HomeMy WebLinkAbout05040173-ApplicationFor Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
RECORD:
NAME
STREET ADDRESS ~g~Jc JOO CITY
BUILDER'S EMAIL ADDRESS
PHONE
STREET ADDRESS CITY
PHONE FAX
~ ~'~&~ ~ q70~
FAX
FOOTAGE:
Ig, OOo
FAMILY
HOME
[] TWO FAMILY
# of units:
[] MULTI-FAMILY
# of Units:.
[] RESIDENTIAL (For
Additions, Remodels, Etc.)
'~- --. N-- L- :N:
Early Release
Y.
[] NEW STRUCTURE
[] ROOM ADDITION(S)
[] PORCH ADDITION(S)
~ REMODEL
[] ACCESSORY BUILDING
[] DETACHED GARAGE
AI-rACNED GARAGE
[] DEMOLITION
Sump Pump: Y ~
Plumber's Indiana State License #:
Which plumbing co~es will be applied to toe ennstn~tion:
[] XntemaUonal Residential Code w/Indiana Amendments
[] Unifmm Plumbing Code w/Indiana Amendments
(Multi-Family Constru~on Code)
F N-' - --TY=-~: (Check all t~at apply for the new
construction area)
CRAWLSPACE [] POST & BEAN
SLAB I~L BASEMENT
Does any part of the propert~ lie within a spedal Flood deaignaUon area: __Y _,~__N WALKOUT: YYL N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, thLs permit is valid only if constractian commences
within 180 days of the date of issuance of the building permit, and must be completed (Cer tillcate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Kules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
I, the unders/gned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in thc use of land or
stnactures :~e~ested by this application will comply with, and conform to, all applicable laws of the State of indiana, and the '7oning Ordinance of Carmel
indiana- 1~3 (Z-289) and amendments, adopted under authotity of LC. 36-? et seq, General Assembly of the State of indiana, and all Acts araendatory
thereto. I further certify that only kitchen, bath. and floor drains axe connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Cerr. iBeate o£Occ~rt~ncyhas been issued by the Department of Community Services, Carmel, Indiana,
Signature of Owner or Authorised Agent Print Date
Additional Fees
Fee Receive