HomeMy WebLinkAbout06040042 Application
City of Carmel/Clay Township Permit#: Ofe-OI-jOOIfOl
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, l!r. Accessory Buildings
BUILDER of
RECORD:
NAME
';)c.lMM,"" (0 Nt;,I4I.Cf ,01'1 cc>.
STREET ADDRESS
1\01- i3uil-i>SA-1- '?\<-w~
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
o eiZ"Ba e S-<-l"'Nl...,..t'DN~T. {Dwl
NAME
Sf. v. Nt ~ e A-.e..M~ <..- ;-1-0,
STREET ADDRESS
i;.$oo r-J- ,..,.~.;>.~ 'T".
ADDRESS OF CONSTRUCTION
00 tJ. WI~'"J>, ~ rr-.
Address of Shell Building (If different than Address of Constructlon)
LOCATION
& PROJECT
INFO:
PHONE '~I"7' 03'-/ (PI I ~
11.1(..
Ff>X 'I"OJ- ;;l(P<f -:2:>~
CITY
1,.Jr;;.,~NAj"VI-\S
STATE
IN
ZIP
/..{(pOl.O&"
BEST METHOD OF CONTACT:
~...,\....
?I~ ~'6:;1--=1:>j ("
Ff>X
"5' . -:r <;<]J;;J. J-7'iJ;I.
PHONE
.1"Yh..
CITY
c A a.., ~<..
STATE
IN
sum # (If Applicable)
ZIP
'I (,o3::t
Lot # and Subdivision (If Applicable)
0;( MECH
BUILDING, PROJECT, OR TENANT NAME:
4.... V,N(.~ c.A.~~
STATE COMMERCIAL -z ..J
DESIGN RElEASE #: ;> l S q ;z "
""fl.. 5 -
~S?~- aM<..IJ,.(?
SCOPE(S) OF 0 FON 0 STR 0;( ARCH
RElEASE: :...- ELEC 0 SPKlR OTHER(S):
TAX MAP PARCEL #:
v 00000 I 00 a
WATER UTILITY
PROVIDER:
SEWER UTILITY
PROVIDER: C4./2-,M~ '-
ioN c..
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS: AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
(\/ / It
# of Floors: j dl \ Elevator or Uft: E;I YES 1$ NO BLOG. CONSTRUCTION TYP .
TYPE OF CONSTRUcnON: TYPE OF IMPROVEMENT:
j2'l: COMMEROAL 0 NEW STRUCTURE
(Privately owned hospitals 0 ADOmON
and medlcaloffi~c~~ CONSTRUCTlmN Room(s)
E!!ii!AliiEU t" '. " latiQs Porch
o IN cOmDI1an<:O \\dth all regu 0' Mezzanine or Deck
urif~rgpiic;.~I~ LGi;nl CodeS' REMODEL
~E~iliih~F .., CO'I ~;, ,\ IN!T'i' SEtj;1JVltiSENANT FINISH
..., "" rllOl ""'': ~ 0 ~~~RY BUILDING
~F~F\<1fi![Ii!.h!d:i;LP.Y I (6VI~Atl1ED GARAGE
apply for 6lI! ho!w'OOnsb'uCtlOMtJrANA 0 ATTACHED GARAGE
~ SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CEll TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOUTlON
""
ESTIMATED COST OF CONSTRUCTION:
(EXClUDING LAND VALUE) if ;;.. ",,0. 0 t:>':>
OCCUPANCY ClASSIFICATION: ?
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y ~N Trusses: _Y ;X N
Lot Split: _Y ~N Sump Pump: _Y X N
Does any part of the property lie within a special Flood
designation area: _Y lL-N
PLUMBING CONTRACTOR:
4cl L....'v,4-.N -I- yOD~
Plumber's Indiana state License #:
,:. ?' 'S' \ 00" \ 'i: 0
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 LC. 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
Occupancyor Substantial ComB '0 as n issued by the Department of Community Services, Cannel, Indiana.
OFFICEUSEONLY:************************************************************************
531~ 00
";({Jt), 00
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4/ J J t , 6D Addlnonal Fees
~A,4 -;17 /-/{<~
t/ :2/ 0(0
!::>4N.G<..-
Print
Signature of Owner or Authorized Agent
INSPECTIONS REQUIRED:
e
i/y
UpperF
Lower Footin
der Slab
Site
f
~~S\(ll~ ~j 11.~t40
Reviewe /Approved:' Dept. of Community Services (Date)
S:Permits/Forms!ILP COMMERQAL
l2-. D" fi:ofV?,~ ,:.~
"ilS/0(p
Oa I
Filing Fees:
Base Inspections:
Cert, of Occupancy:
# Charged Re-
Reviews
TOTAL~
Fee Recelv - /~.