HomeMy WebLinkAbout06040043 Application
City of Carmel/Clay Township Permit #: ()~ 0 t(/)b~3
COMMERCIAL or INSTITUTIONAL IMl'ROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of
RECORD:
PHONE FAX
_ '" :t 7 - ;).38"3 3'1
STATE
ZIP
3''2.
PROPERTY
OWNER:
_ rr CD
iL c..
BEST MErHOD OF CONTACT:
ft -(\11} JL
-8"1'1-39 J
FAX
170/-
ZIP /
0/(. 0 .3
LOCATION
& PROJECT
INFO:
STREET ADDRESS
~ e. t:A1!.;'Jtr:L .Pe
ADDRESS OF CONSTRUCTION
. ~111e.L D~.
PHONE
31
OTY
c.L-
STATE
I\J
&
,
/
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
fi/ff-L of I J..lJ"' Y
,.
w; cJ-t
STATE COMMERCIAL
DESIGN RELEASE #: d( 7 (I L
SCOPE(S) OF 0 FDN 0 STR
RELEASE: ~ELEC 0 SPKLR
SQUARE
FOOTAGE: t2 ;;)... ;z 0
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ;Z.60 OCO . ,0 .0
WATER UTILITY
PROVIDER: )
SEWER UTILITY
of Qft~L PROVIDER: TV Or C
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roors:
~O
t'
BLDG. CONSTRUCTION TYPE: ~ ~ --:-
OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION:
~OMMEROAL \I
. (Privately owned hospitalS -^..-\:
and medical officeS/centers (W . \.l..
o .~~~ ~~
o Munidpal/Public Bid E-
O School .
o Church \.1'0
FOUNDATION TYPE: (Check all which
a&for the new construction area)
}:8J SLAB 0 CRAWL SPACE
o POST & BEAM 0 BASEMENT
(or POST & PIER) WALKOUT:_Y_N
TYPE OF IMPROVEMENT: PROJECT INFORMATION:
o NEW STRUCTURE ~Release ~ Manufactured JL
o ADDmON .,.,-,\.lC \t- _Y N Trusses: _Y N
o Roo 'S,P \;3.\\0 ~
.(fP':f!,'6~,\ e.'1 ,e<:l\lt:Ot Split: _Y N Sump Pump: _Y N
€.~ ,M~nine'~I'e'~cl0S. ~~~ part of the property lie within a specia Flood
~El \ l('::<> ct'1'> ' .,0 \/'
0' EW TENANT FlNIsfj\ --' .... de~_n area: _Y -AN e. ~
......t ~'l" ',~ ~.... \~l\
OO\'>;~~RYBUlip\N~,'i \UPlUMBINGCONTRACTOR: WA.) 'D
M~EDGARAGE- --<r
p€,\tj .::A1mffEDr~\i>-
~~'rcru TOW6t>'(New)
C 0 CELL TOWER CO-LOCATE
o DEMOLmON
Plumber's Indiana state License #:
Class I structure pennits are subject to' the General Administrative Rules of the Sta.te of Indiana (See 675 lAC 12) regarding expiration time frames for
beginning and completing construction.
t, 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
~ ~bS.'{ tallY' C':.,mpJetion has been issued hy the Dep"";"'ent of Community Servic"" Cannel. Indi""..
6dZlL.-~VrU Krz/ rJ-I Sc..R.1 Ve',/lJ 'I-~--,20(f)Co
Signature of OWner or Authorized Agent ' Print Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED' . e Filing Fees: '701, 'to
\11.. .-,: 00 00 # Charged Re-
Upper Footing Lower Footing Under Slab q \~ Base Inspectio s: :J' Reviews
~ MeterBase Site Cert.ofocc,,'lancy: 07, (!) 0
~ ~O Additional Fees
/\
Oto
Fee Received by:
(Dale)