HomeMy WebLinkAbout18020088 Revision Application�1 of CA,
` F` REVISION / PLAN AMENDMENT or ADDENDUM to STATE RELEASE
For Commercial, Institutional, Industrial, or Multi -Family Projects
City of Carmel; Department of Community Services
Permit has been issued: Yes No.
If yes, PERMIT #: 29
BUILDER of
NAME,
PHONE: FAX:
RECORD:
0'
STREET ADDRESS:
CITY: STATE: ZIP:
BUILDER'S EMAIL ADDRESS:
BEST METHOD OF CONTACT:
LOCATION
PRO NAM
Y60
LOT # and SUBDIVISION NAME: (If applicable)
& PROJECT
A DRESS OF CONSTRUCTION:
INFO:
t
NEW SQUARE FOOTAGE OR
AREA AFFECTED BY REVISION: oo
NEW ESTIMATED COST
OF CONSTRUCTION:
NEW FOUNDATION TYPE: U SLAB o CRAWL SPACE
a POST &BEAM a BASEMENT (Walkout _Y _ N )
STATE COMMERCIAL
DESIGN RELrE #•
DATE OF AMENDED RELEASE:
NEW SCOPE(S) OF o FDN ` STR C2CARCH _ MECH PLUM
RELEASE: g ELEC o SPKLR OTHER(S):
# of Floors: Elevator/Lift: YES • • NO
BLDG. CONSTRUCTION TYPE: — f C SJ'k OCCUPANCY CLASSIFICATION: i
OF AME MENT/REVISION, AND/OR STATE RELEASE ADDENDUM/UPDATE INFORMATION:
- 6 vzms
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for
beginning and completing construction.
I —the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the Carmel Unified Development
Ordinance (Z-625-17) and amendments, adopted under authority of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I also certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify, under the penalties of Perjury (Indiana
Code 35-44-2-1) that all of the information I have provided in this Application and other documentation 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 the Dept. of Community Services regarding the truth of the matters addressed. I also agree that the construction will not be used
or occ ed until a Certifi a ccupancyhas been issued by the Department of Community Services, Carmel, Indiana.
Sign ure Owner or Authorized Agent Print Date
Vrra{.c UDC UIVLY'
NEW INSPECTIONS REQUIRED: PLAN AMENDMENT/REVISION FEE:
Upper Footing Lower Footing Under Slab
Rough In Meter Base Final Site
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/Forms/Plan Amend Commercial, Ind, Inst, Multi
ADDITIONAL SQUARE FOOTAGE:
NEW INSPECTIONS REQUIRED:
(If additional inspections other than what already remain on the existing permit are required.)
TOTAL:
Fee Received by:
Date