HomeMy WebLinkAbout06040048 Application
City o/Carmel/Clay Township Permit #: r:xa()'1001j1J
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
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STREET ADDRESS
?I:){)(J .)J<'I;ItUJ~S{.c.:,.J
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
III PROJECT
INFO:
BUI
STATE COM
DESIGN RELEASE #:
.. Co,..-
,o-o:;oi
7~tJH'
mY. / STATE ZIP
4.~.., '.2-18 ~N. </G/C
BEST MEIliOD OF CONTACT: ---r?e.JJ- C~f<- .if-
&-ti 'L..-... ..1/1-: ~ -'(" I(
FAX
.;; 'It 3:50~ <f 96()
STATE
-//.$ ./'1
PHONE
Zek. td -J
FAX
Y3;- u
lie PHONE
CITY
sk 300
}Yr.
o STR
ELEC 0 SPKLR
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# of Roors:
I
Elevator or Lift: 0 YES )('NO
BLDG. CONSTRUCTION TYPE:
-,'-- ,. "
ESTIMATED CoST OF CONSTRyp10N: "
(EXCLUDING'.LArlD VALUE) .....,: 'A .~.! i~,
"1'1, "-~",I :
;\LJ) 1 I::
il'\\ \ APR 1 0 2005
, I \ \, ...)1"1 I; 1,1,
. -l , j ~~, 1 OCCUPANCY ~~~SS.I~SAl!g_~_: i
PROJECT INFORMATION: .....
I -.....-.-........-..
Early Release- 0/' Manufactured y
Permit: _Y il.......N Trusses: _Y A-N
Lot Split: _Y AN Sump Pump: _Y-J!-N
Does any part of the property lie within a special Flood
designation area: _Y XN
PLUMBING CONTRACTOR:
J/P
Plumber's Indiana State License #:
~..
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
TYPE OF CONSTRUCTION:
\.~ COMMERCIAL
~ (Privately owned hospitals
and medical offices/centers
are commerdar)
o INSTITUllONAL
o Municipal/Public Bldg
o School
o Church
FOUNDATION TYPE: (Check all which
apply for the new construction area)
~ SLAB 0 CRAWL SPACE
"e) POST & BEAM 0 BASEMENT
(or POST & PIER) WALKOLlT:_Y_N
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ADDmON
o Room(s)
o Porch
o Mezzanine or Deck
o REMODEL
~ NEW TENANT FINISH
'cr ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o CELL TOWER (New)
o CELL TOWER CO-LOCATE
o DEMOUTION
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, 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
Occupanc or Substantial Com ctio. been issued by the Department of Community Services, Cannel, Indiana,
.. IY'-:;'Jf- A.. G/.e ~-t,..()t
S. Print Date
OFFICE USE ONLY: ************************************************************************
INSPECTIONS REQUIRED: (0 Filing Fees: Ce 3& , hiD
\ 11 ...-") {) ~ 00 # Charged Re.
Upper F oting Lower Footing Under Slab fl \...:.> Base Inspections: """ U , Reviews
Rough In Meter Base ~ Site Cert of Occupa J lJ 7, (JO
~_...~ "",.~,"~_ bill, ~ q:zQ. 0
Il. ls/FonnS/ILP COMMERnAL
Additionai Fees
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