HomeMy WebLinkAbout13060063 Application CITY OF CARMEL / CLAY TOWNSHIP PERMIT # 13D60o63
COMMERCIAL(INSTITUTIONAL IMPROVEMF.NT LOCA7'ION PERMI'l APPLICATION
„,„ For NeH�Structures, Addilions,Tenant Finishes, Remodels,and Acccssory Structures
BUILDER NAME PHONE FAX
oF STv1taT 1� SH DE - X11 (�h1 '�l- 2� 8 • V 3�
RECORD STREETADDRE55 CITY STATE ZIP
� �I - �' 21'� �lyt�l, D'�2
E-MAILADDRE55 BEST METHOD OF
hade e m' JUI�P. r (�'�/Y� CONTA n . nl Q r /-
CL L O v
PLUMBING NAME STATE OF INDIANA
CONTRACTOR LICENSE NUMBER
PROPERTY NAME PHONE FAX
OWNER D I •�jg�•`b �
STREET ADDR 55 CITY STATE ZIP
CD E 00 �i�l °� �N
PROJECT PRO]ECT OR TENANT CO PLEX AND/OR BUILDING NUMBER OF FLOORS ELEVATOR
LOCATION Q \ �j 6tfves ❑No
STREET ADDRESS,INCIUDING SUITE NUMBER CTfY STATE ZIP
�2o IN IN 2 d
HAMILTON COUN7Y PARCEL NUMBER FLOOD ZONE/5
ICo - 3� I I �• �0 - � •- � � �� U�I�N ��J
LOTSPLTT SEWERUTIIIfY WATERUTI SEWE t TER
❑ YES O NO N � � � WI�I AVATOR
13
TYPE OF TYPE OF CONSTRUCTION N�m��or umr�
PERMIT �COMMERCIAL �INSTITUTIONAL- nicipal Public Buil g School Chur ❑ UITI-FAMILY
EARLV RELASE TYPE OFIMPROVEMENT
❑YES ❑NO �NEW STRUQURE FI H ATTAC D GARA ❑ SSORY BUILDN ❑ CELL TOWER
❑ADDITION-❑R orCh❑Deck ❑RE DE ❑DETA ED GARA O DEMOLITION ❑ CO-LOCATE
PRO)ECT P�N COMMISSION I� 5 ND(O TEO COST SQUARE FOOTAGE
TACDATE/5 Subjecttacom CONSTRUCTION, �
� PIIdOCByyj�hall�g �I ' EXCLUDING LAND � OAa��� I�4'3 �
PDF PLANS TYPE OF FOUND n[ �Cdl CodES MANUFACTURED SUMP PUMP PORCH
❑CD ❑E-MAIL � SLAB /+ 7� AA5E���`A}1�Q�}�� TRUSSES ��
❑ CRAWLSPACC�II� P ��]6�j(�� NO ❑VES NO O YES I�J NO
STATE OF CDR NUMBER RE �SH�P URION TYPE OCCUPANCV CU155
INDIANA �X� �A �pj �
CDR SCOPE OF REL ASE ❑ HOOD TYPE OF RELEASE
❑FDN ❑STR ❑ARCH �ELEC ❑ MECH ❑ PLUM O SPKLR ❑OTHER '�'
Class I structure permits are subject to the State of Indiana Gaieral Administrative Rules (GAR 675 IAC 12) regardin�
ex�iration time frames for Ue�*inning and rnmple[ing cunstruction.
I,the undursigned,agree tha[any romlructioq reconstruction,enlarpemeul,rcloca�ion,oraltera�ion ofa structure,or any chan6e in[he use oCland or
ntruetures requesled by this ap�lication will comply with and con(onn to all appiieable la�as ofthe State nf Indiana and the°Zoning Ordinanee oCCarmrl
Indiana-1993"(7-3A9)md amendments.adn��led vndcr authnri��nf LC.36-7 e[ seq.General Asscmhly nftlio Sfa�e ol'Indim�a,and all Acts amendaturv
t6emtu. I further certi � hat onlv kitchen,bath,and Ilour draini are connec[ed to lhe sanilary sea�er. I(urlher oo�r�ifv tha�the construction will nol be
nsed or occupied un ' 'erY ate ofOccupano]or ofSubs[anlial Com�iletion has bcen issued by the Department ufCommunity'Services,Carmel,Indiana.
� U�I � �}�� � 1
Sigmture of Owner o�AuthorizeA Agen[ Vrin ed Nam Dat
:........................................................................................ ...............................................................................................�
REQLIIRED BASE INSPECTIONS * � PERMIT FEES
*Additional inspections may bc rcc�uired. � F��'n�+ / Rcvie�v -�0 Re-Review
� � � i Basc Ins�xctions �3 A 6
i C'� Lower Footin* Rau h-[n �Fire
i Cert of Occu�ancy 7i 0�
' C' U��per Footin� ❑ Meter Base ❑ Forestry _�
� P.R.I.I.
� ❑ Undcrslab �Final ❑ Site
TOTAL �Sg9. � 0
� �����,� �I►���
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: ......... `......... ........... � ........ r ... ......... ........�
..i.nr.YOmss1AFplicrvYions�NCSidontmlAILP Appllcatlmi_010.n� I�.i LpduicJ 0"I'I��_010
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