HomeMy WebLinkAbout05030013-ApplicationPROPERTY
OWNER:
Permit #:
APPLICATION
For Single Family, Multi-Family, & Two Family: New Structure_s, Additions, R~models, & Accessory Structures
~, PHONE , FAX
, ST TE ZIP
BU[LOEPJS EMA[L AD6RES$ 'JRT BES'T M ETHgD O ~F CONTACT~ /~.'~
PHONE FAX
STAT6
ZIP
LOCAT/ON
& PROIECT
INFO: FOOTAGE:
SINGLE FAMILY
TOWN HOME
TVVO FAMILY
# of unitS:
[] MULTi-FAMILY
#of Units:__
RESIDENTIAL(For
Additions, Remodels, Etc.)
~ Release y
Permit:
Lot Split: ----Y
--PE: - __'- -;-T:
[] NEW STRUCTURE
~ ROOM ADDITION(S)
[] PORCH ADDITION(S)
[] REMODEL
[] ACCESSORY BUILDING
DETACHED GARAGE
[] ATI'ACHED GARAGE
[] DEMOLr~ON
Manufactured ~N
Trusses: Y
Sump Pump: Y __~
Plumber's
Which plumbing codes will be applied to Ute construction:
[] InternaUonal ResidenUal Code w/~ndiana Amendments
[] Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
~[~.~J~LT~[~: (Check all thatapplyfor the new
construction ama)
~/~RAWLSPACE [] POST & BEAM
[] SLAB / [] BASEMENT
Does any part of the property lie within a spedal Flood designation area: Y ~ WALKOUT:Y ~NN
dwellings, add~ons, remodels~ structures, t~-'~rmit is valid ~
witl~180 day~ of the date o£is~uance of the buikltog permit, and must be co~m~ pJ~e ~ ~18 m..ontbe o.f ch~
issuance date. Class I structure permits are subject to chc General Administeat/V//R/fle~l~'t/~Ilt/d//ut/t'~S~ t ff~I~ld ll[~t~ammg exp~rauon
time frames £or beginning and e~t~. ~r~c/~> wiIh
I, the undersigned, ~gree that any construction, ~econstmction, enlargement,
structures requested by tkis application will comply w/th, and co?otto to, all appl/ca~b~ ~s, ce o.t carme~
Indiana - 1993~ ( Z~ 289) and amendments, adopted under authont7 of
thereto. I further cerUfy that o~ly kitchen, bath, and ttoor drains are anrmected
used of~ccupied until a CertLrJcatc of Occupancyhas been issued by r4)e Department oX Commumty~ ~rmel, lnctmlm.
/XTUW.~a/~- ~./v~ / ~L-- t~r ~ - /. .
Signatom of er or Authorized Agent- Print / - ' Date
Lower Footing Under Slab
~f Community Servtces
Cert. of Occupancy:
P.R.I,F.:
Renews