HomeMy WebLinkAbout06020137-Application
City of Carmel/ Clay Township Permit #: 1)& rJ .2 t'J/37
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
fWlE/lkccd:u a 11- ~,,~ ~
STREET ADDRESS ~ ~
(iJ 7,;lO,rv<o t;bvr
tC>>Jfr,PHONE [~17) 5'7b-637l
mY STATE
//J#ctf!S f;/
FAX
ZIP
qt:,03fY
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PROPERTY
OWNER:
BUILDER'S EMAlL ADDRESS BEST METHOD OF CONTACT:
~NO/K{r/e /?/I'COVJT/l. (Ol'r]
, ~ PHONE
VeiJu- /., ~:fJ /OtFrJ,td'14N'if
fJl'f,
NAME
FAX
STREET ADDRESS mY
525'5 c: Iq{,~ ST.
STATE
&1 d-rlfC:C-
AI
ZIP
q~o3~
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION
30z CI;OJe C
SUITE # (If Applicable)
C'4 ~ J ~V (./bO >2-
Address of Shell Building (If different than Address of Construction)
.--
Lot # and SubdMslon (If Applicable)
-
BUILDING, PROJECT, OR JENANT NAME:
(/e~oc/';' SA
STATE COMMERCIAl
DESIGN RElEASE #: ~"3
WATER lJT1UlY
PROVIDER: C'C'rS r
r~J ~ k""ortC:JL
ZONING:
TAX MAP PARCEL #:
3& OVV
oS
SCOPE(S) OF 0 FDN 0 STR JLARCH pl-.MECH fA. PLUM
RElEASE: ~ ELEC 0 SPKLR ISTHER(S):
SEWER lJT1UlY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
e )C 1,5 f (EXCLUDING lAND VALUE) 0l'lS, 000
/0/000 f, (/./
PLAN COMMISSION / BZA / BPW OOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Aoo,,;: .., Elevator or lilt: 1:;1 VIiS: . bJ" \\mj)G. CONSTRUCTION TYPE: Te, fP"S""" OCCUPANCY ClASSIFICATION: /j_:> iUt""
~ _",~) r\\) 4!') I ..:>.
TYPE OFCONSTRUCTION"'OI0 ~N\\'(\ ~TYPE O,j&"I!OVEMENT: PROJECT INFORMATION:
lo- r "'0' - C\c';;' GO"- '~~
~OMMEROAJf>.S~ r"<'\\-~':'. "c~\ ,,00 RE Early Release 'vi Manufactured '\/
(P~'OOl~epJ>OSP~~s. ,~..,< ,.!';\" '0,- . ON Permit: _Y6L-N Trusses: _Y ~N
anW~lGfflc~centers ~h;\v\' ~'i \V 0 Room(s) V V
area,\'\l1\erdal)O ~ f<') " I () r 0 Porch Lot Split: _Y ~N Sump Pump: _YA/-N
o INS1lTUT10N~ oX: v f '-. \.. ',. 0 _ _
o ~a~~b1' 'Bi::1"\\:- \,."", ~ Mezzanine or Deck Does any part of the property lie within a speCial Flood
Jq g NoO r REMODEL _ V .
o \\ 0 NEW TENANT FINISH designation area: _Y ~N
o CP 0 ACCESSORY BUILDING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Checkallwhich 0 DETACHED GARAGE ~:-/ i I'? -J~_~7AcrQ~r
apply for the new construction area) 0 ATTACHED GARAGE ~~ ~ r"p'/A/ ~ "...,." ""7 ~
~ SLAB 0 CRAWL SPACE 0 CELL TOWER (New) Plumber's Indiana state License #:
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE LJ lJ Il 0 0:3 ""2
(or POST & PIER) WAlIKOUT:_Y_N 0 DEMOliTION + LlL _ ~
Oass I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for
beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement. relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of I.e. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy or Substantial Completion bas been issued by tbe Department of Conununity Services, Cannel, lIidiana. .
~ )f'~~Z./kd'.ASAP-?lC- ~ b.;J/o~
Slgila OwnerOrAUthOriZ~ prln~ ("3 J 7) 3,/'1-;/1/ . ~- Date
OFFICEUSEONLY:************************************************************************
StJ03. ~ ~
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INSPECTIONS REQUIRED:
Filing Fees:
Upper Footing Lower Footing Under Slab
~ MeterBase ~ Site
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
TO
Fee Received by: