HomeMy WebLinkAboutBurden Revised Permit Application, o. cngyr
REVISION / PLAN AMENDMENT
For New Single Family or "Other" Residential type permit projects
City of Carmel; Department of Community Services
Permit hits been issued: Yes No.
If yes, PERMIT #: 1°10502,Z'3
BUILDER of
NAME:
PHONE:JI•)•ZZI. 7710 "%-t' FAX:
RECORD:
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STREET ADDRESS:
CITY: STATE: ZIP:
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BUILDER'S EMAIL ADDRESS:
BEST METHOD OF CONTACT:
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E:MPIL..
LOCATION
& PROJECT
LOT #: SUBDIVISION NAME:
aaoa+GF s
SECTION:
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INFO:
ADDRESS OF CONSTRUCTION:
�(P`Ci �AiMM�.'tLLA+r�S
GT'. CARr�.,eL.+ Ir-� 'i bCL32.
NEW SQUARE FOOTAGE OR Lj(pZ:, SQ
NEW ESTIMATED COST
NEW FOUNDATION TYPE: SLAB CRAWL SPACE
AREA AFFECTED BY REVISION:
OF CONSTRUCTION:
POST & BEAM BASEMENT ( Walkout _Y _ N )
IF PLANS FOR REVISION/AMENDMENT ARE PART OF THE MASTER PERMIT PROGRAM; NAME OF MODEL AND REFERENCE #/ID OF
PLAN SPECIFICATIONS FOR THIS WORK:
DESCRIPTION OF REVISION: -PbDL-_COVED os —,)�£ 7%A>�.�Eavc ID,�
0f CO�Qr441_�T'E VZO Iz'70 ,o C)o0.
NEW DESIGNATION OF AREA OF WORK SQUARE FOOTAGE:
BASEMENT
(Finished and
Unfinished)
1 Floor
2" Floor
3 Floor
Front
Porch
Rear Porch
or
Sunroom
Total Sq. Ft.
of Garages
TOTAL
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within IRU days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS months of the
issuance date. Class I Atructure permits are subject to the General AdminitiVative 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, iclocation, or alteration of a strUCWIV, or any change in the use of land nr
St Will cs rcqucstCd by this appl icat On will coin ply with, and Conform to, all applicable km s of I he State of Indiana,:md the "(:armcl IT ni I jed I)crclnhmcnt
Ordinance (Z 625 1 ) and amcndnunts, adopted under authority of I.C. i6.7et SOLI, GCneral ;\sscrtbly 01 Lhe State o1 Indiana, and all Acts amendatory
thereto. I :dxi ccnily that only kitchen, bath, and floor drains arc conncctetl ut the saniuu'y sctvcr. I further certify, under the penalties of Perjury (I ndiana
Code 35.44-2-I) that all of the information 1 have provided in this Application and other documentation is true and accurate to the best of my
knowledge and belief, and that 1 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. I also agree that the construction will not be used
or occupied until a lat Certificate olOccupaneyhas been issued by the Department of Community Services, Carmel, Indiana. ..
Signatffe of ar or Authorized Agent Printt Daflit
OFFICE USE ONLY:***********************k*x************s***********k***********s*****
NEW INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
Rough In Meter Base Final Site
PLAN AMENDMENT/REVISION FEE:
ADDITIONAL SQUARE FOOTAGE:
NEW INSPECTIONS REQUIRED:
(If additional inspections other than what already remain on the existing permit are required.)
TOTAL:
Reviewed/Approved: Dept. of Community Services (Date)
S:Permds/Forms/Plan Amend Residential Fee Received by: