HomeMy WebLinkAbout06080098 Application
City of Carmel/Clay Township Permit #: () 0. agOOqg
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & AccessorylBuildings
BUILDER of NAME
RECORD:
f.,ll>
PHONE
'? n 4>7'6 '? 100
FAX
IlrIJ /)t ~
STREET ADDRESS
"??Ja 8, St. D'7Cil~ 'ST
BUILDER'S EMAlL ADDRESS
Ct...,-,~l.::.s' \,1fa..J.h:........ il'v,-,t.e"" Go,,,,
01Y
STATE
tlJ
BEST METHOD OF CONTACT:
PI..o"""-
ZIP
L./ 2.0 <...
PROPERTY
OWNER:
NAME
\-\"",*i
~",k..
PHONE
c,,1!/- '3"31-887.:2.-
01Y
FAX
331-88'2 'L
LOCATION
& PROJECT
INFO:
STREET ADDRESS
E...,>'too.J Ov(~l. to A 4c"l7
ADDRESS OF CONSTRumON ",
10'\2.<; ~ M,ei,\.\ c(.", <<...J..,
\15
STATE
01-\:
ZIP
L.\3,- \ "I
C.A""""'i l.
SUITE # (If Applicable)
l.{f.,O?,'2..
Address of Shell Building (If different than Address of Construction)
\--lIp<
BUILDING, PROJECT, OR TENANT NAME: ZONING:
t\"...\\ to", ~<L"'I..- ;;(
STATE COMMERCIAL
DESIGN RELEASE #:
SCOPE(S) OF 'fiI! FDN ~STR
RELEASE: ~ELEC 0 SPKLR
SEWER UTILITY
PROVIDER: ~T I/. w
e3
1102.-
~~. ~
~
WATER UTILITY
PROVIDER: C ftlL"^ iii L
ESTIMATED COST OF CONSTRU<;T10N:
(EXCLUDING LAND VALUE) 1'10-0,00D, eo
PLAN ,COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUtffi' WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: \ Elevator or Uft: c;J YES .t(. NO _
-""",," ..,'
TYPE OF CONSTRUCTION: rO \,.~ ':TI'~,O~~~~:.%9)lEMENT:
~ COMMER~~ t: !'>sED FOP" ,-II\h Q!l..(~N.EW STRUcnJRE
(Privat~e.rROsPltaJsrnp\'3r'(G ... @O'ADDIl1ONS
andme,dJ~~Ytentets ",',d \.oec.' cr:m:::i\\ROo",ts.h
areconiiiMl1ill6 01 Sl.al.8 ^' ''IN\\'I'.:> 0 .;;;J",1l"
O INSlTIlITIONAL r,' ."0-/1 -\ ' , \ ,.......
.. nlO ,,'J'" \ Ai '-0 Mezzanine or Deck
o M"Cid.p.'ii17PUIlIit B~ \oJ' F \... Ie. 0 REMODEL
00 ~ilQlv 01' cp.. \\ \'NDlp..NFEi NEWTENANTANISH
......1cCh \ 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
t2!t SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLITION
OCCUPANCY CLASSIFICATION: b
PROJECT INFORMATION:
Early Release \ /I Manufactured
Permit: Y _'K-I'J Trusses: X Y_N
Lot Split: Y ~ Sump Pump: _Y X N
Does any part of the property lie within a special Flood
. designation area: _Y tkJ:N
PLUMBING'CONTRACTOR: Sr ~
Plumber's Indiana State License #:
Class I structure permits 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, anq 7onform 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.C. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. 1 further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. 1 further 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 Conununity Services, Carmel, Indiana.
C.~L~b~ P<o;~+~ C~"'~ S..1.0~~'-
Signature of Owner or Authorized Agent Print
~
Date
OFFICEUSEONLY:************************************************************************
/09'2..:58'
/ # Charged Re-
Base Inspections: CJ1 (!) f) .. tJ (f) Reviews
Cert, of Occupancy: 11- '~~ ~ . 00 ., .
H q ? <> Addluonal Fees
TOTAL: 1-'-.)<\
F R ..-Jd b- ~-j," 17" /../1 h <t -<'-f
ee e~ ~l2070cPl
Filing Fees:
(D<€)