HomeMy WebLinkAbout06030001 Application
City of Carmel/ Clay Township erA. Permit #i)"D300D I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
(Vc..t
STREET ADDRESS
- ',,-..
BUILDER'S EMAIL ADDRESS
.,
cI
NAME ...../
QI~
PROPERTY
OWNER:
PHONE
FPiX
CITY
STATE
S)'i)
ZIP
C"
-'>
e/-
BEST METHOD OF CONTACT:
PHONE
5-(6 -()
FPiX
STREET ADDRESS
I 1.,"1 s-' ?
ZIP
\4 . 32..
ZONPvr })
LOCATION
&. PROJECT
INFO:
LOT #
53'1
{:' w6L
C'T-
,j' t~h-v
SUBDIVISION NAME
V,€,"-I1"~_
ADDRESS OF CONSTRUCTION
SEWER UTILITY
PROVIDER:
/2-./
CI.t:?. U/:t>
.<{'
'J Q.
WATER lJTlLITY-r-
PROVIDER: 4-......,
,.-.} ,
SECTION
000 2.
...........c.---.-- .SQUARE.... '7' y'c .:)
,......\ I';'~ /;'C;'. " '.'FOOTAGE' " . ..( ;>
lir\ i;-::. ~tf~) ..:, Ii \\.:...0:, ",' I-~,.
ESTIMATEO cosT; o~jaoNsTRucri6fr > 5"'.C:"~i/ i I"
(EXCLUDING LANDVAUUE) lp () <!:, IU I' CI.
J!r'\ ! !Il ,!
IU'I ill 2006 Ii! Iii
: L\ ItLt)j
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI.FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
CiJ.-1ijEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PLUMBING CO~TRACTOR: ' i
1-\ . R . J"" zKJ;, /II rf}'oAA-' hi ;v-f--J
Plumber's Indiana State License #:
t:-J' '5 g-'t o'~a jl ()
Which plumbing codes will be applied to the construction:
o International Residential Code wjlndiana Amendments
~ifonn Plumbing Code wjlndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release / Manufactured / FOUND~TION TYPE:
Permit: Y VN Trusses: Y :~ N constructIon area)
- - - ~ 0 CRAWLSPACE
Lot Split: _Y ~ Sump Pump: -JL.Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y 4
(Check all that apply for the new
o POST & BEAM ~
0-4lASEMENT
WALKOlfT:_ Y_N
Fo~ Si~gJe Famjly and Two F~ily ~.~.~l~i~~~,..~~~i~i~m~ r~IE.Pqelf~~,!!)of f~tJS~~90'1~~~tur~s.' this permit is valid. only if co.ns~ruction commences
WIthin 180 days of the date of Issuance oftfie buddrhg ~hih~n4 .t;nU~1 D~,!-,;!,!,p'let1d ~Cernflcate of Occupancy Issued) WIthm 18 months of the
issuance date. Class I structure per@!~_*K~hbrtct:tlj~~HiefalVAornifii~tr1tiv~'Rmt?t/flhe State of Indiana (See 675 lAC 12) regarding expiration
eIPe[~~s;JPr'p~g.iJ1Jlj"g1.nd!CD1npleting construction.
I, the undersigned, agree that any cons.u~~~l}. rri)9~sPl\"tj:Qf!~~~mer>>:, ~m:ll.t~~&"~~ation of a structure, or any change in the use of land or
structures requested by this applicatiorL~oinplr'wifu~~&'tttrlHin ~Ol, a'U ~~ab1l;Jij"~&:Qt fge State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - I99r (Z~ 289) and amendIT{~~ ~liif.ty pftf)iAV etf~W~.tA~~embly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitChen, bath, and floor drf~6~r,r)~cted to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupancy has beeO'i~~ea oy tlie Department of Community Services, Carmel, Indiana.
8~ M/~ Ph 4 ~4/') 8/YJ-vr-' $ J~/~I.
Signature of Owner or Authorized Agent Print ' Daol
OFFICEUSEONLY:**************************************************J7********************
Filing Fees: / , .;). 7--. :J ()
INSPECTIONS REQUIRED: I . <') '"
"';;';;'a - "M)~ . , Base Inspections: ~" 1, {v # Charged Re'
~r FOO~ ower Footl r Slab .-, ./ ReViews
Cert, of Occupancy: .::. - J
P.R.I.F.: ! ;}... 6/, 00 Additional Fees
~~f ~1oLf, 30
e Received by:
Site
I
ReviewedjA roved: Dept. of Community Services
S:Permits/Forms!ILP RESIDENTIAL