HomeMy WebLinkAbout12100070 Application (2) f
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°°+,o p`e_= REVISION / PLAN I NDMENT or ADDENDUM to STATE RELEASE
C ; For.Commercial, Install ••3r• 7 r dnsYnal, or Multi-Family Projects
--° City of Carmel;Departme`fro 'll . 4,entices M 1V 0 9/ yO C. F}-7C_ `1 13 9,5
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Permit has been issued: _ Yes No l „cif yes,PERMIT�.it /f1/J �+'0 070
BUILDER of NAME: PHONE: L_rLCi(� FAX':
RECORD: Clevp0 pi C v'e✓' 0 3 1 7- 753- 9S)
STREET ADDRESS: y STATE: ZIP:
9)07 i'Verrwoiic L , P/o h-he II -7`70 Li 16 /4 cc
BUILDER'S EMAIL ADDRESS: I BEST METHOD OF CONTACT: /% /J
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LOCATION PROJECT NAME: / n LOT nd SUBDIVISION NAME:(If applicable)
& PROJECT /INN up0,irctol_>°.S 1s r�y� ,ia�P ✓,
INFO: ADDRESS OF CONSTRUCTION: • D�
a5 a5 w Iy I ' sr, Wcsi-PIeciJ )
NEW SQUARE FOOTAGE OR e)(I S:hb1 NEW ESTIMATED COS;yT�/ l NEW FOUNDATION TYPE: A-CRAWL SPACE
AREA AFFECTED BY REVISION:S. 1-e. �' OF CONSTRUCTION: YC 9Or O(/ C POST&BEAM 0 BASEMENT (Walkout_Y_N)
STATE COMMERCIALREI t`A on,�r p/� DATE OF'AMENDED RELEASE: NEW�//�$(C��}OPPE(S)OFD n FDN O STR ❑ ARCH ❑ MECH o PLUM
DESIGN RELEASE#: Subject td/ FOR 1-4STRUCn L-A E:� UU 'EELECra0`SSPKLR OTHER(S):
77 "^'WtMtN».%bl ail in... S /f,�2G/�
#of Floors: DEPI,yr 8tat L. ,0 NO BG C f ry�kY t'� COP/C.S .CON U ON TYPE: O PANCY CLASSIFICATION:
FCARMEL/Nit;SnE�jjR ICtS,
ON QG C' b
DESCRIPTION'OF Asti NT/ft ON,AND/OR STATE RELEASE`ADDENDUM/UPDATE INFORMATION:
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Class I structure permits are subject.to the General Administrative Rules of the St of Indiana(See 675 IAC 12)'rEgardmg expiration time frames'for
beginning and completing construction.
I,the undersigned,agree that any construction;reconstruction enlargement,relocation;or alteration of a structure,or any change in the use of land or
structures requested by this application will comply with and conform to all applicable laws of the State of Indiana,and the"Zoning Ordinance of Carmel
Indiana'1993"(Z=289)and amendments adopted under authority of I.C.36-7 it seq,Genera]Assembly of.the State of Indiana,and all Acts amendatory
thereto. I also certify that only kitchen;bath,andfloor drains are connected to the sanitary sewer. l further certify,under the penalties of Perjury(Indiana
Code 35-44.2-1)that all of the information I have provided in this Application and other documentation is true and accurate to the best of my
knowledge and belief,and that I have not knowingly or intentionally provided-or omitted any information that would tend to hide,obscure,or
otherwise mislead the Dept of Community Services regarding the truth of the matters addressed. I also agree that the construction will not be used
' or occupi.. until a CertiBeate of Occu pancy has been issued by t. Departm/eentt�/oiConimunity Services,Carmel, ndiana.
001 7 ad 7'It 1 -7:g la-Cr L-CA/_3
tSrnat• eofOwner orAuthorized'A9-, 'rint Date
OFFICE USE ONLY: ****** )K*x**************************************************************
NEW INSPECTIONS REQUIRED: ?LAN AMENDMENT/REVISION • 1313 .00
Upper Footing Lower Footing Under Slat
ADDITIONAL SQUARE'FOOTAGE:
NEW INSPECTIONS REQUIRED:
Rough In Meter Base Final (If:additional inspections other than what already remain o •• •-rmit are required.)
(\'�� TOTAL: 4313.oc)
Ufl1 lit anal∎e ii 6113113 r(An c' t6. 13
Reviewed/Approve Dept:of Community Services (Date)
s9ermits/Forms/Plan A Commercial,Intl,Inst,Multi Fee Recely by: Tate