HomeMy WebLinkAbout06050227 Application
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City of Carmel/Clay Township Permit #:
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For C\lmmercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
NAM '47'704 t$/17/A7V<
SlREI1 ADDRESS
/ 1co5" t,J. /0'0 0 AI
.DJ (.
PHONE
'.3/7) 44/-/"<:;25
FAX
($/7) 495""- 5"844
fDtZrv/~
STATE
r,J
ZIP
4{oo4o
BUILDER'S EMAIL ADDRESS
!1a4:I::PhLD e MAc.. Co
NAM~' ~,~
r r~~ClL C, LLC-.
,~DRE5~ . '"'
.' riB lA-nf...(! ~OeI .,l.)L.
ADDRESS OF CONSfR}JClJ<;/N n ,
10485"" .N..IY/rC-1+( ~ ~
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
PHONE
.3/7) 574-5488
FAX
LOCATION
&. PROJECT
INFO:
CITY STATE
::::LIJoI. , A-.J ~ L<S ::t.,J
sum # (If Applicable)
too
ZIP
41009
,
. 1-'
BUI~G, PROJEct, OR TE. NANT NAME:
llt!.MSwAd. W,II.J-c..CSS
STATE COMMERCIAL ~ 11..
DESIGN RELEASE #: '1/ T/ .
t~(5
Lot # and Subdivision (If Applicable)
Address of Shell Building (If different than Address of Construction)
SCOPE(S) OF 0 FDN
RELEASE: 0 ElEC
o STR 0 ARCH
o SPKLR OTHER(S):
o MECH
o
./
SEWER.umrrv---e><':f . - -'. -= ::ES11MATED COST OF CONSfRUcnO
PROVIDER: ~~ (!""C'.I,L: il ,\,]0 !~; !r"(EXCLUDINGLANDVAWE) cr~O.r-
! II \ \ I c::.:, \.\..':.1 I ~:-::; ,j \ ,-:;:~:,;,,! \ \ 1
PLANCOMMISSION/BZA/BPWDOCKETNUMBERS;ANOioR r~'J:'-" -- - A ..lll! \1.1..-.r-: . A.Jre
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If APplicabl~j:'J ~~ t1Z>,,( -n.<iitHiItT',..-bl1(TCQ'T/2:9137eT4C>- n,
,l r, , I; I.
." II 1'11'1
# of Floors: Elevator or Uft: c;I YES ~ BLD . E: It L ) 1
ILl t..ll J"- ,
TYPE OF CONSTRUCTION: TYPE OF.IMPROYEMENT:--"-PROJECT INFORMATION:
rzJ COMMEROAL P NEW STRUCTURE Early ~elease /' Manufactured ~
(pnvatelyowQSkitAiSED FOR cORiCAPAJ;11P.I'C------- --'-Permit: _Y..0 Trusses: _Y.----.JI
and medical pffil1O.$iW/tfrs '" I [!JJ ~~;J&N -;:-' :..----- t.-C
are commercTa~~J 0 ~O~Plla~;.e With AlllThg!Joia11ons Lot Split: _Y ~ Sump Pump: _Y_N
o INsrmmONAL . of Sta,e anr Local Co&;;ls Mezzanine or Deck Does any part of the property lie within a special Flood
o Mum-fIUIl1'E:JlIdIt;O~;'M ~REM'~ .-
O S~ 1,1 UN dO 'C'.J:::t;> designation area: Y.......N
OF C NEW' ""..",NISH - -
o Ch ARMEL / CIc1WA(:~~I\:tilING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (CheCkallwhi?lNDIAN~ DETACHED1iAA'AGE /!/ //J
ap~ construction area) 0 ATTACHED GARAGE f'T..
LAB 0 CRAWL SPACE 0 CELL TOWER (New) Plumber's Indiana State License #:
o POST & BEAM 0 BASEMENT P CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_~O OEMOUTION
WATER UTIlITY
PROVIDER:
OCCUPANCY ClASSIFICATION:
Class I structure permits are subject to the General A<Jmiliistrative 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 I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I funhercertify 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
cx or Subs ill mpletion has been issued by the Department of Community Services, Carmel, Indiana.
(J he H4~'-::U. #t:1-r-ro ..l
re of Owner or Authorized Agent
Print
Date
6'/3/ jatp
,
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: 1,1d..4b Filing Fees: ::3 d;? . () ()
~. ~ I ) 0 A') 0 () # Charged Re-
Upper Footing Lower Footing Under Slab r,~ > Base Inspections: v . Reviews
c..F'~ Cert. of Occu a . 0 7. 0 0
r:,(I4A. 509.t.D.
(~
Rough In
Meter Base
Revlewed/ proved: Dept. of Community Servic
S:Pennlts/FormS/ILP CQMMEROAl
Fee Received by: