HomeMy WebLinkAbout06020006 Application
~9ty of Carmel/Gay Township Permit #: {}&()'){)O"to
":OMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
.LDER of
.fCORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME
JAi'\.I\~
Co
dF C:'A.--lv-"",(
STREET ADDRESS
2.00 4M.~D/<:'AI Yi2 sVI"'-A
BUILDER'S EMAlL ADDRESS
J//r1m' ; t? /7fr?AX . A./~f-
PHONE ' .7-5"7"{- !,(,"/ 7 FAX
rAJ. TN<:..-. 317-S'ffJ-2~<7
01Y
C1"'~,,",~/
STATE
..:;-;:u
ZIP
L/?O 3' .2
FAX
J'/l-S-;? /- 2&27
NAME
:E, r. H6/00'; 's.
STREET ADDRESS
rltJO IIftdk/?/ j)~
PHONE
j'/7-S'7Y-U,c" '-17
01Y
~r~1>-/
~/. ~
ADDRESS OF CONSTRUCTION
'/ pI'" $/, :"). ~ .
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
/)fAco./l Lt-L
'-I .~ Vi J.
WATER lITlLTIY (. I SEWER lITlLTIY
PROVIDER: L, r rL ~ PROVIDER:
PlAN COMMISSION I BZA I BPW DOQ(ET NUMBERS; ANDIOR
COUN1Y WELL ANDIOR SEPTIC PERMIT "S (If Applicable):
STATE COMMERQAL
DESIGN RELEASE #:
# of Aoors: 3
SCOPE(S) OF ~ FDN
RElEASE: 0 ELEC 0
Cerrl<L1
STATE
...--
';-rJ
ZIP
.y~/l3 L
SUITE # (If Applicable)
Lot # and SubdMsion (If Applicable)
ZONING:
TAX MAP PARCEL':
5oo'3o/00"/{)OO
o PLUM SQUARE
FOOTAGE: l, 02 '-I
ARCH
OTHER(S):
OMECH
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LANO VALUE) 't' 5'0 () ( ODD
Elevator or Un:: It YES 0 NO
BLDG. CONSTRUCTION TYPE: v-A
OCCUPANCY CLASSIFICATION:
.~
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ COMMEROAL 0 NEW STRUCTURE
leo;lYal<;!)' owned !'ospoals j;8( ADDmON
~ih~~~~~?~ CONSTRUCTlem ::;(s)
O INiWi!G9Il1QONA,....OI'!,., ,,.""\('<,, ,~"tt" ,~l! fE' 't' ""
Sl1Tl.M1 ':::. -..... .~, ",.,) -;quia IC~j Mezzanine or Deck
o MUnlO~rIPUbIIC Bldg" "I (~C,(jf~ REMODEL
ID!EF5!=h@!-eel"',"''''I rv '''rOI.-NE~TENANTFlNISH
~~ch ..,",." J )~, L.!;:;
r.1 l ^ 0' -,-, ; -, '. '. 0 ACC SORY BUILDING
FOUNDA'I'r, E: (Ched<all-whichA'r' TO'GzNiii!'t~EDGARAGE
apply for the new constru~~n:~'!.~t::.. 0 ATTACHED GARAGE
o SLAB Asf. CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM Jii1 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOlIT:-X.Y_N 0 DEMOUTlON
PROJECT INFORMATION:
Early Release V Manufactured X
Penn it: _Y ~N Trusses: _Y _N
Lot Split: _Y AN Sump Pump: XY_N
Does any part of the property lie within a special Flood
designation area: _Y ~N
PLUMBING CONTRACTOR:
LJhih1~~il ?(JMl1t"7
Plumber's Indiana State License #:
C P 1'1'700f3(p
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.
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 I.c. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, b , and floor drains are nnect to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occu 'Y or Substan R1 Co do as been issued by the Departmen} of Conununity Services, Carmel, Indiana.
~ MIL JArW%J 1. DvUJ TC ~""?'r.2:
ner or Authorized Agent Print
v
OFFICE USE ONLY: *****************
:;:31 /Oto
o /
*~W*** **********************~*1*****~**************
% Filing Fees: I) I t, r; c" /
/.. r7 3 7..! # Charged Re-
Base Inspections' ,e' '/ , Reviews
Cert, of Occu / c ? - ,{o
. ' ;j! ~;<').. J?-, 3 / Additional Fees
~42J ~~?7
Reviewed/ Appr
~:_FonnS(ILP
Fee Received by: