HomeMy WebLinkAbout06020118 Application
City of Carmel/Clay Township permit~:(P():2 () !IZ
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
STREET ADDRESS
PHONE
FAX
BUILDER of
RECORD:
NAME
L..e.~
CITY
STATE
BUILDER'S EMAIL ADDRESS
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
FAX
.:t.s3-8o
STATE
ZIP
&22-0
LOCATION
8< PROJECT
INFO:
BUILDING, PROJECT, OR TENANT NAME:
(o",+ou P-> ~lcL>'\.
STATE COMMERCIAL
DESIGN RELEASE #:
SCOPE(S) DF 0 FDN I\(' $fR rYARCH 0 MECH 0
RELEASE: 0 ELEC if SPKLR lITHER(S):
ZONING:
871::,8
WATER lITlLTIY SEWER lITlLTIY
PROVIDER:.:f \1\ PROVIDERC
PLAN COMMISSION / B / BPW DOCKET NUMBERS; AND/OR
COUN1Y WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roors:
Elevator or Uft: c;:I YES '1( NO
BLDG. CON$fRUcnON TIPE:
OCCUPANCY CLASSIFICATION: B
TYPE F UCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
l;lQ CO ~SEO FOR CONSn:;qcl\lffl?TRUCTURE Early Release Manufactured
( WOWhed(l>9sl>!\a.ls'1riCo ",'.' . ,.. 'E1 AOOIllON Permit: Y~ Trusses: _Y.)L..N
and medicaI8fF1,te:SJce~t,~~" ' - ..Iu1 c:;iii r&IJu!n"l(Q)1sRoom{s) \....
~rC!a!t)'~~: ,-I, ,u LCc.al , .";, 0 Porch Lot Split: _Y N Sump Pump: _Y ~N
o ICN MTv ~l~ CL!r/i.i.~/U;'" :/fY ~''''.~E.9c\II'-''P..... Mezzanine or Deck Does any part of the property lie within a special Flood
.... r~I~Y~'WIhc,~I:d9 , \ :.)Kr'REMODEL '.. \/
o School V/~..I CLA ( I.Glii'!'@VIjTENANTFINISH deSignation area. _Y....l:LN
o Church INDIANA 0 'ACCESSORY BUILDING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Chec~ all which 0 DETACHED GARAGE ~ A ~ ::1 h I .I "
apply for the new construction area) 0 ATTACHED GARAGE ,V E~- f' ._~ "5 ~ a- py; ,,6-v \.!:=--
~ SLAB 0 CRAWL SPACE 0 CELL TOWER (New) ~mis Indiana State License #:
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE O.~. .....
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLITION -'l!!!" . ~. ' a
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, eruaJ::gement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply witK and conform to, all ap~' cable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z~
289) and amendments, adopted under aut:hOrity of LC. 36,7 et seq, Gene I Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, an oor drains are connec;ted to the sanitary sewer. I er certify that the construction will not be used or occupied until a Certificate of
Occ 'Ya S . omp/edon'has ~n i~sued by the Depar1ent of Community Services, Carmel, Indiana. /
I V d ~/ l TY\()Jtho- -r;.:fqSk :( }) 1.0 (p
thorized Agent ) \ ~ J- Y Print Date
.. /
OFFICE USE ONLY: ***** *******-"********************************************************
INSPEcnONS REQUIRED: ~j Filing Fees: I q "3 B . q ^
Base Inspections: . / q A , 5' 0
{Cert. of Occupa cy: / f) 3 , (J 0
\ .If' ,'6'12 L/"! .
TOTAL.: / ~R;pJJj~::::
Upper Footing Lower Footing Under Slab
~ Meter Base ~ Site
~~~\~~(\J\~ 1~
ReviewedYApproved: Dept. of Community Services
~.\ S:PermIts/Foi'ms/ILP COMMERQAL
# Charged Re-
Reviews
Additional Fees
.1A"J.('(("
(Date)
Fee Received by: