HomeMy WebLinkAbout06010142-Application
City of Carmel/Clay Township Permit #: (}(PO/ 0 r tJ/l..
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of NAME
RECORD: >V\f. (..
511lEET ADDRESS
Di:
PROPERTY
OWNER:
BUILDER'S EMAlL ADDRESS
D; rJKS;
NAME
\'vi; Yo /.i-N.J, Y - 0(
511lEET ADDRESS
<6?2.o C
ADDRESS OF CONSTRUCTION
PHONE
3/7-5
CITY
f"i
PHONE
..... ND
FAX
.s /(-5
STATE
ZIP
5 -J
BEST METHOD OF CONTACT:
~
'i
FAX
"3/7- 57'7-5/
ZIP
CITY
.5.;;-1 3<: ::r:
~-v
sum # (If Applloall1e)
'-I ~
LOCATION
& PROJECT
INFO:
WATER l1TlLITY
PROVlDER:vr. \AJ ~
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of F'oors:i'"',
"t.
Elevator or Uft:
YES
Q NO
BLDG. CONSTRUCTION TYPE: II-.B
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
Oit COMMERClAaa.~D FOR C09.B~~~
~~v~:~>tilB:ompiiance wnrl Zl~~~~2s
are commercial) of State and Local Coce. Porch
o IN~~i.lJi,IGid~OMMUNp:,Y Srn~orOeck
o Sc~'TY OF CARMEL I C~Y~iWi!l~SH
o ChU'rcn INDIAN\liJ ACCESSORY BUILDING
FOUNDATION TYPE: (Check all whiclt 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
)8l. SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(Dr POST & PIER) WALKOUT:_Y_N 0 DEMOliTION
ARCH
OTHER(S):
STATE
,
Lot # and Subdivision (If Applicable)
o MECH
31..[5
. -
"/lt~
EsnMATED COST OF CONSTRUCTION:
(EXCLUDING LANO VALUE) "" 115'
g;..
OCCUPANCY CLASSIFICATION: '5
[
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y XN Trusses: _Y >< 'N
Lot Split: _Y _N Sump Pump: _Y t4-N
Does any part of the property lie within a special Flood
designation area: _Y '>( N
PLUMBING CONTRACTOR:
\<iRkL,"\\PlvWl'l:,i>-,.'\
Plumber's Indiana State License #:
lC\~S<; '(
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 Cannellndiana - 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 Eurthercertify 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 has been issued by the Department of Community Services, Cannel, Indiana.
~ _ ~ -::rl1l_,=\--r:--..;)...~
Signature of OWner or'" Authorized Agent Print .
I-Z'f-ou
Date
OFFICEUSEONLY:************************************************************************
INSPEcnONS REQUIRED: Filing Fees: cr-a cr, ro'l
I a'" 0 # Charged Re-
Upper Footing Lower Footing Under Slab Base Inspections: / " ' 5: Reviews
~~ Meter Base ~ Site Cert, of Occupan _ _ I tJ 3. 0 ()
- _ _.Jk. ~~ L III Additional Fees
~ T~ ~,/;;.1f / ~.;.). 7
/ /~~~ ~/
Reviewed/-\pproved: Dept. of Community Services
S:PermIts/Forms/ILP COMMERaAl
Fee
lved by: