HomeMy WebLinkAbout06050196 Application
City of Carmel/Clay Township
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
Permit #:
tJ&oso I q (p
BUILDER of NAME
RECORD:
PHONE
FAX
lioN
u3G>
STREET ADDRESS
CITY
0'
STATE
ZIP
PROPERTY
OWNER:
1001 A S ,+",220
BUILDER'S EMAlL ADDRESS
-t,' ~O "rle. COI'Yl
NAME
u..o.,v' JIll
BEST METHOD OF CONTACT:
ern-.',f c,- . l'f -,?So'-"O'li
PHONE FAX
C33G
LOCATION
& PROJECT
INFO:
IN)) I AM ()/2opcRf/e'
CITY
13 1'~,;AJfI,,/O() D
STATE
.,N
sum # (If Applicable)
ZIP
3' o:;J.7
I-e E S J.
Address of Shell Building (If different than Address of Construction)
Lot # and SubdMsion (If Applicable)
SEWER lJTlLITY /' -rn ,. I'l-..
PROVIDER: ~~ ~ ~ ~.."V~ V
TAX MAP PARCEL #;
BUILDING, PROJECT, OR TENANT NAME:
r
STATE COMMERCIAL
DESIGN RELEASE #: 31 b 3 'i
~~~~~LITY .~ ~,~t-\
V6sr C,;.. ..;
SCOPE(S) OF flJ FDN 0 STR
RElEASE: 0 ELfC 0 SPKLR
SQUARE
FOOTAGE: 337 3'sc';
ESI1MATED COST OF CONSTRUmON:
(EXCLUDINGLANDVALU i::,c~ Me" W;<o./oo. D(()'
PLAN COMMISSION I BZA / BPW OOCKET NUMBERS; ANDIOR
com-lTY WE AND/OR S~PTI~ PERMIT'S (If Applicable): AI / A
LV Elevator or Ufl: ~ YES Q NO BLDG. CONSTRUmON TYPE: ';'A OCCUPANCY CLASSIFICATION:" ,
~ ",...r .:1:2 '<
TYPE OF CONSTRUCTION: NSi OVEMENT: PROJECT INFORMATION:
~ COMM~CJA~ c.t:0 fOP. cO 1\\1 all faillUI~ STRUCTURE Early Release Manufactured
(~IilIWfi~~~lance VI cod(:;'J.. ADD!l1ON Permit: LY _N Trusses: X Y_N
anjl,[T)l'll,'et~l!f<e9!<:e~~~nd LOcal Sr::r'l\l\Q::~oom(s)
a~inerd~s\a'C ~, UNIT< {;on ,Q,I-ll~~ Lot Split: _Y -LLN Sump Pump: ~Y_N
o IN5TITU110NA <= r,~M ,,,,< 10\f'J~ Mezzanine or Deck Does any part of the property lie within a spedal Flood
o ~jilCfp Publf>., I tL I CV' 0 REMODEL
o ~Scho\ll\r:: C",K ,,' Ie 0 NEW TE designation area: Y X oN.. ~ .. ' , .:. J A. - '- tJ
cC'<lh1m:rI" 11'101"''''''' 0 ACCES~~~~~:~~~G PLUMBING CONTRACToR: 13~-'~: ~WJU0lIl,S'1L{r
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
Cil) SLAB 0 CRAWL SPACE 0 CELL TOWER (New) Plumber's Indiana State License #:
Cil) POST & BEAM r.&i BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y-2L,N 0 DEMOLTflON
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 Cannel 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 tha;t 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 Substantial Completion has been issued by the Department of Community Services, Cannel, Indiana.
''''0/101.4<;
Print
T, I<eei)
s-h? !c.x..
Date
~
Review /Approved: Dept. of COmmunity Services
S:PermIts/FormsIILP COMMERQAl
Base Inspecti
- ..,.
C Cert, of Dee
TOTAL:
1I