HomeMy WebLinkAbout06030221 Application
City ofCarmel/aay Township Permit #: 0 r.e 0 3() l~ I
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
ON W~Lt"'~
STREET ADDRESS
tSiI~ CO';Iv' h..f:.F.:f/
LLL
PHONE
?ol 7 C:;7 '-f-'7l.f9 2.-
FAX
BUILDER of
RECORD:
NAME
t7 $7~ 9~
T
CITY
N2- M ~L-
STATE
\IV
ZIP
40>2-
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
ELL~'4) ~NWf:;LL-S.. Co,....,
NAME PHONE
(..I..p.Mlt-,..,r-\ CO,..>.-Jn. PM'~$ D&I'T:' 'b\"") -
STREET ADDRESS CITY
\ ~ 5"_,,,,,) t-'..o".J ~. CA-L-c
BEST METHOD OF CONTACT:
AIL...-
FAX
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRucnON
U. lbTH ~
l---
sum # (If Applicable)
STATE
IN
ZIP
4ho33
Lot # and Subdivision (If Applicable)
Address of Shell Building (If different than Address of Construction)
BU LDING, PROJECT, OR TENANT NAME:
pc:; Lc. -rz>"'-' ~II- E-A-S"'--
STATE COMMEROAL SCOPE(S) OF '1,1< FDN 9<;STR
DESIGN RELEASE #: 3' G obi:) RELEASE: ELEC 0 SPKLR
TAX MAP PARCEL #:
n -0'7 ->;,-CO-CO-Q2.e;;
o
1J,(ARCH
dniER(S):
o MECH 0 PLUM
SQUARE
FOOTAGE:
~
.~, ,/:-{ .LJ /11.
WATER UTILITY
PROVIDER:
~ Pc-
SEWER UTILITY
PROVIDER:
tJ!A-
ESTIMATED COST OF CONSTRUcnq
(EXCLUDING LAND VALUE)
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND EPTIC PERMIT #'S (If Applicable):
C'r::r. 1"':'.-,1""1 __. .___~. ._
- '-' ~._- , '-"" \"_'\..~I ,_J I r .1,.11. )1 II
Su J'Sevatororuft: [;q'ES . ,NO. BLDG. CON UcnONTYPE:"" ~
~....., ,.... ,A.., I i(..:,,,,, <~0 \',Il,1 RII f pnl d~h("lnC' ~I'f::;V'
E F CON U iil\ ::;tat" ,,,':el LoC,TYPEcOF'I:MPROVEMENT: PROJECT INFORMATION:
o COMMER! - OF cor-!li\;'U~!i:~EWfSfRUc;'luRE EarlyRelease ~ Manufactured \J1
(prtvilte no:dliiOsp'}l;i~R1v1EL / (;' r,0TADomONri1p PermIt: Y Trusses: _Y ~
and medical offices/centers ,.1-M\1 uD''ltR6bm(S) \..ir1.
are commercial) INDI/\NA 0 Porch Lot Split: Y_N sumpPump:_Y~
~ INSlTTUl10NAL 0 Mezzanine or Deck Does any part of the pro:):6 lie within a special Flood
W Municipal/Public Bldg ~~. 00 REMODEL
b' School NEW TENANT FINISH designation area: _Y N
o Church ACCESSORY BUILDING PLUMBING CON RACTO :
FOUNDATION TYPE: (Check all which DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
~ SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOUTION
OCCUPANCY CLASSIFICATION:
\J
Class I 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.
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 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, 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 Substanti Jetion has been issued by the Department of Community Services, Cannel, Indiana.
~ 'H lEt> W&CL5:; Hie,
Print
zed Agent
;;/~/o<"
Da
OFFICEUSEONLY:************************************************************************
(Date)
Filing Fees:
Base Inspections:
Cert of Occupancy:
TOTAL: .A A
FeeRec~'- 1/
-~~~
# Charged Re-
Reviews
INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
~;~r~ Site
Additional Fees
A -
~ /! (1lN1L '(Jolt?