HomeMy WebLinkAbout14050200 Application l
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•""�"�` CITY OF CARIVYEL / CLAY TOVVNSHIP PERMIT # lYOS07�oa
COMMERCIAL/INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
�xm�x� Par Nc�c StrucWres,Addi[ions,Tenant Pinishcs, Rcmodcls„and Accessor��Struciures
BUILDER ,"�^E � ��� � Fa�c / �
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RECORD ST EET ADDRES �� C � STATE ZIP , /
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E- /I�L�ADDRESS _ BEST,METHODOF �
FaS I/lIQ � � �� CONTACT � ./Y)
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PLUMBING NAME 57qTE OF INDIANA
CONTRACTOR LICENSE NUMBER
PROPERTY �N�� �L� ��/ r NE � �/�'�' ,l�
OWNER
EETADDRE55 ITY' STATE ZIV
�S //iJ
PRO]ECT OJECTORTENA,T COMPLEXAND/O L�D�G � q NUMBEROFFLOORS ELEVATOR
LOCATION /�/ / I �--l�/�(J� � O YES ❑ No
STREETADDRE55,T UD �SUITE NUMB�/;/�D ���� STATE ,��
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HAMILTONCOUN PARCELNUMBER ZONING FLOODZONE/5
�/3//-D�' �CbJ. �-
LOT SPL1T SE R UTILITY WATER U ILITY � SEWE
❑ ves ❑ No L u�s x v�
TYPE OF PE OF CONSfRUCT10[N� pq'A Number of Unitr
PERMIT coMMeRani ❑'`�Ely_ AL-❑MUnicipal/PUbIicB i oo��]�urLT ❑ MULTi-FAMILY
EARLY RELEASE TYPE OFIMVROVEME
� ❑ NEW STRUCTURE ��tt�CO � �1TT,��'�GT F ISH ❑ ATiACHED GARAGE ❑ CCESSORY BUILDNG ❑ CELL TOWER
❑ YES NO �ADDITION-❑ ❑PB/Qf D�eZ�� �MO�EL//Q ❑ DErACHEDGARAGE EMOLITION ❑ CO-LOCATE
PROJECT P�N COMMIS� S /$ND/ E SQUARE FOOTA E
TAC DATE/5 . STRUCTION,
F�ARM� �N��YS f EXCLUDING LAND �/� �� �
PDFVLANS TYPEOFFOUNDATION (���,�� MANUFACTURED SUMP PUMP PORCH
O CD ❑ E-MAIL � SLAB ❑ BASEMLfiJ'C�/rypryy���,[,J�`LKc SN�(� TRUSSES
❑ CRAWLSPACE ❑ POST&BEAM �"'� ❑ POST&PIEW- ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
STATE OF �D NUMB/ER� RELEASE DATE CON5TRUCTION TVPE OCCUPANCY CLA
INDIANA Y J�' a� � � S�� ��
CDR SCO E OF RELEASE � HOOD TYPE O`F�REL/EASE ��
❑ FDN� STR� ARCH�ELEC�MECHfIJ PLUM�SPKLR ❑ OTHER aJ/_�•L���!'+ +!/
Clasa 1 strucWre permits are subjecC to ihc Slate of Indiana Ceneral Administrative Itules(CAR 675 IAC 12) regarJing
e���iration time Games fur beginnins�.and.com��letin�construciion.
1.dm underxibned,ayree�hat anv conslruction�reaonstruclion,enlargement,relotation,or aheratiun uf a strutAUrq ur anv chan�e in the.use ol'IanJ or
struct�mes reyuestnl bv Ihis a�>plicn�ion�cill com�d��with anJ ionfurm lo nll n�plicahle laws uf Ihe Slale u(Indinnn anJ Ihe°ZuninK Ordinnnce ul'Cannel
Indiana-IYYi^(Z-2N9)inel amcnJmenL�,adopted under authorilr ofLC {L-7 e� .vui�.Ceneral Assemhlv u(thcllnte uf Imliana,anJ all AtLV amendaturv
�here�u. I further crrlil;v that nnh'kilcheq bath,a�d Iluor drains are connected to Ihe sinitarr seaver. I 1'ur�her '•rtify Ihat lhr i�unstru�'�iun�rill nu�be
�uc � on�pi�{i���lila . Ii�atcof0'cu�ancy roftiubslanlinl.Cnmp�lctiJonha�.brc..n�i.vsucd cUi/p�art ntofG nmuni�vScrrice..Can I,lud'
V_aG`-�—s�i�--/ - 'C� � �
i ature o Owner or Auf�orized Agen Printetl Name Da[-?�
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REQUIRED BASE INSPECTIONS * � � PERMIT PEES
*Additiunal ins��ections mar bc rec�uired. i Filin�/ Rcvicw �� • � Re-Re��icw
: 6asclns�cctions �g•OO
[ ❑ I.o�ccr Footinb �Rou�h-In �Firc ; Cert. ofOccu��ancY Z •O Olhcr
V �
� ❑ ll���cr 1'ootin� ❑ Meter Base ❑ 1'orestry
� P.R.I.I�.
; ❑ Undcrslab �Final ❑ Sitc
, '• 7'O7'AL �Z7 .30 /-� E
'• ��- - - �� � 06/ /I'�—
; R.. .,..cd/Rcl n �I-I Irrartmi n �f Commm�in S•n'in> � : � I ic R �d_Dc�iart nrm.�I Comm� t�S rrci�ce Daie
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