HomeMy WebLinkAbout06020001-Application
City of Carmel/Clay Township Permit #: QCa 0 d.a)()\
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of NAME
RECORD:
STREET ADDRESS
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
/
Address o~ Shell Building (If dlffere than Address of Constructl.on)
BUILDI I PROJEcr, OR TENANT NAME:
STATE COMMERCIAL
DESIGN RELEASE #:
. SCOPE(S) OF . 0 FDN 0 STR
RELEASE: ,p< ELfC 0 SPKlR
SEWER LmLITY , , )
PROVIDER: t-rA IV
WATER LmLITY.
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable): ~~
# of Roors: Elevator or Uft: c;I YES NO BLDG. CONSTRUcnON TYPE:
FAX
Lot # and SubdMslon (If Applicable)
I
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) tf~ fj3'l
OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
;P-' COMMEROAL 1M NEW STRUCTURE
. (Privately owned hospitals '13 - ADOmON
and medical offices/centers 0 Room(s)
~Ei~:bR CONSTRUCTION 0 porch.
Subj({!;t t<MlinidPiil/PUbli@lildg') all mqulatcrs E~OD~~a",ne or Deck
o oSCHoole 3~ld Local Codes. ~EW TENANT ANISH
=-lfl ,,\ly'nr1.ML',,ITi St:RV1(tIlSACCESSORYBUILDING
b(C~"Fk,a'l,yv~,lc,h__-\'Vr.' q-, I~ACHED GARAGE
ap conslructlon.area) I U. 'e:J" ATTACHED GARAGE
.Ji'! SLAB d;~ r;?AAWt'SPACE 0 CELL TOWER (New)
- Li POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOUTION
PROJECT INFORMATION:
Early, Release V Manufactured
Permit: _Y~N Trusses: _Y XN
Lot Split: _Y XN Sump Pump: _Y 1N
Does any part of the property lie within a special Flood
designation area: _Y ~N
PLUMBING CONTRACTOR:
!?/J ~)~ /';::.-.'\
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PI~ :;"1ndia~.a/~~ L1ce~!t;:;\;"rj ':Si",\ \\\
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Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 rA~12) ~~t.uuiiii expiratij . ~\ia'r;J \
beginning and completing construction. \\ \ \ \ \ ') I,.: :> \
I. the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or ~y .ch~e in ~ ~ dr land or strucrores ~
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning~Oidinance~annel Indjana-==-I993" (2'.,..-/
289) and amendments, adopted under authority of l.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts ~'endafury thereto. Uutther certify...that-only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be ushi\or 'cic't.upieduiitiI a Certi/jate of
Occupancy or Su Camp). tion h ued by the Department of Community Services, Cannel, Indiana. \'0 v \/ /"
\ ~ a-;2~,t7~
\".-'" Date
.a;~~ ~ ~/;;d~AJI'
Print
OFFICEUSEONLY:************************************************************************
3 -::,3 1 . '10
/ c;- .?_ 51)
/ b ~ ./1 ()
, .hi: .3 3 _) Additional Fees
u. - 'V (7
~~
INSPECTIONS REQUIRED:
Filing Fees:
Base Inspections:
# Charged Re-
Reviews
Lower Footing Under Slab
Meter Base @ Site
Reviewedl proved: Dept. of Community Services
S:PermIt5/FomiS/liP COMMEROAL
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