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HomeMy WebLinkAbout05070169-Application@ RECORD: Permit #:~~ RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures E~P. EET ADDRESS FAX ZIP PROPERTY OWNER: BEST METHOD OF CONTACT: PHONE LOCATION ZONING: &PRO.1EGT ~'~ ~ ! INFO: J SEWER tJ~J~L~ [ ~,*~ EST[MA'i'ED COST OF CONSTEU~FJON: I P,ow m UDING V^LUE) .U U.E ~ ~ CAUTI V ~ R~M ADD~ON(S) Plum~s Indiana S~ Li~n~ I R~IDEN~ [~r ~ ~r ~: ~.L ~~F~, ~ ?~ ~ Intuitional R~id~fial ~e w/Zndiana ~endmn~ A diU r~ ~ ~;" ~J[A~CHED~GE d ons, Retake s~ ~ ~,. r~ ~ ............ ........ ~ ,' ~ Un~m Plumbing C~e w/~nd ama Am~dmen~ ~ ~ ~ ~,.~L'~H~E~ ~LJVV~L~[~~ (MuiU-FemilyCon~ion~de) P;- - [ - A --: EaSy Rel~ .~ ~anufa~md ~: (Check all ~t a~y for ~e~w For S~e F~y ~d Two F~y dw~gs, a~iaons, rmodds, ancot acc~o~ s~e~r~, r~ p~t is v~d only ff consr~caon eomm~nc~ ~r~ 180 da~ of ~he ~re of i~ee of the bua~g ~, ~d mus~ be complet~ (Ce~ieate of Occupancy i~ued) ~ 18 monks of the ~u~ee ~r~ CI~ I s~e~ ~ ar~ subj~r ro r~ ~ne~ Adminisr~aw Ru~ ~ the S~te of lndi~a ~ 6~ IAC 12) r~g ~aaon amc ~ for ~ning ~d completing eonst~eaon. I, ~e unde~i~. ~ee ~r ~y cons~c~on, ~cons~caon, e~menr, rdoca~on, or ~r~aon of a s~c~re, or ~y ch~gc ~ ~e u~ of ~d or s~c~r~ requ~d by ~s app~ca~on ~ comply ~, ~d co~o~ to, ~ app~cabl~ ~ws of ~h~ Stare of In~a, ~d ~he ~Zomg O~ce of C~d ~- 1993' (Z-289) ~d ~, adopted und~ au~oa~ of I.C. 36-7 er ~q, G~ ~s~bly of ~e S~r~ of ~a, ~d ~ Acrs am~o~ · ~ro. I ~h~ c~ ~ar o~y ~r~, ba~, ~d floor &~s ~e co~r~d ro ~e s~r~ s~wer. I ~her c~y ~t the comr~eaon ~ not be o[~c~p~cy~ ~n ~ by the De~ of Communi~ Se~c~, C~el, InCa. OFFICE USE ONLY: ************************************************************************ · Filing Fees: , INSPECTIONS REQUIRED. ~ __ ~-.. - _ ...~-'--. _~.~.~ B~se Inspections: ~ # ?arged Re- upper voofingp Lower rOOUng uneer ~mD Kev ews occ .ano/: P.R.I.F.: ~) (~) Additional Fees Reviewea/Ap ) TOTAL: