HomeMy WebLinkAbout06070170 Application
City of Carmel/Clay Township Permit #: fJ60r] 0 )70
I
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of
RECORD:
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mY
C r-d ..::z:-:.
I.. .;/:;..:" Co,....,
(1 PHONE
J~{\4H:e.r
FAX
STATE
~
BE
METHOD OF CONTACT:
7/0-~{)1 ~
FAX
E3$1 . 1/67:;
STATE ]11
~H. y6o"J~
PROPERTY
OWNER:
(grot.
PHONE
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRucrrON
lJ... -t J-O
/Jr..
BUILDING, PROJECT, OR TENANT NAME: 'J
..:=. ""'I1"CI.c/l
STATE COM EROAL SCOPE(S) OF g,....FDN 0 STR
DESIGN RElEASE #: 3 / 7 3 -0 RElEASE: rp-'ELEC 0 SPKLR
SUITE # (If Applicable)
Lot # and SubdMslon (If Applicable)
TAX MAP PARCEL #:
erARCH
OTHER(S):
~ MECH
PLUM
SQUARE
FOOTAGE: ? 0 0
.....
t..;O. 000
WATER UTIliTY
PROVIDER:
r"", cJ
SEWER UTIliTY
PROVIDER:
Co I f'r) e../
ESTIMATEO COST OF CONSTRUcrrON:
(EXCLUDING lAND VALUE)
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUIm' WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roors:
Elevator or uft: J(.. YES Q NO
BlDG. CONSTRUcrrON TYPE:
l3 OCCUPANCY CLASSIFICATION: 13. (C E IY\,
PROJECT INFORMATION:
Early Release ')(J Manufactured V
Permit: _Y _N Trusses: _Y.t::';::N
Lot Split: _Y~N Sump Pump: _Y-p
Does any part of the property lie within a special Flood
designation area: _Y 4-N
PLmI~G C:::I;R: /i7 e ci
Plumber's Indiana State License #:
PC l?/VS7'106
.
TYPE OF CONSTRUCTION: TYPE.OF IMPROVEMENT:
~ COMMEROAL r:'" ....C'?I C,O:"O',:NEW-STRUcruRE
(PrlValeIYr>Jllll~~ili.oS{ltals') ~ ,,?n'.;" ~J\lCJ.'''Ai>QmON
and medlc!al'offlCesJcen~e~)\l\P . '{)"oJ (,0(; 0 Rool'l1(5"),
Q......1.n. 8(...;l ~u ~rI L \... - 1\1,.,; ,
Dare comm".....l ; S\8\8 8\'~ 'I "''/ SID' P6ictJ. , P
INSTITUllONAL 0 _ cO\ Ic!\U~' \ ' ,O\j~ni~~ or Deck
o Muni~{BtIbI19Bldg' '~ I CdS REMODEL
o Scho&iJ'" Of CI\I'\H,\::L ^.ell NEWTENANTFINISH
o Chlf'l:llj'( \ND\'''b~ ACCESSDRY BUILDING
FOUNDATION TYPEr '(Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
~LAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLlTlON
dass 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 Carmel Indiana - 1993" (Z;
289) and amendments, adopted under authority of I.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 connect to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Dce eyorS Z2com etio as been issued by the Departmen:m;;r setJj~=:~w.a. 'J. ~ C- D 6
Slgnatu of OWner or Authorized Agent Print Date
OFFICE USE ONLY: **************************************** ********************************
INSPECTIONS REQUIRED: Filing Fees: -"/5 i. 00
"l 0 0 0 # Charged Re-
Upper Footing Lower Footing Under Slab Base Inspections: /'vO, Reviews
(RoUg~ Meter Base G Site Cert. of Occupancy: () ,,0 V
TOTAL.- ~{g ~.pt?
Fee Recelvk ~
Additional Fees
or"
Review /Approved: Dept. of Ccmmunity Servic
S:PennIts/F6rmsIILP COMMERQAl