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HomeMy WebLinkAbout05110150-ApplicationCity of Carmel~Clay Township ~C'5 \-- permit # RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures RECORD: STREET ADDRESS BUILDER'S EMAIL ADDRESS PROPERTY NAME OWNER: LOCATION & PRO3ECT INFO: PHONE FAX CiTY STATE ZiP BEST METHOD OF EONTACT: STREET ADDRESS SHONE FAX r i SUBDIVISION NAME __ ADDRESS OF CONSTRUCTION PROVIDER: CT~'~jOb PROVIDER: SECTIO~ PE :F ON R:: -'N: ~ SINGLE FAMILY /C] TOWN HOME [] TWO FAMILY # of units: []] MULTI-FAMILY # of Units: [] RESIDENTIAL (For Additions, RemodeJs, Etc.) PR- E ~ NF-'MATION: Ear y Release Permit y ,~r _N ESTIMATED COST ZIP SQUARE TYPE OF IMPROVEMENt: PLUMBIN( NEw S RUC URE C/ ROOM ADDITION(S) Plumber's Indiana : {~ PORCH ADDITION(S) [] REMODEL ~ ACCESSORY BUILDING ~plmbi~ ~es will ~ appli~ to ~e mn~m~ion: ~ D~ACHED GAUGE ~ International Residential Code w/Indiana Amendmen~ ~ A~ACHED GAUGE ~ Unifo~ Plumbing Code w/Indiana ~endmen~ ~ DE~OL~T[ON (MultFFamily Con~ru~ion Code) Manufa~ured FOUNDA~ON ~PE: (Check all ~at apply for ~e new Trusts: Y ~ N constru~on area) Y~N Sump Pump: ~ Y N ~ C~WLSPACE ~ PO~& B~M ~ -- ~ S~B ~ BASEME~ ~ lie within a sp~l Floo~ designation ama: Y ~N WALKO~ y~ For Sin~e Fa~y and Two Family is v~d only ff construction commenc~ ~thin 180 days of the date of lssu pancy issued) ~t~n 18 months of the issuance date, ~lass I structure peri--State ~f'~diana (See 675 AC 12) regardinR e~irat on I, the unaemgned, agree that any construction, teco~ or ~t~ture. or any change in the use of l~d or s=ucturcs requested by thN apphcation ~vi~ comply ~,~ffd ~fifQ (~~na, and the 'Zon~g O~ce of C~md india- 1993" (Z-289) and amendments, adopted under aurhority~f I.C. 36 ~er al Assembly of the State of In~ana, ~d ~ Acts amendatow thereto. I ~r~ cert~y that o~y htchen, bath, ~d floor drains are connected to th~'sa~i~a~ sewer. I further cer~y that the construction wi] not be used or occupi~ until a Cerriacare o[OccupancyMs been issued by the Department of Comnmnlt. Semites. C~meh Indiana. e Inspe~ions: Reviews Ce~. of Occupant: al P.R.I.F.: // ~ goo~ti0nal Fee~