HomeMy WebLinkAbout06050098 Application
City of Carmel/Clay Township Permit #: OfttOSro18
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, l!r. Accessory Buildings
BUILDER of
RECORD:
NAME
PHONE
JD,V LlC 31')- 8'1') - 03(,0
FAX
SICiJA-(vi\t
STREET ADDRESS
- ~1')-03(,~
OTY
CA (In E l-
STATE
2JV
ZIP
'-/(,03J.
BUILDER'S EMAIL ADDRESS
'"so'" €J ,,I,,,,,. ""i
PROPERTY
OWNER:
NAME
f' [.~ (lJ"- :t
L
BEST METHOD OF CONTACT:
'31/-'\'1'-')<; IS
PHONE FAX
J - )f)-onO - 0350
CITY STATE ZIP
C+,{(r)EL .1:'" "/1.031.
sum # (If Applicable)
LN '1(,0 ;).
Lot # and Subdivision (If Applicable)
STREET ADDRESS
LOCATION
& PROJECT
INFO:
r-l Av'E
ADDRESS OF CONSTRUmON
5LJ
BUILDING. PROJECT. OR TENANT NAME:
Cfr,< EL elT Ce,vTC-<
STATE COMMERCIAL
DESIGNRELEASE#: 3/77q
I.
TAX MAP PARCEL #:0 ~
I'" tJ13(.00t9 ao
SQUARE q
FOOTAGE: f.s; 1 5 J.f
ON
Address of Shell Building (If different than Address of Construction)
SCOPE(S) OF . FDN 0 STR 0 ARCH 0 MECH 0
RELEASE: 0 ELEC 0 SPKlR OTHER(S):
WATER UTILITY
PROVIDER: C,/-,f /I1[L
SEWER UITlITY
PROVIDER: C /f;( ft1 t L
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) // ~ !):l. / ~ ')
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Roars:
':L Elevator or Lift:: "YES Q NO
BLDG. CONSTRUCTlONTYPE: (3 . .,.( (.'+L . OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
lIlJ COMMEROAL '~ NEW STRUCTURE iP
(Privately owned hospitals "'0 ADDmON C6IL~/I"""
and medIcal offices/centers 0 Room&r~
are commercial) 0 POrch
o INSTITUTlONAL 0 Mezzanine or Deck
o Munid~I!'/J.~~D FOR ;:;::j ...ll&.1':1.0DEL
o SchoolSub' C~'J~EWtrmPmJ/l1ISH
o Church JeC! to compliance 'll1l:h ~gBll !lm~DING
FOUNDATION TYPE: 19,eck aIlf~ and LOtGl cQ!8;ACHED~'xItKGE
apply for the new CO~~i"''l!brv],\II u' Q... ~tHED GARAGE
II SLAB CIiB' ~~~~JiE "d y c€t1~~~)
o POST & BEAM 0 BASEMENT ' LI CtJ\'ytijL9';flWf>&FRJ!PCATE
(or POST & PIER) WALKOUT:_+NDIAN~ DEMOiJi'Ib'N
PROJECT INFORMATION:
Early Release Manufactured
Permit: _y ---1"N Trusses: _Y LN
lot Split: _y XN Sump Pump: .JL.Y_N
Does any part of the property lie within a special Flood
designation area: _Y -LN"
PLUMBING CONTRACTOR: 13~' 12, ~i .
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 frames for
beginning and completing construction.
I, the undersigned, agree that any consrruction, 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 J.e. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, a 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 s Completion has been issued by the Department of Community Services, Carmel, Indiana.
~Mu) ,/j . it) /If ;)p _ S II z/ 0&
Signature of Owner or Authorized Agent Print Date
Additional Fees
proved: Dept. of Community Services
LP COMMERCIAL
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