HomeMy WebLinkAbout06110034 Application
City of Carmel/Clay Township Permit #: () (p l/d08t
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATIO
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NPJI
FAX:
575 b?3/'i-
ZIP:
PROPERTY
OWNER:
FAX:
CITY:
STATE:
ZIP:
LOCATION
&. PROJECT
INFO:
TYPE OF IMPROVEMENT:
If NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDINr
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
1111:1 'I' !
ESTIMATED COST OF CZONSTRUCTI ,': I :,
EXCLUDING LAND VALUE) Iii! 8 ; f I III
fL.J _I if
'- ilL. ill
.-~e/I
--
TAX MAP ~CEL " .... --__
7-/u~o(cxm- {Xff-
PLUMBING CONTRACTOR:
ltaV'l1~ o-.sn~ ~C-
Plumber's Indiana State LIcense #:
(If /0')00 () I
NAME OF lfTIlITY CAV N CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~INGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Which plumbing codes will be applied to the construction:
~ntemational Residential Code w IIndiana Amendments
~ Uniform Plumbing Code w/Indiana Amendments
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
OFFICE USE ONLY: ********************;;********************************* -*
Filing Fees:
INSPECTIONS REQUIRED:
c:..Up~~g ~wer FO~ Under Slab
c;oUgh~~ ~nal ~
.
'I ll-LS-
Reviewed/Appr Dept. of Community Services (Date)
S:PermIts/Forms{IlP RESIDENTIAL
~:71
53 S-tJ
I J-tl (}O
.
# Charged Re-
Reviews
Additional Fees
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