HomeMy WebLinkAbout06060149 Application
City of Carmel/Clay Township
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, l!t Accessory Buildings
Permit #: 1)00 (n 01 ~ 1
BUILDER of
RECORD:
CctJSTR NJ ~1~NE.
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FAX
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PROPERTY
OWNER:
FAX
STA
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LOCATION
8< PROJECT
INFO:
ADDRESS OF CONSfRUCTlON sum # (If Applicable)
5mB' If I
Address of Shell Building (If different than Address of Construction) Lot # and Subdivision (If Applicable)
BUILDI~~, PROJECT,
L- \ f\lCDL
ZONING:
TAX MAP PARCEL #:
IlId -11-00-00 ~ol.;l.oO
~ PLUM SQUARE 2 0r\ q
FOOTAGE: l..>-'
STATE COMMERCIAL SCOPE(S) OF 0 FDN 0 SfR
DESIGN RELEASE #: <3\ '2:f1 RELEASE: 'R ELfC 0 SPKLR
WATER UTILITY SEWER UTILITY
PROVIDER: .' PROVIDER: ~ft
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Aoors: Elevator or Uft: YES c;J NO BLDG. CONSfRUCTlON TYPE: fX Sl S9 OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IM~~N PROJECT INFORMATION:
\0' COMMEROAL "'Od$.~ \!I(ions Early Release Manufactured
..,...., (PrivaleIYOwnedh~5l"ASE.O r 'Ll' ~Of'l)9\Jal Permit: Yff'l Trusses: ~N
and medical offices)c.!iit~.. compliance dl~QJ1l(s) ,
arecommerdal) Sublect to t oncl LOC, \?O>1>.1\:1\j\CfS Lot Split: _Y N Sump Pump: _Y f'I
o INSTlTlJ110NAL 0\ Sta e ~ U N\1JY Mehari omp
o MuniciPal/Pu!lli~ OF COM~ ~lilllEl:fOv:l'~~,n Does any part of the property lie within a special Flood
o School U CARM; NEWtEf'lANTFlNISH designation area: _Y~N
o Church r.\1'< OF \~\Sli6S0iY UILDING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (CheCk all which . \ DETA~ IGE '^ A c..-G VO-rN n I 8C~l (-t~ \ ~
apply for the new construct/on area) 0 A~ (G>\'Rl GE ~ ~ M
QlL SLAB 0 CRAWL SPACE 0 ~~lL\T.9Y'1!iR eN ) Plumber's Indiana State license #:
o POST&BEAM 0 BASEMENT ~'GEil~,TOW~ 0 'CATE 0'[ ,//'1/_
(or POST & PIER) WALKOUT: Y ~ ~~ ~~).OEM0UT10 ~~ CJr 0 D 57 '-fV14/
Class I structure pennits are subjttft<(th~\'~al Adrnini e R of the iiltate of Indiana (See 675 lAC 12) regarding expiration time frames for
((;:~~" ,.,_ . . g and mple' ..'construction.
It the undersigned, agree that any co~s.~ . , recon~t tiob; enlargemm't, relocati , or alteration of a structure, or any change in the use of land or structures
requested by this application will comp!y.w~, d co to, all apPtkable law the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z~
289) and amendments, adopted under aUt{t'o~t}:\ f LC. 6,7 et ~;"'General Assefublyof the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, andrliO ins are connect~ ~ 1~'i"'itary,.>eWer. I ~&certify that the constru c tion will not!'e used or occupied until a CertiFicate of
Oce C orSu tan . 'l1lpletJonhas~~iJ~d:6ytheDe entofCommuruty Services, Carmel,Indlana. 7n II.
. , .;;;fr;YJ 120/3 ~ U -W ~Ol/
Signat re of Owner or Authorized Agent Print Date
rX ARCH
OTHER(S):
o MECH
ESTIMATED COST OF CONSfRUCTlON:
(EXCLUDING LAND VALUE) $
0::>0
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: & ce 3 . 00
. . '0 O?\ # Charged Re-
Upper Footing lower FootIng Under Slab Base Inspections: f?'., '" Ou Reviews
Meter Base ~ Site Cert. of occupancy:i. 0 ~. CfL
~ Cf 0 0 tJ Additional Fees
TOTAL: -I-- #
DOli ~~:~~.tf/o-~/(J6
Approved: Dept. of Community Services
mS/ILP COMMEROAl
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