HomeMy WebLinkAbout06040186 Application
City of Carmel/Clay Township Permit#: O{pO~Ot3&
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of NAME
RECORD:
PHONE
FI\)(
-r
L.1c
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CITY
'~J
STATE
hi
ZIP
'I
PROPERTY
OWNER:
BUILDER'S EMAll ADDRESS
'b;
NAME
rv\;DW(; 0/(
STREET ADDRESS
6'7
ADDRESS OF CONSTRUCTION
BEST METliOD OF CONTACT:
PHONE
FI\)(
cm STATE
ZIP
5J:~
LOCATION
& PROJECT
INFO:
SUITE # (If Applicable)
,-J
Address of Shell Building (If different than Address of Construction)
Lot # and Subdivision (If Applicable)
BUILDING, PROJECT, OR TENANT NAME:
Y; rv\l (..' - I
STATE COMMERCIAL
DESIGN RELEASE #:
SCOPE(S) OF P FDN 0 STR
RELEASE: r;/ ElEC 0 SPKLR
ZONING:
?UD
rs/ ARCH
OTHER(S):
TI\)( MAP PARCEL #:
1'7132
MECH
o PLUM
SQUARE
FOOTAGE:
l'-ilS
WA1ER UTIliTY
PROVIDER: Ve: . :x
PLAN COMMISSION / BZA / BPW OOCKET NUMBERS; ANO/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LANO VALUE) ~
[) NO
BLDG. CONSTRUCTION TYPE:
OCCUPANCY CLASSIFICATION: ];
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y A-N Trusses: _Y ~N
Lot Split: _Y ~N Sump Pump: _Y ~N
Does any part of the property lie within a special Flood
designation area: _Y).:LN
PLUMBING CONTRACTOR:
\;,l'\.~ 't>)0""').,:~)
Plumber's Indiana State License #:
It1.S\(.
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ COMMERCIAL RELEASED FOR <e9r~!fvJWR\blJ~1\I
(Privately owne&lpjlBlSt to co'"np"<JncCDv'....OOmONulations
and medical officeS/centersof Stats ane) Loca! CGdiRoom(s)
are commercial) ",."" } ~ r,' ,-_' 0., rPQ!ch ~
o INSTI1\JTlONAlDEPT OF Cufv:k,Urii \ b^\1Men.hge~?1>eck
o Munici~(1lopIi(llld~ARMEL /CD:LREMODSWNSHIP
o School ~"I'lEW TENANT FINISH
o Church IN 0 l'tJ"ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
(8\ 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 DEMOLITION
u,.~ ____....---,0 r .. j;' ,
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (S~~ ~??.:.~~C:~)lk~in.\{~Jf}li?tion 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 ~~e. of land or structures
requested by this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the,:'.ZQni~ Ord.~ ?f C~fmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of I.c. 36-7 et seq, General Assembly of the State of Indiana, and~aiI'&ts6m'ndM:6ifiyVthe<<;t? 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 Certilicate of
Occupancy or Substantial Completion has been issued by the Department of Community Services, Carmel, lnrli2M j L
~ ::- I - 'T<l:h-v-." ~^",...)
Signature of O\/IIner or Authorized Agent Print'
4/<'1/0(,
Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Ci'11~ Filing Fees: 6 ~ 3, ') 5: '
( ..., ~ In # Charged Re-
Upper Footing Lower Footing Under Slab.? Base Inspections: ".... {)C) ~ U L/ ReViews
Rough In Meter Base ~ Site Cert. of Occupanq!: / () 7 .. (j 0
J l82d>f. TOT ~~z2:-1[;~~9;~;~t
Reviewed/Ap roved: Dept. of Community SOlVices
COMMERCIAL
Additional Fees
Fee Received by: