HomeMy WebLinkAbout05050202-ApplicationPermit #
New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
NAME PHONE
PHONE FAX
STREET
STATE ZIP
ADDRESS OF CONSTRUCTION SUITE # (If ADblicable) //x?/,~
~d~ ~ Shell Building (If di~t ~an Add~ ~ ~n~n) ~t · and Su~sion (If ~pl~able]
SCOPE(S)
WATER bT~UTY
PROVIDER:
PLAN COMMISSZON / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTy WELL AND/OR SEPTIC PEP, NIT #~ Of Applicable):
# of Room: JR: [~ YES
C3 PLUM
EST[MATED COST OF CONSTRUCT]ON:
(EXCLUDING LAND VALUE) ~.~
~c subject co the
designation area:
Plumber's Indiana State License #:
f with, and conform to
~he Departme~
OFFZCE USE ONLY: ************************************************
INSPECTIONS REQUIRED: Filing Fees:
Under Slab Base Inspections:
~te Cert. of Occupancy:
# Charged Re-
Reviews
Additional Fees