HomeMy WebLinkAbout06040070 Application
City of Carmel/Clay Township Permit #: ~!atJLj0D7lJ
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
STREET ADDRESS
Cf830 /bf\......r t{'lU
PHONE
<Se'0ic.e<;".
CITY
..:t. VI<!.;
FAX
BUILDER of
RECORD: ,
S7'f - 'S't 1.8
57'1- 5Y''l(
STATE
,:::C 10.
BEST METHOD OF CONTACT:
6- l1lj<\.iL ~ e-
FAX
ZIP
7"- Z'i/o
PROPERTY
OWNER:
NAME
51, Vi 1'Ic:.e ftt--
;'{cl COI1.,{........d.. Cor>l
PHONE
STREET ADDRESS
/3S-CD ,J~ rl1e"tJ~
CITY
S(r~"-+
eM meL
STATE
X,v.
ZIP
LOCATION
,. PROJECT
INFO:
Lot # and Subdivision (If AppUcable)
Address of Shell Building (If different than Address of Construction)
IJ.An Sired-,
9JITE ~!!)APPllca e)
'?- r:
STATE COMMEROAL
DESIGN RElEASE #:
I'-I"$'/{
SCOPE(S) OF 0 FDN 0 STR JlJ: ARCH JIi MECH
RELEASE: 'Ill ELEC 0 SPKLR bl1-iER(S):
SQUARE
FOOTAGE: lIDO
BUILDING. PROJECT. OR TENANT NAME:
.6-r. iJ; (lUll f- Crif'rW'
TAX MAP PARCEL #:
WATER UTILITY
PROVIDER:
SEWER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION: d
(EXCLUDING LAND VALUE) .0'15 DC!:' ~....:-
PLAN COMMISSION I BZA I BPW DOO<ET NUMBERS; ANDIOR
COUNTY WELL ANDIOR SEPTIC PERMIT #'5 (If Applicable):
# of Floors: 3
Elevator or LIft.: YES Q NO
BLDG. CONSTRUCTION TtPE:
,/!?CCUPANCY CLASSIFICATION: B Pe
PROJECT INFORMATION:
Early Release 1 Manufactured
Permit: _Y...c-N Trusses: _Y LN
Lot Split: _Y ~N Sump Pump: _Y.J(N
Does any part of the property lie within a special Flood
designation area: _y-X-N
PLUMBING CONTRACTOR: tJ / tt
(VD worl<- ~I \
TYPE OF CON!rrRUCTION: TYPE OF IMPROVEMENT:
ell COMMERCIAL 0 NEW STRUCTURE
(Plivately owned hospitals 0 ADDmON
and m~fli~slcenters 0 Room(s)
areci>niiM!llll:l::ASfD FOR C""'.'''''T~l o.TI'R'Il.
o IN~C1I( r m~l~~ "-,'I;,'" ~1~ineorDeck
o I MunTO~a1/Pu~ri~~qgD"'"' Ice Wl!i\:9ii 'REMODllDns
o , S<;tI!I!L 0._.,,,, " and l.QGai !\al;cliNEW TENANT FINISH
0, cM/cIl"'T 0,- COrvlr<,lUNlr,f.J,:'~9S~'6BUILDlNG
FOUNDATION WPfa:tleck,alL-wlJich , d~ 'OETA~GE
apply for the new conStHidttln'iir'ea)" - / C i j, tJ T iA'M'.l>.tHtibJ4#lAAGE
@ SLAB ci~ CRAWL SPliiifiANA 0 CELL TOWER (New)
. POST & BEAM O' BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLITION
Plumber's Indiana State License #:
Oass 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 Cannel Indiana - 1993" (Z~
289) and amendments, adopted under authority of r.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, and oar drai are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occup c '1' . Completion has been issued by the Department of Conununity Services, Carmel, Indiana.
Roh #flfY/-1on 0/-12-0(;
Print
Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: (p g '^ '" ()O
. _ nO 0 () # Charged Re-
Upper Footing Lower Footong Under Slab Base Inspections: ""' · ~ Reviews
~g~ Meter Base G Site Cert. of Occupancy: / () 7 , 0 "Z)
TOTAL.... 3Q. 0 Additional Fees
Reviewed/Ap oved: Dept. of Community Services
S:Permits/Forms{ILP CQMMER<JAl
Fee Received