HomeMy WebLinkAbout07020102 Application
City of Carmel/Clay Township Permit #:()? olD I DJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
PLufcRftr:.
ETT Co~tR\
PROPERTY
OWNER:
PHONE:
'3/1-3Lj~-ioL 1
FAX:
SAW\6
CITY:
CAR-L-
STATE:
ZIP:
~O32...
ZIP:
&033
ZONING: s!
SQUARE A''''17 G j I
FCOTAGE: r I:::' ,.. d
. "::> .
ESTIMATED COST OF CONSTRUcnON; ,L>.
(EXCLUDING LAND VALUE).' " I () ('j)O:" a
.,r
:/,
; i r'\~ i
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNlY WELL ANDIOR SEPTIC PERMIT #'S (IF APPUCABLE):
o International Residential Code wI Indiana Amendments
o Unifonn Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for theinew
construction area) ~
o CRAWLSPAC~NS't~ BEAM ~PIER
~~:?~~5111reWlll~~~~Y-+N )
For Single Family and Two Family dwellings. additions, remodels. and/or accessory S~f~l1hQ~rnYb~' ~ 1: ~9~e~ces wiclun 180
days of the date of issuance of the building pennit, and must be completed (Certificate of6ccupu\cy\S'tuc . . ! ln3nitis o' ate. Class I
structure pennits are subject to the General Administrative Rules of the St.ate of Indiana (Se$.,6f{1F lID I ~ ~nl es for beginning and
completmgconstruct~\""" _I\.O,W\E.L I
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or il~O-f.t ~e,.~\~ ~in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the StokAbI lhdiana, and the ..~ht\5n.1iI1ance of Cannel Indiana -199r (Z'
289) and amendments, adopted under authority of I. 7-et-seq,. eneral Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected e sanita~ sewer. I hi er certify that the construction will not be used or occupied until a Certificate of
Q. a,ncy has been issued by the Dep ment of C unity Services, eI.Indiana.
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
)i'i RESIOENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
~yLN
~yXN
Lot Split:
OFFICE USE ONLY: ***
INSPECTI
~pper FO~ La
~~U9h ~ Meter Base
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
i8( /)E.C.k
Manufactured
Trusses:
Sump Pump:
~y <N
~y ...2LN
'.' ,.,
TAX MAP PARCEL 'I:
"f I:
.j' "
t'l ....
o 2007
)
PLUMBING CONTRACTOR: #-
L___.tt/ .
"V I
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
Z//8/01
Date' I
*****~rttJ** ***********************************************
7jJ- t( Fi' 9 Fees:
U d SI b Base Inspections: I t',fJO
n er i! 5.-'?,. J:"'.()
Cert. of Occupancy: ",2 :J'-
P.R.I.F.:
,
C '(t1. Co f1/SJ-) ''2 . Z6 'a1
Reviewed/Apploved: Dept. of tommunity Services (Date)
S:Perrnlts/FonnS/lLP RESIDENTIAL
# Charged Re-
Reviews
Additional Fees
~ TOTA17
(V_~J-- ,
Fee eceiv by:
?J .:(::< 0, CO
f rUt( /1/iJA
; I ~I~ 1- - '-- Date