HomeMy WebLinkAbout06010160-Application
City of Carmel/Clay Township Permit #: 0 tJf) I C) {(pO
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of
RECORD:
NAME 'D\A
STREET ADDRESS
00
.:? I =t ~ FAX
?o '?- OOCl
~t
:?ol? - & '1-9
E. gL~
S-h<>-+
PROPERTY
OWNER:
BUILDER'S EMAlL ADDRESS
C_\D_ ( c\::- llu.l:
~. ~ (' c~~-+-...
STREET ADDRESS ~
(p 00 E, 9 L - S+-'eR... ~
LOCATION
& PROJECT
INFO:
ADDRESS OF CONSTRUCTION
000 ~ 9G -6 S+re.~-t
Address of Shell BuildIng (If dIfferent than Address of Con uction)
CI1Y
<\>-
STATE
~
ZIP
'+" do 0
c)
..-----..,
~I"'-
BEST METHOD OF CONTACT:
LO.'Y'-- <:l. /'V\. 0...(
PHONE 31'1 - FAX
g"o&,,- &, =
0'+-[;'0[;'
Lo 'Cf-q 1-
CI1Y STATE
~(Oc.l 'I ~l ls
C" SUITE # (If Applicable)
~ V\.. "k LS'o
ZIP
(--+f.o ~
a
Lot # and Subdivision (If Applicable)
BUILDING/ PROJECT, OR TENANT NAME:
'(Y\o.-." ' ~
STATE COMMERCIAL
DESIGN RELEASE #: 3 51'-+ \
WATER UTILITY
PROVIDER: -:::t=
TAX MAP PARCEL #:
[3 '-I;) -00-00'(;12>,0
SQUARE
FOOTAGE: S
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) -$ l!i S' ol. 5 o. ~
~lLkG...
SCOPE(S) OF 0 FDN 0 STR
RELEASE: ~ELEC 0 SPKLR
s,
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Aoors: 5 , "r",9 i , \ ~G, CONSTRUCTION TYPE'
~~~ 'I l~ '=
TYPE~_._N"" t. -II rTYPa_....PROVEMENT:
J 11::lnCeW1rll;J ~
~ CIilIl1OOli8ClAtl camp , "I ra! CNJeSO l'I~STRUCTURE
lPIfv'leIY~SlIlOSP;iaIS(, _0_', ! ~r::\I'\W\~ON
and medl~ce'~~~r:s!'UNln ~,- NdU\p-oom(s)
EriliiE!col~ .L / C LJ','( TOW "b' Porch
o I '€ARME' 0 Mezzanine or Deck
apaIfPubli~~eJllANA O/REMODEL
o School rszr NEW TENANT FINISH
o Church 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
~ SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
/Q POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOtIT:_Y_N 0 DEMOLITION
'OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release v<: Manufactured _______
Penn It: _Y _N Trusses: _Y _N
Lot Split: _Y 1..-1'f Sump Pump: _Y ~
Does any part of the property lie within a special Flood
designation area: _Y ~
PLUMBING CONTRACTOR:
cK lrt:: h o-tt
Plumber's Indiana State License #:
I () (0 S' 3;) (jncA
Class J 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.
It 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 Le. 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 C~fJetion has bee~ issued by the Department of Conununity Services, el, Indiana.
~~~~..J\~D ' \, 1-;.)1-01.0
Signature of owner'M Authorized Agent U Print Date
OFFICE USE ONLY: **************************************** ********************************
INSPECTIONS REQUIRED: Filing Fees: I 9 y:( / 7
. # Charged Re.
Upper Footing Lower Footing Under Slab Base Inspections: /4a .,-C) Reviews
~9h ~ Meter Base G "Site ) /) 3: ~ 0
- ".' (, ;Yy{2 b /- Additional Fees
t~ R\nH\r\-JJ. - .:t})" ~,300t. -?"~(} V
Reviewed/Approved: Dept. of Community Services (Dale)
S:Permlts/FormS/ILP COMMERQAL