HomeMy WebLinkAbout06050177 Application
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Permit #: OuOS7)~77
City of Carmel/Clay Township
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of NAME PHONE FAA
I' GOM r . ~O/O
RECORD: .-,. Con! tV' ~S '5~O S
SlllEIT ADDRESS CITY STATE ZIP
NN IAl 'i~
BUILDER'S EMAlL ADDRESS
N Co . colV7 S
PROPERTY NAME PHONE FAA
OWNER:
SlllEIT ADDRESS CITY STATE ZIP
/
LOCATION
& PROJECT
INFO: Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
STATE COMMERCIAL
DESIGN RELEASE #: :5
WATER UTILTIY
PROVIDER:
SCOPE(S) OF 0 FDN 0 ~ c::1--A1l6i
RELEASE: o/.-ftEc ~KLR OTHER(S):
SEWER UTILTIY
PROVIDER:
INt>
PLAN COMMISSION / BZA / BPW DOC IT NUMBERS; AND/OR
COU",," WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors:
.--
.)
BLDG. CONSTRUCTION TYPE: S.
Elevator or Lift:
TY;.s;F CONSTRUCTION: TYPE OF IMPROVEMENT:
. CO~~[;b.f&sR cm,rsTRl~:~~~CTURE
~~~Qfft~~ters1CG with ail renuiatitIDs Roam(s)
o IN~~~~tate EmcJ LoCt~1 Codes. 0 Porch.
"""''''TCM:: ~-l"'" ".I"rv '.cr::r"f,ro- MezzanmeorDeck
L.lJ::rJunOUfJal;eilbIll'Sldg-', " "C' - CJ' ';RtMODEL
Cgv~PO~CARrV1EL I eLl\Y TCCWiIj-.JfWIWNANTFlNISH
ure I' 'n' p. . ! , 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all'YMJehH 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
o SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM ~ BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N D DEMOUTION
ZONING:
TAX MAP PARCEL #:
o I..MfcH o'-f'CUM
SQUARE
FOOTAGE: 3:z 0 0
ESllMATED COST OF CONSTRUCTION: oC!
(EXCLUDING LAND VALUE) I 6 ~ CJ (') 0' -
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release / Manufactured . /
Permit: Y V N Trusses: Y v N
Lot Split: Y V( Sump Pump: _y~
Does any part of the property lie within a special Flood
designation area: _Y Vr{
PLUMBING CONTRACTOR:
k "f' k' O-Q-~
Plumber's Indiana State License #:
! 0 {, 5"3 ~
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
Occupancy or S bstantial Co ~n issued by the Department of Community Services, Carmel, Indiana.
. fler,-Y)~ gdr~
Signature of Owner or Autho z Agent Print
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: ,Filing Fees: 15 1'/ . 0 0
Upper Footing Lower Footing nder Slab.,,' Base Inspections: '2, V f) . f) fJ # c~:~gee.:;s Re-
~ Meter Base Site Cert. of Occupancy: f) 000
~ ~ Additional Fees
TQ.!!, .
~OO(P ~
Review Approved: Dept. of Community Services
S:PennIts/Fo sllLP COMMERCIAL
Fee ReceIved by:
~ -6~lol,
Date