HomeMy WebLinkAbout07120034 ApplicationCity of Carmel/Clay Township Permit #a 1'2C0
RESIDENTIAL HVIPROVEMENT LOCATION PERMIT APPLICATION
" For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME-
J1FS E S E Jn!C PHONE
&3S--Z FAX
'-25.30
RECORD:
STREET ADDRESS
317 S STMY .4 VF CITY STATE
NpiAA,q C ZIP
,v 4o? o
BUILDER'S EMAIL ADDRESS
S'FS i v c Z 6 4 oL - co,-f BEST METHOD OF CONTACT:
PROPERTY
OWNER: NAME #A,9 -€
Dd? `F DST G PHONE 77(o-0667 &"1 2- N- 7 7S
STREET ADDRESS
44 s P_Cju CITY STATE
/It/ ZIP
a3
LOCATION LOT R SUBDIVISION NAME
SECTION
ZONING:
S'
& PROJECT -
INFO: ADDRESS OF CONSTRUCTION SQU
FOOTAGE:
YAMg-
SEWER UTI
PROVIDER: 1' WATER UTILITY
PROVIDER: i
ESTIMATED COST OF CONSTRUCnON: /w
-
(EXCLUDING LAND VALUE) 0 Z '
NAME OF UTILITY EXCA ATION CONTRACTOR; RAN COMMISSION / BZA / BPW DOCKET
' V
S (IF APPLICABLE): I
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #
*
TYPE OF CONSTRUCTION:
X SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units:
? MULTI-FAMILY
# of Units:
? RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPEOFIMPROVEMENT'
? NEW STRUCTURE
C7 ROOM ADDITION(S)
? PORCH ADDITION(S)
5d REMODEL fjf AAA
? ACCESSORY BUILDING
? DETACHED GARAGE
? ATTACHED GARAGE
? DEMOLITION
PLUMBING CONTRACT
Plumber's Indiana State tense #:
PC &106163 Y
Which plumbing codes will be applied to the constnretion:
O International Residential Code w/Indiana Amendments
Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
Early Release L? Manufactured ?' cconstr cction arrN TYPE: (Check all that apply for the new
Permit: _Y _N Trusses: _Y N / ) ,(^,?ON
/? ? CRAWLSPACE ? 564jap 0?5
Lot Split; _Y ?ump Pump: _Y_ +? D SLAB G Et3T3
Does any part of the property lie within a special Flood designation area: T,YId?,?? ce `?} L{c?t4T N
For Single Family and Two family dwellings, additions, remodels, and/or accessory struTtEt?is'e j¢Ip(hcbns ?' '=m ences
within 180 days of the date of issuance of the building permit, and must be completed ( sate OS be u monof the
issuance date. Class I structure permits are subject to the General Administrative Rules of the Sta atndian 67fi4AC 12) regarding expiration
Lime frames for beginning and completing co an. r P^^,, AANN
1, the undersigned, agree that any construction, reconstruction, enlargement, relaxation, or altera?jj of "Pnge fn the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of to e of Indiana, and the'Zoning Ordinance of Carmel
Indiana - 1993" (Z-269) and dments, adopted under authority of I.C. 36-7 et seq, General Assembly of the Stare of Indiana, and all.4tts amendamry-
thereto. I fu terrify that Idtchen, bath, and floor drains are connected Lo the sanitary sewer. I further certify that the construction will not be
used or ue pie until a C sate afOccupancyhas been issued by the Department of Community Services, Carmel, Indiana.
F Sj194v'F,'z- 1 3o o
Signature
Agent
OFFICE USE ONLY:*************
INSPECTIONS REQUI
Upper Footing Lower Footing
Rough In eter Base
CV.
ved: Dept. of Community
RESIDENTIAL
Print \ Date
Filing F S: { /1
Sla Base I pections: ?/? 0 # RlevewwsRe-
Cert f Occupancy: j S4
gAdditional Fees
TOTAL: -AZ 3 Q /•' a6'