HomeMy WebLinkAbout06070070 Revision Info
BUILDER of
RECORD:
REVISION / PLAN AMENDMENT or ADDENDUM to STATE RELEASE
For Commercial, Institutional, Industrial, or Multi-Family Projects ~. .
City of Cannel; Department of Community Services ac 01 6()lo 7, CU!o7 tx5&8 , CitJo 760isA
:jO(oOlC2:V-\ o(J)0"7CO&5 CisJo 70iXi
If yes, PERMIT #: OiflO 7 Oc;(p \ , CiJD"7 OO(c;:J, ~07Cf) .~
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/ Yes
No.
Permit has been issued:
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s;;Bq5R~\:e~ c;ilee\-
BUILOEII\S ~MAlL ADDRESS:
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PHONE:
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FAX:
00 31l-5b;).ij1Cbi
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CITY:
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LOT # an? ~UBDMSION NAME: (If applicable)
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ADDRESS DF CONSTRUcrrO. I,'.iqalo - ';;)q . ,""->cS>", l:)Q8S -ldq43 *,U<I,..l, 0, \2q ) -1~41,. I' p'.
\;:;lcQ7-I;;!l<lS ct\(<<,\>~o('e. ';::lQ::J:H;'ILi8 S',.;.r;D..k g. l::lq -ldQl\7::;.,,\"Sh'C IJ,Q53-eQ71 <:o",,~lli- Ct
NEW SQUARE FOOTAGE OR NEW ESfIMATED COST NEW FOUNDATlO E: 0 SLAB 0 CRAWL PACE
AREA AFFECTED BY REVISION: ----,. OF CONSTRUCTION:' 0 POST & BEAM . 0 BASEMENT (Walkout _ Y _ N) ..
LOCATION
&. PROJECT
INFO:
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BEST METHOD OF CONTACT:
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# of Floors:
Elevator/Uft: c;l YES ~o BLDG. CONSTRUCTION TYPE:
OCCUPANCY ClASSIACATlON:
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STATE CDMMERCIAL
DESIGN RElEASE #: 318911
DATE OF AMENDED RElEASE:
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NEW SCOPE(S) OF
FDN 0 STR 0 ARCH 0 MECH 0 PLUM
RELEASE: 0 ELEC 0 SPKLR OTHER(S):
DESCRIPTION OF AME~DMENT/REV)SION, AND/OR STATE RELEASE ADDENDUM/UPDATE INFORMATION:
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Class I structure permits are subject to the General Administrative Rules of th,e State of Indiana (See 675 lAC 12) re~~~i:li;'#<;;'for
. begmnmg and complenng constructlon. ,__.-~ /~ i'r;:J \, ~iJ "..;:.::.-.:J~, \ \ \ \ \
. I. the undersiQ11ed, agree that any construction, reconstruction, enlargeI1'l;ent; reloea. tion, or_alteration. -of a strU~~i' ~~!U;rb~~ or\ \ ,- '\' \
structures requested by this application will comply with, and conform to, all applicable laws of the State o.f In' , - "Zoning Ordinance of cm~'
Indiana -1993" (Z-289) and amendments. adopted under authority of LC. 36-7 et seq, General Assembly of the St\t't~_. diana, and all Acts 'Ill\~tOI'l\ \
thereto. I also certify that only kitchen. bath, and floor drains are connected to the-sanitary sewer. I further ce ~ th\Pffi!alt\espf ~ <u. .
Code 35...44#2~1) that all of the information I have provided in this Application and other documentation is acdtt\l~ to the best of my \ \ . \
knowledge and belief. and that I have not knowingly or intentionally provided or omitted any information d tend to hide , r \
otherwise mislead the Dept. of Community Services regarding the truth of the matters addressed. I also a~..1~~~ coon will not be used _
ccupied until a Cerrillcato of Occupancy has been issued by the Department of Community Services. c_ediana. _-.-----
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Print Date
Fee Received by:
o FI E USE ONLY: ****************************************
-Jy A NEW INSPECTIONS REQUIRED: PLAN AMENDME T/REVISION FEE:
'1N .5 dsSessed w;tfA.l!Yrt'S/l1ii/ '
Upper Footing Lower Footing Under sYab Pt"/l ADDmONAL SQUARE FOOTAGE.
~,.iNEW INSPECTIONS REQUIRED:
Rough In Meter Base Final Site (If addltlonallnspect1ons other than what already remain on the exI
Reviewed/ proved: Dept. of Community Services
S:PermIts/FormS/Plan Amend Commercial, Ind, Inst, Multi
TOTAL:
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