HomeMy WebLinkAbout06080001 Application
City of Carmel/Clay Township Permit #: DCe 0<00081
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICA nON
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, 8< Accessory Buildings
BUILDER of
RECORD:
NAME
.J,t,~ /ll-v;,1I ~ ~liUA'l16 ,~(.. "It-
STREET ADDRESS
1(6"/ S ~M'E floA -I~$' II/Ire c.
BUILDER'S EMAIL ADDRESS
c..1-Iof.F€G fi)/JrL
~At.. f1O.Jf~~
PROPERTY
OWNER:
NAME
PlNJlf'<l.1.(; POI~
t)l-oHlO lot.. L
STREET ADDRESS
o/8"f s: $I~ pQ\'t)
mY
fJ/cre L.
LOCATION
8r. PROJECT
INFO:
ADDRESS OF CONSTRUCTION
'1D~5 f)t,j) ~QZolDvW ~
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
pr,vN'kIE 'R11~ Nl'a/Mt..-
Lfr1;Ir
SCOPE(S) OF IX FDN iX STR r;( ARCH ~ MECH
RELEASE: 0( ELEC 0 SPKLR OTHER(S):
STATE COMMERCIAL
DESIGN RELEASE #: ~I '61 Lf3
WATER UTIlITY
PROVIDER: ll.A9-A,"1-
SEWER UTIlITY
PROVIDER:
l:1'1-~
PHONE
1'1 eo
OarlA
FAX
$r1 Bi6-1tJ'5
-18'5D
mY
~~~
STATE
//1/
ZIP
'11.1'12-
BEST METHOD OF CONTACT:
1,.z ~~ -1'1/'b
PHONE
111 ~1..-1B5D
FAX
311 ~y; - 71.1 g
STATE
.liPa'W~ 1/11
ZIP
1-//"1'11-
SUITE # (If Applicable)
Lot # and Subdivision (If Applicable)
TAX MAP PARCEL #:
o 6000(:) 130DO
t.O,IJPD
ESI1MATED COST OF CONSTRUCTION:
(EXQUDING LAND VALUE) :fI -t, fJDfl, (lfJO. f)[)
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; ANDIOR ..
COUN1Y WEll ANDIOR SEPTIC PERMIT #'S (If Applicable): i'DtIIer".. ry.: I tOO' 'D
# of Floors: 2- Elevator or Lift: K YES 0 NO BLDG, CONSTRUCTION TYPE: ~ea... OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE'Of', IMPROVEMENT: PROJECT INFORMATION:
......r~\ \, ,\ 1'-'
~ COMMERCIAL (' 0 ~.\s " ",) '.. Ol cNEW STRUCTURE
(Pnvatel~qed~lalsJ ~ 1~\ rj\ r-,JJo ADOmON
RtaJldEi~\aiI'olfi;.!',S/CI!'llerse " . C"::" ~ - ~ Room(s)
1Irecq[l1m~al} I\-", fld LO~?\ c,.-:~-"\\j\L I:-E) Porch
o Illsi1\RmR~~4a\e c' , " 'NII",J- ^' I q::ul" Mezzanine or Deck
o Muniqpa~ubh6 Bldg "'I '\ U[!j \"i?EMODEL
~Jsth60': ~,f\t:.L I eli, 0 NEW TENANT FINISH
FOUNDAlttO~(~eck\IJJQ~l;Ii\ g ~~~~~~~YG~g~NG
apply for the new construction area) 0 ATTACHED GARAGE
~ SLAB 0 CRAVVLSPACE 0 CELL TOVVER(New)
o POST & BEAM 0 BASEMENT 0 CELL TOVVER CO-LOCATE
(or POST & PIER) VVALKOUT:_Y_N 0 DEMOLITION
'9i'/alPl.S
5
Early Release Manufactured
Permit: _Y -X-N Trusses: XY_N
Lot Split: _Y LN Sump Pump: _Y ~N
Does any part of the property lie within a special Flood
designation area: Y LN " ",)"
PLUMBING CONTRACToR: 0 0/ \20 '^-(5. ~
Plumber's Indiana State License #:
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frWles for
beginning and completing construction.
I. the undersigned, agree t any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this appli iOIl'~ll comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana ~ 1993" (Z~
289) and amen en, ago.pted 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, ba, o~-arain nnected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certi!icate of
Occu a ti "1etion has been issued by the Department of Community Services, Carmel, Indiana.
d/IPI~ Hci'1'rE'
Print
Reviewed/ pproved: Dep!. of Community Services
S:PermIts/FormS/ILP COMMEROAl
o7/'l,11 UlP/"
Date
Additional Fees