HomeMy WebLinkAbout06080058 Application
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City of Carmel/Clay Township Permit #: (JCzO ~fJOS~
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
STATE COMMERCIAL
DESIGN RELEASE #:
WATER UTILIlY
PROVIDER: Ve 0
NAME
Lav/l,
PHONE
(317) 8'18-6500
FAX
(3J7) g'l8 -,65//
Con.sln.dion
dLe
STREET ADDRESS
'10/ ?ennJ vanJc. Park.",
BUILDER'S EMAIL ADDRESS
'nicJ,oJs @ lau#'. ner
mY STATE
lnc;{"'1na oils IN.
BEST METHOD OF CONTACT:
EYn",i/
NAME
/1erid i"" Medic" I 4ssoc./a.J.es (J"e .LLC
STREET ADDRESS
'10) ?enns Ivan;'.. P...kwc.
ADDRESS OF CO STRUCTlON
/2 )8'i?A ",;:..J.I... Men,L"" 5.fr-eef
PHONE
(317) 575- 3/<'/0
ZIP
~62 80
FAX
(317) 5.6'1-31'1'0
STATE ZIP
.IN. 7/6280
sum # (If Applicable) J / S-
TN. ~60.3':?
mY
lndianc;
;'-s
Address of Shell Building (If djfferent than Address of Construction)
54me A.s- Above
BUILDING, PROJECT, OR TENANT NAME:
Aes#ie~c fYash-c So
e,...
of
TAX MAP PARCEL #:
Nof A
/!'( PLUM
Lot # and Subdivision (If Applicable)
N",+ A ';ic,;"ble
.I no/.i<Ma
319990
SCOPE(S) OF 0 FDN
RELEASE: ~ ELEC
OSTRoM ARCH W MECH
o SPKLR OTHER(S):
SQUARE
FOOTAGE:
SEWER UTILIlY
PROVIDER: Cc.rm e I
EST1MATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) JI; II 'i! 2 96 . 00
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
JlccdJe
173'1
RSF
# of Roors: :3 Elevatororuft:)Q YES Q NO BLDG. CONSTRUCTION TYPE: [XsT 5?K OCCUPANCY CLASSIFICATION: B REM
";; OF CONSTREf~e~ASED FOR CVi~~~~~~~~~~ENT: PROJECT INFORMATION:
COMMEROA .. 0 oNi;W,51RU9i\JBE Early Release V Manufactured X
(Prlvatelyoli)ilfia;no51lita~COmp"ance Vld "ADiJifIoN'~ Permit: _Y -4-N Trusses: _Y_N
and medical officeS/ce~rstate and Local CocO'. ~:",m,leL Lot Split: _Y A-N Sump Pump: _Y X N
o IN~n;;lii'gpT OF COMMUNI1Y S!3~\POf2h:~
OM' imoI/""""," Rld"R' 'E' / C." "y",' .\,\f1~1~'1'" Deck Does any part of the property lie within a special Flood
UJ11!l1.'l-Y'crr~'" IV,l_ ~0' REMODEL X
o School INDIANIlQ NEWTENANTFINISH designation area: _Y_N
o Church 0 ACCESSORY BUILDING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE f
apply for the new construction area) 0 AlTACHED GARAGE C 5 M /1echMical Cons-!,
~ SLAB 0 CRAWL SPACE 0 CEll TOWER (New) Plumber's Indiana State License #:
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE r
(or POST & PIER) WALKOUT:_Y_N 0 DEMOUTION 0106'137
Inc.
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.
It 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 I.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 drains are connected to the sanitary sewer. I funher 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.
~ a ;?:?'
~ature of Owner or Authorized Agent
JoSh=.
Print
A.
N/cJ,o/.r
0'8/09/06
Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: f- Filing Fees: & I). " t-j{p
. . fl\ 1 ..... "'f) # Charged Re-
Upper FootIng Lower FootIng Under Slab II \ Base Inspections: ",V,. 0 0 Reviews
Rough In Meter Base ~ Site Cert. of Occupancy: " 7 ~ CJ
Reviewe Approved: Dept. of Community Services
s:Permits/ ms/lLP COMMERQAL
Additional Fees