HomeMy WebLinkAbout06060220 Application
City of Carmel/Clay [ownskip Permit #: (J(~ D0b;;(}.O
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
NAME
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STREET ADDRESS
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31'7-br?? -J/p()q FAX
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STATE
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BUILDER'S ~L ADDRESS
J'Ill'elrlf!, tit{np..n .Or
PROPERTY
OWNER:
STATE
7"1\1
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION
SUITE # (If Applicable)
BUILDING, p~a TENANT NAME:
, Sf .
STATE COMMERCIAL tOcom ,~;" ,..Or :~~~(S)OF 0. FDN 0. STR 0. ARCH 0. MECH 0. PLUM
DESIGN R E #: Of St P,lanc:e Wi , "RElEAS€'rI9' !-Ec::;-oC::?P~,"o;rnER(S):--'-'----'--;
ate :~,_,.., ,f: ,":1/ . IC,..,\ II ,I,. fie I, ;,',', . ".~ '-'
~R~~~OF :!', C;OM!V;I~~~~~: :~~~~fu,yIS IN Vk-"-c -"''-:'''~~~~~G catrD ~A~~~)STRU~/ON:
~_ :r,..,...~) "/~ 1,1111 ~
PlANCOMMISSION/BZA/BIfflIlQCK&'NUM~J"Rf;'~P/o<:.s ill \\1 . JUN 262006 1'1 jli
COUNTY WELL AND/OR SEPTtOEltIti\ti~~1(If APplJd..IO-y.,S,'-!/P i i! WI Pi. i i i~.: : 1
Elevator or Lift: 0 YES NO BLDG.-CONSmuCTlONTYPE:-----J - ! OCCUPANCYCLASSIFlCATlON:
" I
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:____PROJECT_INFORMATION:
rEf COMMEROAL ~~/ 0 NEW STRUCTURE Early Release i Manufactured
(Privately owned hospitals ~ i 0 ADOmON Permit: Y Trusses: _vvN
and medical offices/centers ,J I. 0 Room(s) _ - - ./
arecommerdal), 0 Porch LotSpht: _Y N Sump Pump: _Y.!:::.N
o INSTIlUTIO ONAL .) 0 Mezzanine or Deck Does any part of the prop~e within a special Flood
MuniCipal/Public Bldg 0 REMODEL '
o School 0 NEW TENANT FINISH designation area: _ Y N
o Church ~ ACCESSORY BUILDING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE ,,// II ~
apply for the new construction area) 0 ATTACHED GARAGE C/-t:r..
G?' SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST 8< BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST 8< PIER) WALKOUT:_Y_N 0 DEMOunON
Lot # and Subdivision (If Applicable)
/A-
TAX MAP PARCEL #:
,00
# of Floors: I
Plumber's Indiana State License #:
dass I structure permits 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 ofl.C. 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 dra. are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy or SubstRn' Com letion has been issued by the Department of Community Services, Cannel, Indiana. f. l1
. (VJ1fZ'i.. ~'\\ & 117 M
Print Date!
OFFICEUSEONLY:************************************************************************
~~ON"'''.''''~ RIi",_, leSS'. IlO
. # Charged Re-
pper Footing Lower FOOting~ Under Slab Base Inspections: ;;z CJ 0 , () 0 Reviews
Rough In Meter Base e Site Cert, of Occupancy: / (J 7 f) 0
~ 00
Reviewed! Appro
S:Permits/Forms!ILP