HomeMy WebLinkAbout06010035-Application
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City of Carmel/ Clay Township Permit #: O(P 0 I O~
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
,',,'
t'\~n" o'Y\<'>1+
-15'3 E lP'~ S+
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
Wi <"oC- .. +. \
NAME
u..-.0,"o. c...\""",.,
STREET ADDRESS
+ eM',. t..c""
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTlON
30 IY\,,<-, "",,<. ';\ C!.
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
0,<" S
STATE COMMEROAL
DESIGN RELEASE #: ') \ ~ \ ., e,
WATER UTIUlY
PROVIDER: .I w Co
PHONE
FAX
317 -51'1- I 55$"
317-n'l-/:}5Co
ZIP
'-/1od.d.O
OTY
I,.,.l \<,.
STATE
I'J
PHONE
BEST METHOD OF CONTACT:
311-S3l3. -;1.900 Cell
FAX
~17- 65'l-/S'2S-
CITY
- J. \~
STATE
I"-l
ZIP
~1o)..2.0
SUITE # (If Applicable)
SCOPE(S) OF l$. FDN 'il5 STR ill! ARCH ex MECH P{ PLUM
RELEASE: ~ ELEC 0 SPKLR 6THER(S):
# of F'oors: 2-. Elevator or Lift: a YES ')If. NO BLDG. CONSTRUCTlON lYPE: Web,! f,...",,<. OCCUPANCY CLASSIFICATION: B
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
C8t COMMERCIAL ~.5J.RlJC]:lJRf
(privatelyowRlBI2iiMlED FOR CCQl).l~b\ill:looIIUN
and medical illl~remB compliance with alr:reg8d~S
are comme~u Ie; Porch
o INSlTTUTlONAL of State and Loca 0 ~~ r Deck
o Mu~~"Mc@pgCOMMUNJjYR m~~
is :~TY OF CARMEL I ~!~~Ji~G
FOUNDATION TYPE: (Check all which INDIAr@ DETACHED GARAGE
apply for the new construction area) 0 AlTACHED GARAGE '
:t8. SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLfllON
SEWER UTIUlY
PROVIDER: c..~ W \)
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUf'fTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable): 050700 I (
SQUARE
FOOTAGE: l../,t../;).D sf'
ESTIMATED COST OF CONSTRUCTlON:
(EXCLUDING LAND VALUE) $SBS oc:>O
Early Release" Manufactured X
Permit: _Y..c.N Trusses: _Y_N
Lot Split: _Y IN Sump Pump: _Y-.XN
Does any part of the property lie within a special Flood
designation area: _Y ~N
PLUMBING CONTRACTOR:
\'l\dur~'1 ~<<.-"."~,'",,I
Plumber's Indiana State License #:
l'Lc 01051'40
Class I structure permits 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 Cannel Indiana - 1993" (Z'
289) and amendments, adopted under authority of LC. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I furthercercify 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
OcciicYl1ubs"'?fal Completion has been issued by the Department of Community Services, Carmel, Iud""",.
~/1.. tfbL W9l" (Yl. L(2or-\.,,_ \ liP lei,
Signature of Owner or Authorized Agent Print Date'
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: I A- I If. <;? tJ
~ . r~2 # Charged Re-
,,_pper ~~/ Lower FootIng Under Slab Base Inspections: _=,.,.-5' 0 Reviews
~~ eter Base. Cert. of Occupancy: 0, tJ 0
~ r\ t S, 30 Additional Fees
~ ~\~""~ 10H\, \(), 200(., O-'{)/o
Reviewed/ pproved: Dept. of Community Servicesl (Date) Fee
S:Permits/Forms/ILP COMMEROAl