table below is true and accurate to the best of my knowledge and
belief, and that I have not knowingly or intentionally provided or omitted any information that would tend
to hide, obscure or otherwise mislead the Dept. of Community Services regarding the truth of the
matters addressed therein.
BASEMENT
1st Floor
2nd Floor
3rd Floor
Front
Rear
Total Sq.
TOTAL
(Finished and
Porch
Porch or
Ft. Of
Unfinished)
Sunroom
Garages
NOTE: Additional plans and/or information may be required, if submitted plans are not of sufficient clarity or detail, to
indicate the nature and extent of the work proposed and to determine compliance with all applicable codes and
ordinances.
In addition to the above, the Building Inspector will be provided with any information relative to commitments
made In the zoning process for the property involved. This would include any Plan Commission and/or BZA
activity.
APPLICANT'S SIGNATU
ADDRESS:
PHONE: \ (J _��J
Department of Community Services
One Civic Square, Carmel, IN 46032 (317) 571-2444
s:form s/i mprvloc/pe rm info rev. March 2000