HomeMy WebLinkAbout06080036 Application
City ojCarmeliClay Township Permit #: e ~O S~Wb
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLI€ATION
For Commercial or Institutiona'l: New Structures, Additions, Remodels, Tenant Finishes, 8< AccessorY Buildings
AROi ozf MECH ,Ef PLUM SQUARE
OTHER(S): FOOTAGE: 20, 1Ft 0
ESTIMATED COST OF CONSTRUCTION:h
(EXCLUDING LAND VALUE) r 001' ocr..?
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
liQ COMMEROAL 0 NEW STRUCTURE Early Release ~ Manufactured \/'
(Privately owned hospitals 0 ADomON Permit: Y N Trusses: Y.A......N
and medical offices/centers 0 Room(s) ~ ~
,-,A~f'!al~ 0 Porch Lot Split: _Y _N Sump Pump: _Y...,.&N
'--tUb)'''"'t NAll OR. CONSTRUCTJ[)1\' 0 Mezzanine or Deck Does any part of the property lie within a special Flood
"" MunlcIPal/pubilc.BI~~, '. 1 w.,; 'REMODEL \...,
o (School 'r "'_"""C v, 1/) a J reQul~_c;;" designation area: _Y ~N
~'.'-"cC anU L Or": I C ~ ~ ~ 'NEW TENANT ANISH
DEr:e (\;hurc~,. '^' " ~:j OC,OS, 0 ACCESSORY BUILDING PLUMBING CONTRACTOR:
~~~~::'(OlecKIaIl'WhiJ:hSERVI@SDETACHEDGARAGE 1)1"" '17/I,IJ , ['....J-
applyfO, "ew,cqn!;tI;!,I~"'L"L~)( TOWN~ 'IWACHEDGARAGE_ __.!~r-i) j20-^ 8~ '(''''.....'Ii
k SLAB C!N[C)\WI<j.,&PACE ,'__ ___~,__J::t:LL,.TO,WE~ (N""!)" C CC,' ,Illumber's Indiana State License #:
o POST & BEAM 0 BASEMENT ':~::, D":CELL'TOWER CO-LOCATE,: ' .
(or POST & PIER) WALKOUT:_Y---':'N \"GJi ,DE~.oLmON '11\ ','
" 'I. '11 I;;
Class I structure pennies are subject to th~.deii~rkI Administrative Rul~.....o~ the $t~te~o~Indiana (See 675 lAC 12) regarding expiration time frames for
\ \ i~\ \ \ ~ agd ~W/iIeting',<\ow,ttuction.
I, the undersigned, agree that any construction, reconstrUctiorl;Vt\1l{rgement, relocation, or alteration of a structure, or any change in the use of land or structures
Wjuested by this application will comply witb. and:,~onrohn to. all applicable Iaw~9ftbe State of Indiana. and~2'llTlIn~CJI\Iii'i"aha'~'E~l'In<'t!>.dmn!I- ~E
289) and amendments, adopted under authority oB-c. 36~7,et seq;General"ASs'em.bly of the" State c?f Indiana, ~# a,Il Acts amendatory thereto. I furthercert:lfy _: aC'bnly
kitchen, b . and floor dra' are connected to rhi, sanitary sewer. I further certify tha.!.~e _~onstruction ~t~~u~~o~.occupied lll\tiLa-cti:l"tWt.ii" .
Occu y or Su ranti Completion has been ~~~_~YE>e Departmen1?A~mm""l;;:;;;;armel: Indiana. 0 rch/;,
of Owner 0 thorlzed Agent prin~ ;r;-:
OFFICE USE ONLY: **************************************** ********************************
INSPECTIONS REQUIRED: ~ Filing Fees: 1/;1., 68'. <8 0
, . /t 11 ,.., J"\ 0 # Charged Re-
Upper Footing Lower Footing Under Slab '"0 Base Inspections: ,r.;v6) . t) Reviews
~eter Base ~ Site Cert. of Occupancy: ) () , 0 5
~.. ~ .r 0 Additional Fees
\ TOifAL: .:) ,
l a.OO/;.
BUILDER of
RECORD:
NAME
jWUtr4'
ir OtiS( (c.U
/(1)
at-v
STREET ADDRESS
'/17
PROPERTY
OWNER:
BUILDER'S EMAlL ADDRESS
l^f€5 f'/€U) C0:>5:S e AO'--, (,O"'J
!/t1A6 Jt.;vESr/l1tWf
STREET ADDi/}3 fA ICEJi
NAME
f)~ [,
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION
1112 {(0fS70,./';;' lNfI
Address of Shell Building (If different than Address of Construction)
/
BUILDING, PROJECT, OR TENANT NAME:
6o".bWI/.-L
ZONING:
STATE COMMEROAL
DESIGN RELEASE #: 3 f '1 7 77
WATER UTILITY
PROVIDER: eJI.1..Mt8-
SCOPE(S) OF /G<' FDN '" STR
RELEASE: ~ ELEC ~SPKLR
SEWER UTILITY
PROVIDER: Cf,(jY/t:l.
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
KEYS1"rI(i (,yRy J/(Pf5
BLDG. CONSTRUCTION TYPE: 1l-
# of Aoors:
Elevator or Lift: Q YES ~ NO
PHONE
FAX
87)- 07JO
Jir~?t.5
ZIP
1626 f
CITY
STATE
IrI
BEST METHOD OF CONTACT:
201 ~ F/78
FAX
7IJb-0860
ZIP u/
7~/?!3
PHONE
8Y'6'- )0 Z-)"
CITY
STATE
CIIM1B-
..L#
Ifl
TAX MAP PARCEL #:
1'J7( .pU ,4t1~'rJt>
\ OCCUPANCY CLASSIFICATION:
Fee Received by:
Revlewed/A proved: Dept. of Community Services
S:Permits/Form ILP COMMERCIAL
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