HomeMy WebLinkAbout06080163 Application
CALL A-1 EXPEDITORS IiV /I <"
City afCarmel/Clay Township 695.3514 Permit #:uoe 8 0 ,~
RESIDENTIAL IMPROVEMEN'PE60WI<fJNIPBRiMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
r
m
3if7-73i8
4Cod7g
'(
BUILDER of
RECORD:
NAM
r
J-I.
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
Lbi
AXiHK
CITY
oce dc:o ..L
ht'~._..... J I BESTMETHOD~c:.ONTAcr:
~ -LXEe5 ti::)(y)~, COm
57/-q/53
~I 2fJ
FAX
LOCATION
& PROJECT
INFO:
STREET ADDRESS
dd
LOT # SUBDMSION NAME
I
ZIP
33
SECTION ZONING:
$-
SQUARE
FOOTAGE: ~
ESTIMATED COST OF CONSTljUCTION:
(EXQ.UDING LANO VALUE) R:lLJ.3 0
NAME OF UTI VATlON CONTRA OR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
-.IDH
O(bOdN~
TYPE OF CONSTRUCTION:
~SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
~m.Ch'
TYPE VEMENT: PLUMBING CONTRACTOR:
N~~'Ei&:t E ~'J.I E.. 6m,"f.h
~,~w ) 'Plumber's Indiana State License #:
. "'~ ,,~S}'O+.s' tot 7 ry 7
~~~~~:F~:~~::;e::e~::IP~:::~~::~::~:~ndments
~~O~t~/- .s'~ i9~ 1:rw6lfu Plumbing Code w/lndiana Amendments
'VA r J'; '9"" (M(i1f-Famlly Construction Code)
PROJECT INFORMATION: '1 o~ "'C
DATION TYPE: (Check all that apply for the new
Early Release . /' Manufactured./ ction area)
Permit: _Y...k::...N. Trusses: ....k:::...Y_N
1<-7 . /' 0 CRAWLSPACE
Lot Split: _Y LN Sump Pump: ....k:::...Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y ~
o ...J'OST & BEAM I
t:a' BASEMENT
WALKOUT:_Y ~N
--'"--'''1
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this permit is vilid oq:Jyjh~RIl~~Of~~ ~~ (\T~\\ j
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy i~~) ~Il...~:1nona.d.bffi{e:~ \ \ \ \!
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 61? IA 12}regaraing expiration \ \ 'i 'II
time frames for beginning and completing construction. , i lJ \ 1 I I j
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any :. "e the ~f W1cfpr 'Jnnf5: ' \ \ ) i !
Structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the1~Zo g ordWface4f ~arfde'" \ Lj I
Indiana -1993" (2,289) and amendments, adopted under authority of LC. 36;7 et seq, General Assembly of the State of lndi4H d Acts amendatoryW
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that IfI1= c \ " '
or occupied pnti! a Certificate of OccupaIJcy has been issued by the Department of Community Services, Carmel, Indiana.
, Q, LOll; A, B;lI..hSONG--f!E.tJl:NE. \
Print Date
Rough'!
run -
Reviewed/Approved: Dept. of Community Services
~ S:Permlts/FonnS/lLP RESIDENllAL
~
OFFICE USE ONLY: ******** *************** *** ** **** ** ******** ******* ~J** ****** **** *** ******
Filing Fees: /O~. 00
INSPECTION EQUIRED: l '1
~ =-<.... Base Inspections: ;:;2 '7,? <)(; # Cha~ged Re-
c.. Upper ~tin~ Under Slab 0 ReVlews
Cert. of Occupancy: , C-3 . 51 I
If} GI. cJO.
/l TOTA~: ;ff
~
Site
P,R,LF.:
Additional Fees
3fjO
(Date)
Fee R