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HomeMy WebLinkAbout06080124 Application City of Carmel/Clay Township Permit #: tJ~O?!()IZ/-{ COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLI<rATION For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory' Buildings BUILDER of NAME PHONp 011- FAX .2 if- RECORD: lIL c IV L, (lg -loocn (tog- 10 ~'7 STREET AODRESS 0# 100 CITY STATE ZIP Co Od '(, BEST METHOD OF CONTACT: C- C PROPERTY NAME << 31'1-- FAX ~ Ii- OWNER: '^-- E'D-- " "-l., 000 STREET ADDRESS 9~~ Sf STATE ZIP &0 'i' 0. (s- . -:I/v LOCATION ADDRESS OF CONSTRUCTION S:.t.ee.: (If Applicable) &. PROJECT 'Il--, INFO: Address of Shell Building (If djfferent than Address of Construction) BUILDING, PROJECT, OR TEN U STATE COMMERCIAL DESIGN RELEASE #: 3 JO:5 ~ SCOPE(S) OF 9-' FDN 0 STR RELEASE: p.---l:LEC 0 SPKLR TAX MAP PARCEL #: i I (P - /3-1/ - 0 </-11' -0'0 .6/ SQUARE I FOOTAGE: d) '/.]~- ESllMATEO COST OF CONSTRUCTION: (EXCLUDING LAND VALUE) ::, WATER UTIlITY PRO~DER: ~ ' PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR COUNTY WEll AND/OR SEPTIC PERMIT #'5 (If Applicable): # of Roars: Elevator or Uft: c;I YES 0 NO OCCUPANCY ClASSIFICATION: TYPE OF NSTR A.SED FOR 00, I sou",,, NT: COMMEROAlcuhiect to compliance v@" ~UCTURE (Privatelyo~mosp'~~ State and LOC@jC Ol'i~r'" and meclcal officesicentels M M U N I TY SB R Rl!dm~r:' arecommercjlljEPT OF CO -iFrIwrqsHIP o INSTITUTl~-}T.\.( f.).t:I~ARMEL I C\J\Y I!:)-' ~ezzanlneorDeck o MOo _,Ij,,_C Bldg . t'lA REMODEL o School \ND\A.~ NEWTENANTFINISH o Church 0 ACCESSORY BUILDING FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE apply for the new construction area) 0 ATTACHED GARAGE t.B- 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 DEMOUTION PROJECT INFORMATION: Early Release Manufactured Permit: _Y ~N Trusses: _y RN , Lot Split: _Y~N Sump Pump: _Y~N Does any part of the property lie within a S~a1.J';:ff\\ designation area: _Y ~N ~ ~ ~ \\ PLUMBING ONTRACTOR: ~ ~ I:, ;.-/ '\ \ ~ c;::---~ ""'" \ Plumber's Indiana Sta \ #: '1. \ 'tJ t>-\\G dass I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) re or beginning and completing construction. I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any chang requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordin annel 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 further certify that the construction will not be used or occupied until a Certificate of Deeu ey or Subsblnt:ial Complctio:, has been issued b! the Dep~of Communi': Serees, Carmel, Indiana. . I IlrJVA ~,,\ ,/J!(>- ?-d..-I-o(, Signature of Owner 0 uthoriz Agent Print ,. Date Site Base Inspections: Cert. of Occupancy: TOTAL: Addinon,1 Fees (JOe, Reviewed{Ap roved: Dept. of CommunitY Services S:PermIts/Fonns{I ~. COMMEROAl Fee Received by: