HomeMy WebLinkAbout06060039 Application
'"
06Qb003Y
City of Carmel/Clay Township Permit #:
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
A-
~.
.
"o~ ..0-
BUILDER of NAME
RECORD:
('()\J
LC
PHONE
fJtfb- ~
FAX
('317) 6'16- ~ I
us.
STATE
/
ZIP
CITY
v
BEST METHOD OF CONTACT:
"
~ '
(!.+
PROPERTY
OWNER:
FAX fst/b- ~ '.
ZIP
CITY
STATE
tV I
Address of Shell Building (If different than Address of Construction)
LOCATION
&. PROJECT
INFO:
..--:;
L , # and Subdlvlslon (If Applicable)
(C
STATE COMMERCIAL SCOPE(S) OF >l 0 FDN 0 STR 1J! MOl 0 MEOi 0 PLUM SQUARE
DESIGN RELEASE #: I 1t./ RELEASE: I'" ELEC 0 SPKlR OTHER(S): FOOTAGE,
WATER UTILITY SEWER U:T!t{rYr~ iF'" I.S n \\,7 f c:::' ~~TED COST OF CONSTRUCTION:
PROVIDER: ,.,....., US PROVIDER: I)U-,..-'" ''", ~~ t.S. '(EXa.UDlNGLANDVALUE) II 8//
"'LA A 1!ll ..---- II "-
PLAN COMMI~ON:tBZA / BPW OOCKET NUMBERS; AND/okv \ 111'1'/
COUNTY WELL AND~SEPT1C PERMIT #'5 (If APPlicable):llill JU " ~
~ -Elevator or Uft: 0 YES "NbU U LOG, CONSTRUCTION TYPE: 1MB I OCCUPANCY ClASSIFICATION:
TYPE OF coNmuCnoN: TY E OF 1M ROVE E PROJEllT INFORMATION:
pI COMMERCIAL O-NEW'STRtJCfURE EarlY-R~lease Manufactured /
(Pl1vatel~<j:!I\\Sllllals 0 ADDmON Permit: _Y LN Trusses: Y V N
and me<ii.c.itotn~&;@ ~O 0 Room(s) / /
a"'coml1\~ctto . Fi CONS'" 0 Porch Lot Split: _Y'y"'-N Sump Pump: _Y..!L..-;;
o INSTITUTIONAL ,Il' ;ornpl18nco " I AUnT,l:l'fi<!Jnlne or Deck Does any part of the property lie within a special Flood
o ~/PUblidBld921'C1' '''th@)' r,REMODIOC v / 0
S2c~qbi I OF COIviV,f~ocer C~~EWTENANT FINISH designation area: _Y.Y...-N
o tMfdi)FCAI'2".....: i')'\/!'T'(51;:: 'l(:<;:ESSORY BUILDING PLUMBINGCONTRACTO~:~)" ,bf) , ;::;, /l,d.' t~-'
FOUNDATION TYPE: (Check'alfllVt1l&o/ Cr Q~/bE1'~GARAGE <G/" t/~/..
applyJor the new construction 'rorJlA vy'~ CDJm GARAGE
~ SLAB 0 CRAWL SPACIONA 0 CEL (New) Plumber's Indi~na Sta,te;.! d /' ~/' '
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO.LOCATE v /'<r
(or POST & PIER) WALKOUT: Y N 0 DEMOLmON
:33 ,5"$3
163.00
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.
It 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 J.e. 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 Certificatc of
cy or Subs omp/chon has en issued by the Department of Community Services, Cannel. Indiana.
:D~~ ~ ,J
~""11 r.s
. s J PVDC.,>c
Date'
Print
-,
OFFICEUSEONLY:********************************************************~***************
INSPECTIONS REQUIRED: ~ Filing Fees: &-fp se; ~ <'(},7
, .~O #~~
Upper Footing Lower Footing ~Slab Base Inspections: rJ...,{)() ,1/ Reviews
Rough In Meter Base ~Site Cert, of Occupan : tf / 6 7 ,(J 0
TOTAL: .f\1- & ~. D Additional Fees
-~
Reviewed/ proved: Dept. of Community Servi
S:PemItslFtll1T1S/11P COMMERClAl
Fee Received by: