HomeMy WebLinkAbout06080149 Application
City of Carmel/Clay Township Permit #: f)(d)go/1~
I
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
,For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, 8< Accessory Buildings
BUILDER of
RECORD:
W/l
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
J.4I~b;n/T
ADDRESS OF CONSlRUcrr N
'0 /--r 1/
Address of Shell Building (If different than Address of Construction)
BUIlDING, PROJECT, OR TENANT NAMJ:
- ,? CJ)"v
STATE COMMERCIAL ~ /Q-? /
DESIGN RELEASE #: ::::>/ /.?-{ ;
WATER UTILTIY C SEWER UTILITY '/7 h ~
PROVIDER: . Q PROVIDER: C 7 ,t::-#'l/ V
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUN1Y WELL AND/OR SEPnC PERMIT #'S (If Applicable):
# of Roors: :J...... Elevator or Lift: YES Q NO
PHO) :3-93~
C)d;JfC,
~ -f~tJ' /
STATE
p./
P
O~3
C:::-?<32~8
BEST METHOD OF CONTACT:
a~
'3~3 - />CJ 2-
CITY
~04t'J
FAX
SUITE # (If Applicable)
....----
Lot # and Subdivision (If Applicable)
TAX MAP PARCEL #:
I (30 ~Ot)00031
~~~~E: J f 9 If:p
EsnMATED COST OF CONSlRUcrrON:
(EXCLUDING LAND VALUE) / ~4:;>~
BLDG, CONSlRUcrrON TYPE: /1-,6 <)/' ~ OCCUPANCY CLASSIFICATION:
~PE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
COMMEROAL 'IZf NEW STRUCTURE
(Privately owned hospitals /Q ADOmON
and medical offices/centers 0 Room(s)
are corrfilCr<@IEASED FOR CONSTROOTiQbJ
o IN~~~g~J61iEBId'g'~ii2nce withqi r8cQ,at~nine or Deck
o School of State ailcJ LOCell Ddl~~~?~~ANT FINISH
o Ctii)@PT OF COMMUNIT'cEFAC'asSOii.Y;BUILDING
FOUNDATION'WPE'A~I~~iGl1 /' r.LP8T{oJi:J;fI(Hl;Pi~GE
apply for the n~ eohs'tfUcU6fi' area)' ~ J 'tJ 'Ali'Ac*b 'GARAGE
)g. SLAB 0 CRAWLS~I/-\r~A 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOlJT:_Y_N 0 DEMOLITION
PROJECT INFORMATION:
Early Relea~~ V Manufactured \,
Permit: ~y -,CiN Trusses: _Y-LL-N
Lot Split: _Y ~N Sump Pump: _Y ~N
Does any part of the property lie within a special Flood
designation area: _Y ~N' I
PLUMBING CONTRACTOR: ,
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 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 Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of Ie. 36--7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, b ,and floor drains are connected to sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occu or Substantial rpletion h issued by the Department of Conununity Services, Cannel, Indiana.
fS;?'&Ct' fJ. ?~I!t31..--
Print
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OFFICEUSEONLY:************************************************************************
~' PECTIONS REQUIRED: .' e Filing Fees: ~Z; <is r 0'. 77 I
, .. [...1 ~ () # Charged Re-
o '. Upper Footi Lower Footmg Under Slab ~ J.-, Base Inspections: 0 , e; V Reviews
'" Rough In ~r Ba~ Final te . Cert. of Occupancy: 0 7, 0 0
. . ~ I. &, 0 ~ 17 Additional Fees
" . ..' 6Oc. TOTA.LLp ~ l~) ~ . I I.
~- ~ L:ll~
Review " roved: Dept. of Community Services Fee ReS!. eived by: {-7 I I A
s:_ ILP COMMEROAL ~r\ 4 ::> { 0 '-t'
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