HomeMy WebLinkAbout06020101 Application
City ofCarme// Clay Township b Permit #OIdJ;{ D J 0/
RESIDENTIAL IMPROVEMENT LOCATIO~T APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
Which plumbing codes will be applied to the construction:
~ International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
~ulti-Family Construction Code)
PROJECT INFORMATION: RELEA :>[D FOR CONSTRUr.T/ON
E I R I /' M f ct d /,S"b,FOUNDATIONo'TYPE:p(C?,eig lcm'Atapplyforthe new
ar y. e ease ~,anu a ure ~'constructionareaf ,,"', ..'" I kf f II
Permit: _Y ~Trusses: _Y ~N 'o''' ""'"'' 8'1) ~oc21 Codes.
/" '1:-uT0,cCRAWLSPAGE., ,~POSJ, EAM
Lot Split: Y Sump Pump: ../Y N Lo"" '0' ',,' ~o'"..",,-,J,lY ~h'A'S' E'~
- - - - r',--", ,-SLAB uo. B 'MENT
\';i I ~ 0,- l.' .. ,rl / C' f," . ''', 'hllD
Does any part of the property lie within a special Flood designation area":""'ViCy lff ,/ i u~~our:
BUILDER of
RECORD:
NAME 'I " -
C If\'1t e50 I Fwet t+olYlc2A
STREET ADDRESS
"no e. c ; l2..-l, q,r-O to.
BUILDER'S EMAlL ADDRESS
c./jI.!c,I:.Ta e. J'lJflO, c..o'n
PROPERTY
OWNER:
NAME
Sj:>,mfl
STREET ADDRESS
LOCATION
& PROJECT
INFO:
LOT #
"*
SUBDIVISION NAME
"" It u:.Jo Del
NAME OF UTILITY EXCAV 11 CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCI<ET
NUMBERS; TAC DATE(S', AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
!2f SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
1l(( NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLlTION
PHONE
Jftc- &.~~q.sOl.?
FAX
~ 4"'\f- ~40(
cm
STATE
::;:;1
ZIP
4(..//;1..
OF CONTACT:
.1"1-.0...... - -sqo-'i.-rs,:,-
FAX
PHONE
OTY
STATE
ZIP
SECTION
SQUARE
FOOTAGE: .
ESTIMATED COST OF CONSTRUCTION:
(EXCLUD!NGo'LA~p:YA~)-;:::';--;i~~ :~~'-'QI":? 0 l:J
:; i \ \ 13;':; \-.'_~i i-=:~;; U . \.'/ L:n:,:;; Ii \ ~;
~-t(pSfQcJe-if'6)mQ()1 cIJ
PLUMBINGifd,NT'Wi0$:2 2006 .. ii II!
''P"""I J~~.~~ ~I
Plumber's Irdi~na StateUcense :
Inl'777
Y1-N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 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 "Zoning Ordinance of Carmel
Indiana -1993" (Z,289) and amendmen~pted under authOrity of LC. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only ~ath, and floor drains are connected to the sanitary sewer. I funher certify that the construction will not be
used or oc ie unril a~wCCUpanCYhas been issued by rhe Depanment of Community Services. Cannel, Indiana.
(/ r ~c e'AI1/~ei ~/Av@/ r2-if.,-OIu
o Owner or Authorized Agent Print - Date
OFFICEUSEONLY:********************************************~**************************
Filing Fees: L... 7'1. 6 V
INSPECTI~S REQUIRED: ') 6''', fGI # Charged Reo'
I'i'i: ~ "_~ Base Inspections: ~ /.
~p~oot~ Lower ~ Under Slab 51- s-cJ Reviews
- _, =-- Cert. of Occupancy:
Rough ete Base Final Sitii' I J G I- dO
P. R.I. F. : Additional Fees
./ TOTAL:--' 4#;;25"5'1.3 ()
!t'd) ()&!J6&}'1 .
Fee"Recelved by:
,