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~