HomeMy WebLinkAbout13060005 Application �t m[4nia�
• CITY OF CARMEL / CLAY TOWNSHIP PERMIT # 1306 0 005"
. COMMERCIAL/INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
,,,u�a„e For Ncw Structures�Additions,Tcnaul Finishes, Remodels,and Accessory Strudures
BUILDER NAME PHONE FA%
oF IQ2e Lo' ns �ru��io�t � 3l . S�o- �ooS 31�. 5}� . s��
RECORD STREETADDRE55 CITV STA7E IP
o e � C'Pll� � f��� rd s �- ��zao
E- AIL ADDRE55 Q.�I n BEST ME HOD OF
ee Pi � M�W.�e 1 (ZG , �O CONTAR
ell - ''Oio_�[yZ� ar eu,�: �
PLUMBING NAME STATE OF INDIANA /�/�
CONTRACTOR �� � �U� b/ � / n G . �ICENSE NUMBER � y.5� � I
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PROPERTY NAME PHONE FAX
OWNER � ei5 e C��" MB [-Lc.._ bt�. �1� l , q9oo �l?�, S�-�,�+�&�
STREET ADDRESS CITY STATE Z
Gs Ea.s+ Sa"=� �-. � a�o Y s r� . �z�lo
PROJECT PROJECT OR TEfYANT COMPLEX AND/OR BUILDING NUMBER OF FLOORS ELEVATOR
LOCATION �Q r � CAIG C�s ❑No
STREET ADORE55,INCC ING SUITE NUMBER STATE ZIP
en �� �c� � � �oZB�
HAMILTON COUNTV s�� NST U � ZON G FLOOD ZONE/5
bectficom wtl ulations
LOTSPLIT SEWERUTILITY �� d���qd SEWER WATER
❑ �ES o "° P OF C MUNIIY S RVICE °TI�` 5 EX� ATOR y�
r•�
TYPE OF TYPE OF CONSTR rv�mber or umr�
PERMIT �COMMERCIAL ❑IN T IONAI� ���p � ildir��„ C�SCI�oI�]� h ❑MULTI-FAMILY
v
EARLY REL,A�/SE' TYVE OFIMPROVEMENi
❑VES KJ NO �NEW STRUCTURE ❑ W TEf MISH ❑ A1TA GAF G ❑ACCESSORY BUILDNG ❑ CELL TOWER
❑ADDITION-❑ROOm/s ❑P ❑Deck REMODE � �E�GA � ODEMOIITION ❑ CO-LOCATE
PRO]ECT P�N COMMISSION/BZA I BP DOCKET NUMBER/ STIMATED COST SQUARE FOOTAGE
TAC DATE/S � � OF CONSTRUCTION� .� 1S oQQ [j �/ �
EXCLUDING LAND T / � ��
PDKPLAN/S TY FFOUNDATION SUMPPUMP PORCH
❑CO �E-MAIL SLAB ❑ BASEMENT-❑WALK-OUT RUSSES ,�// ��
❑CRAWLSPACE ❑ POST&BEAM ❑POST&PIER ❑VES NO ❑YES LJ NO ❑VES LKNO
STATE OF CDR NUMBER RELEASE DATE CONSTRUCTION TVPE OCCUPANCY CLA55
INDIANA 3 �9 , � �. l� /-Q S�K F
CDR SCOPE OF RELEASE �,� �,/� � ❑ HOOD TYPE O RELEASE
❑FDN ❑STR ARCH LJ ELEC L�9 MECH L7 PLUM❑ SPKLR ❑ OTHER ��d/�dQ�
Class I structure perniits are subject to the State of Indiana General Administra[ive Rules (GAR 675 IAC 12) regarding
expiration timc f'ramea for beginnin�and com�leting construction.
I,tl�e nndersigned,agree that any construction,reconstruoliun,enlargemenq relocalion,or alferatinn ufa struc[ure,or any change in the une of land or
structures requested by this ap��lica�ion�r�ill cnm�>ly with and e'onli�rtn lo all applirable laws ofthe Slate of Indiaua and[he"/.onin�.Ordinance ofCarmel
Indiana-1993"(L-289)and amendmenL,adn�rieJ under authority ol'LC.36-7 e[ seq,Genrral Assembly o(Ihe State of Indiana,and all Acts amenda/ory
thereto. I lurther mrtif'v that onh�kilchen,bath�and Ilonr dr.nins are cnnnected m the sanitarv srwer. 1(urt6ereertif��that the<nnstruction�rill not be
used orocou ied until a Certific.�te uFOccuPancy or ol'Substantial Completiun has been issued bv the Devar[ment of Covimuni[y Services,Carmel,Indiann.
/y7c'ke ,�c�s ��� �. !
Signature of O er or Authorizetl Ag [ Printed Name Date
.......................................................................................y ,..............................................................................................,,
REQUIRED BASE INSPECTIONS * '• PERMIT FEES
*Additional inspections may be rcyuired. � F���ng/ Review ZZ85-3 0 Re-Revicw
� 6aseinspections 3.3.0 O
[ ❑ Lower Footin� Rough-In Fire I Z(� .00
� i Cert.of Occupancy° �_ ___
: ❑ Upper Faotins ❑ Mcter Basc ❑ Forestry �.
� P.R.LF.
' ❑ Underslab �Final ❑ Site
/� � ToTaL 2.G43.3o
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