HomeMy WebLinkAbout07020016 Revision Info
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REVISION / PLAN AMENDMENT or ADDENDUM to STATE RElJEASE
For Commercial, Institutional, Industrial, or Multi-Family Projects
City of Cannel; Department of Community Services
Permit has been issued: I Yes No. If yes, PERMIT #: 01rJ2.00/b I
BUILDER of NAME: PHONE: FAX: ,
. RECORD: G:/. wtArcl (2.o<7e {?eV'e'lo/"I1t-e41+ G:J. l L C ?e>e>~4-717 X 114 1.17-7/4-2
STREET ADDRESS: . CITY: STATE: ZIP:
7101 ChMtV{brd7vt'({e tca",J I VI d t 4./"" PO //'7 /1'1 . 46zf1-
BUILDER'S EMAlL ADDRESS: BEST METHOD OF OONTACT:
qfoeve _ /,,0....11141111 @ -erJwardto7edP1Y,. Coli1
LOCATION PROJECT NAME: /t/-eXdJ.1drid - f7v/ld ;~4 ('2- LOT # and SUBDIVISION NAME: (If applicable)
& PROJECT
INFO: ADDRESS OF CONSTRUcnON: /7070 P-eYlY/;11 /Vtrl1td 9/rce+-
NEW SQUARE FOOTAGE OR NEW ESTiMATED COST , NEW FOUNDATION TYPE: ~B 0 CRA~l SPACE
AREA AFFEcrEO BY REVISION: OF CONSTRUCTlON: o POST & BEAM 0 BAS ( Walkout _ Y _ N )
STATE OOMMEROAL DATE OF AMENDED RElEASE: NEW SCOPE(S) OF o FaN ~ STR ft( ARCH "" MEOi ~ PLUM
DESIGN RElEASE #: 721 b~:' 4/1'2/07
RELEASE: )4iELK 0 SPKLR OTHER(S): .
. 3 ]I,( NO I BLDG. CONSTR~cnON~: Y - E7
# of Floors: ,. E1evator/Uft: Q YES OCQJPANCY CLASSIFICATION: ~ -2
DESCRIPTION OF AMENDMENT/REVISION, AND/OR STATE RELEASE ADDENDUM/UPDATE INFORMATION:
11ff:. (0(;4/ rerYYl':.r Wa.? it;~v-ed b4fecJ 011 d fbVHclAh'on ~lea(4 rWl -fhe ~k. .
tfiuUJ -fife" {it" p/avv, all,) '7Pet;;fr'cIf1hOlA.r, were /iubHoft'tt.,..d -to dll d re ","ewe) by
-fh~ ~fyJr' ai'll <I{ . ~dA;'J CtJIM1r(lcHrJVI tJeq(1/f R.dt7dk: Wf/y)*ued.
Class "I struc~ permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for
beginning and completing construction.
I. the undersimLed, agree that any consrruction, reconsouction, enlargement, reloc;ation. 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 State of Indiana. and the "Zoning Ordinance of G:armcl
Indiana -1993" (Z-289) and amendments, adopted under authority of Le 36-7 et seq. General Assembly of the State of Indiana. and all Acts amendatoty
thereto. I also certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I. further certify, under the penalties of Perjury (Indiana
Code 35-44-2il) that all of the information I have provided in this Application and other documentation is true and accurate to the best of my
knowledge and belief, and that [ have not knowingly or intentionally provided or omitted any infonnation that would tend to hide, obscure, or
otherwise mislead the Dept. of Community Services regarding the truth of the matters addressed. [also agree that the construction Will not beused
or aceu . d until a CerciEicate of Occupancyhas been issued by the Department of Community Services, Carnie!, Indiana.
9N!veJ1 M. IIvVIffd'I1t1
Print
4/tzc/o7
Date .
OFFICEUSEONLY:************************************************************************
, V NEW INSPEcnoNS ",?",RED, PlAN AMENDMENT/REVlSION ~ f:f1({flZJ
'jf-- f~r'~~~e~~i9G~:~ PfflJ;/DDrnONALSQUARE FOOTAGE' L L!7de:r!~
. ~NEW INSPECTIONS REQUIRED: 0 fj () :l D () / )
. Rough In Meter Base Final Site (If addltlonallnspectlons other than what already remain on the exJstlng pennlt are required.) ~
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