HomeMy WebLinkAbout06030146 Application
,
Permit #:
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER:
NA?rL
STREET ADDRESS
/600 tJ.
(
(". LD'
PHONE
t"3I7)fi7.3 -;J7/.;J.
FAX
C 317 ,y73- /zt;Z-
~/. t)/~r",;/ a /,'
STREET ADC:R,ESS - . ~
I ieIICd7~JJ~:r3!jf4vc.,
SUBDIVISION NAME
CITY
2,' ,r,fle
STATE
+- .-L-
ZIP
'16017
'. '~~RESS OF SON<;TRUCTIO~ . ..sr -~
. :'t50 .:a/r .1.31 __ --.5./ .
~JATER UTILITY
PROVIDER:
BEST METHOD OF CONTACT:
I/~ PeN PM
PHONE
('3rJ 57/- :u.slF
FAX
('
/- ..la.3
STATE
ZIP
y.~ 3 Z
~
SEmON
ZONING:
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'$ (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUcrURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o .-ATTACHED GARAGE
(B" DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
Manufactured
Trusses:
_Y_N
_Y_N
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 PO~ & B.EAM
Lot Split: _Y _N Sump Pump: _Y _N 0 SLAB _._ D BASEMEN;r\....
Does any part of the property lie within a special Flood designation area: (,-'-~'f~'~:;~.~' _:c.. Y'ALKout\ ('c.' Y_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structu\~'s,\hi~'r?err;;j'~is valid only if cons~illctiJri commences
within 180 days of the date of issuance of the building permit, and must be completed (Cen'ific1.t~ of Occupan<;y i~u~f{ithiri\i8 rh~nths of the
issuance date. Class I structure permits are subject to the General Administrative Rules of th~'~at~ lof In~~ (%e &7sltA"e'12) r~gk!~irig expiration
. . time fram~s for beginning and co~pleting consth\cqo~.~.~____.j - \
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 ~ate\5f.lndiarul,;~ the ~Zoning O~91..nance ~f Carmel
Indiana - 199r (Z~289) and amendments, adopted under authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and'alrActs amendatory
thereto. I further certify that only kitchen, bath, and floor drains afe connected to the sanitary sewer. \1 furth_er^certifyth~t the construction will not be
used or occupi until a CenHicare of Occupancy has been issued by the Department of Commurii~rvices, Carmel, Indiana.
Pr,'nt 1) A-v ,d L- R.1t '7
Signature of 0 uthorized Agent
'3 -<.,0- ~
Date
OFFICEUSEONLY:************************************************************************
Filing Fees:
Base Inspections:
Upper Footing
Rough In
INSPECTIONS REQUIRED:
Lower Footing Under Slab
Meter Base Final Q
Charged Re-
Reviews
Cert. of Occupancy:
P.R.I.F.:
Additional Fees
.100(,
Reviewed pproved: Dept. of Community Services
S:PermitsjFormsjILP RESIDENTIAL