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HomeMy WebLinkAbout05090052-ApplicationRECORD: PROPERTY OWNER: Permit #: J or Znstitutionah New Structures, Additions, Remodels, Tenant finishes, &Accessory Buildings NAME PHONE ~ FAX Address of Shelt Building (If different t~an Addres~ of Construction) SCOPE(S) OF RELEASE: PROVIDER: AND/OR PERMtT #'S (Ii' Appllcabte): YE~ [~ NO BLDG, CONEFRUC'E[ON TYPE: COMMERCIAL (privately owned hospitals and medical offices/centers are commen:lal) .P- : -. -_VEM--.i : [] ADDed'ION [] Room(s) [] Porch NEW 'TENANT I ~CUPANCY CLASS[ Perm~ Lot Split= _Y. a special Rood Plumber's Indiana State License #: Upper ~ung