HomeMy WebLinkAbout07090144 Application? or C.,q
City of Carmel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME PHONE FAX
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RECOR
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STREET ADDRESS-)
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C?Cl?ilivoa ZIP
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BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
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PROPERTY E PHONE FAX
OWNER: :-WVfL.. I VDU[
STREET ADDRESS s?a1ecFgS?o CITY SATE ZIP
LOCATION
&PROJECT LOT z F/s?ls
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INFO: ADDRESS OF N57YC`T``
1
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69 SQUARE
3 TAGS:
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So \ V tJYYI
SEWER UTILITY
OVIDER
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WATEK/EHty
PROVIDE ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
PR
: C
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION ! BZA! BPW D
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT A5 (IF APPLI /,??
CABl?J '
TY F CONSTRUCTION:
, SINGLE FAMILY
bG TOWN N HOME
O TWO FAMILY
# of units:
D MULTI-FAMILY
# of Units:
O RESIDENTIAL (For
Additions, Remodels, Etc.)
PRO) ECTINFORMATION:
TYPE OF IMPROVEMENT:
NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
D REMODEL
D ACCESSORY BUILDING
D 'DETACHED GARAGE
O ATTACHED GARAGE
D DEMOLITION
PLUMBING CONTRACTOR:
Plumber's Indiana State License #:
r-? OJT,, c\ 9
Early Release Manufactured
Permit: _Y ? N Trusses: ,/Y _N
Lot Split: _Y ?N Sump Pump: ? Y -N
Does any part of the property lie within a special Flood desi
For Single Family and Two Family dwellings, additions, i
within ISO days of the date of issuance of the build"
issuance date. Class I structure permits are s'ubjcet a rja"
time fr ies
I, the undersigned, agree that any construction, reconst [ir
structures requested by this application: will comply v,1rh, 14`c
Indiana - 1993' (Z-389) and amendments, adopted under aut\
thereto. I further certify that only'_titchen, bath, and floor dA
used.or oecuoied until a Cero ' ce ofOcrurancvhgs been
Agent
ed by the Department of Community Services, C:u Fv
Print Date
Which plumbing codes will be applied to the construction:
14 International Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
GZi` CRAWLSPACE D POST & BEAM
D SLAB D BASEMENT
area: _Y "?' N WALKOUT:_Y N
T
or} tuctures, this permit is valid onl dco e!
iple(Certificate of Omupan pcd ?tf?t L?QQ rr+?vt 1,f
t Riof the State of Indiana ( dl(1? re,QSrdmga?l . u
eOnrling and completing construction.
dargcmrnt, rdncation,<u.aheratier. nfastructure, er. {hann????++ t tti?ce''))
Icrm m, alit laves of the State of Indiana. an r?"Zc3tfn?dHtaf
o?,CiJSi et seq. General Assenhly of the State of I aiaTta, and all Acts u
4 oc nnected to the sanina:- sewer. I further certify t at the construction
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OFFICE USE ONLY:
Filing Fees: b
ECTIONS REQUIRED:
3 ? G
;< cnaraed Re-
Base Inspections:
Upper Footi Lower Footing Unb
Cert. of Occupancy:
5 Reviews
Rough I stet Base inal Si (i l F
Addi
i
/ fl m. D 0
P.R.I.F.:
l /T6TAL: ees
ona
t
Reviewed/Approved: Dept d. `'Community Services (Date) `
S: Pemnts!FmrsntP RESmEN?at Fee ReceNed Dv: