HomeMy WebLinkAbout05020054-Application ~ it #:
Perm ~
IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Ac~_-ssory Structures
BUILDER of PHONE FAX
RECORD:
PROPERTY
OWNER:
LOCATION
& PRO3ECT
INFO:
SUBDWI$10N NAME
PHONE FAX
NAME OF UT[I. ITY EXCAVATION CONTRACTOR; fl.~N COMMISSION / EZA / BPW DOCXET
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units:
[] MULTI-FAMILY
# of Units
[] RESIDENI~L (For
Additions, Remodels, Etc.)
Early Release
permit:
N
EW STRUCTURE
ROOM ADDITION(S)
[] PORCH ADDITION(S)
[] REMODEL
~ ACCESSORY BUILDING
[] DETACHED GARAGE
C3 ATTACHED GARAGE
[] DEHOLITION
ESTIMATED C~ST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
PL -BIN= NTRA- : :
Plumber's Indiana Slate License #:
Which plumbing codes will be appti~d to the construction:
~] ~ntemational ResMenfla! Code w/Xndlana Amendments
[] Uniform Plumbing Codew/ZndlanaAmendments
(Multi-Family Construc'don Code)
Manufactured ~L~: (Check all that apply for the new
Trusses:
Lot Split: Y__z~_N Sump Pump: _/~_f N
u
~ any pa~ of ~e pm~ lie wbin a
For S~e Fa~y ~d Two F~y dw~gs, ad~
~e frm~ for ~n~g ~d complet~g co~t~c~on,
~d~ au~odt
o
Print
Date
Reviews
Cert. of Occupancy: ~-~ ~0
P.R.I.F.: ~ ~ ~7 ~;~ Add~ona~.~