HomeMy WebLinkAbout06080166 Application
Permit#: {)(f)J)?,oIWo
City of Carmel! Clay Township
COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings)
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME:
l....Au-rH GOr-..\s.TeUC-TIOW
STREET ADDRESS:
LLC
LVA-NIA P
FAX:
M6 - (05 "
500
mY:
INDIA-NI\:A't-I$.
STATE:
IN
zee>
ZIP:
BUILDER'S EMAIl ADDRESS: BEST METHOD OF CONTACT:
l'Y)\len-l::.im; Lio..€Jla.uth.net... &;:""'A-IL.
NAME: PHONE:
""",n..'D, I~T$ oNe!:> LL.C 1'5 -3' 40
STREET ADDRESS: CITY: STATE:
401 Pl=N"-l~VL.V.MJIA e IN
ADDRESS OF C~NSTRUCTION:
121 /~oe~ IAN
Address of Shell Building: (If different than Address of Construction)
'sA-M(;;
BUILDING, PROJECT, OR TENANT NAME:
/2.e. A-i....L cS /VI I L~
STATE CDMMEROAL
DESIGN RELEASE #:
WATER UTIllTY
PROVIDER:
FAX:
C3"~' 5to4 -3/46
ZIP:
4(02.80
ZONING:
SCOPE(S) OF 0 FDN 0 STR \/J ARCH 1lll. MECH b(
RELEASE: ~ ELEC 0 SPKLR 6THER(S):
SQUARE <"-
FOOTAGE: 283'a 1Z..s"
SEWER UTIUTY
PROVIDER: GA-l2..MbL.
PLAN COMMISSION / aZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: 3 Elevator or lift: lit YES Q NO BLDG. CONSTRUCTION TYPE: E.)(ST I SP K OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF I~OVEMENT: PROJECT INFORMATION:
~ COMMERCIAL S:'i~C'~~cruRE Early Release Manufactured
(pnvately owned hospitals il'Id~@I~\ ~(')lli5VlYiON Permit: _Y X-N Trusses:
offices/centers~~~ml) v~\\\i a\\, .... 0 ..Bqqm(s)
o IN5T!JJJTI~t:.v ",,\"ICEl . \ COoes [ii)~'eoi'<h Lot Split: _Y LN
rj>.'MaIiiF~IRlll>1f2\B~c LOC\}~\,J SE.?-'t]IJ .t!,~ne or Deck
CJs\lltl'lOilI 0\ S\,,\6 N 'J \'-\ \ '8\ (1$6l'1oiet FLOOD ZONE AREA DESIGNATION(Sl
o Church ,- CO\'JI \ c\J'l:ll! NEWTENANTFINISH
o MUlT1-~I/'''' 0, ?<\'JIE.\..I ",0 ACCESSORY BUILDING
Numbe~u i{)r~ \~D\P-~' 0 DETACHED GARAGE
. 0 ATTACHED GARAGE
FOUNDATION E: (Chec~ all whIch 0 CEll TOWER (New)
apply for the new constructIon area) 0 CEll TOWER CO-lOCATE
1;lQ SLAB 0 CRAWL SPACE 0 DEMOLfTION
o POST &_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) <t\ 244 5Cf e . Co
5J eEIV\
_Y-1L.N
_Y-.X,N
I
FOR THIS PROPERTY:
Sump Pump:
/'VOT
ApPL-IGA 6L.E:
PLUMBING CONTRACTOR:
';''''T"G.RPe,M", !;.t.-"-n.,ZJCAL-..... M4;.6HA-IVIC.M..-
Plumber's Indiana State License #:
PC I 02.0042. Cj
c.P.30~OOlq
0"-
Class I structure permits are subject to the Genera] Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expirarion 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 LC. 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 Certifica.te of Occupancy or Substantial Completion has been
issued by the Department of Community Services, Carmel, Indiana.
G..-A~c.-:-.~~ /...~
Signature of Owner or Authorized Agent
M A'TT~--v-J
Print
:;
V,,",IJT"I MIC::11..11\
B/Z8/0f.J.>
Date
OFFICE USE ONLY: ************************************************************************
INSPECTIONS REQUIRED: Filing Fees: ~ '}... ~, ;2,;;;Z
Upper Footing lower Footing Under Slab Base Inspections: 0 0 . Ot)
Cert. of Occupancy: J'lJ '/ ( (!) 0
1// "J. 9, L7.?,f.
*_ 11, _I / a./'vd
'/1/ of(;; Date
(j)(o TOTAL ~
t). II
Fee Receiv y: -
ReviewedfAp roved: Dept. of Community Services
S:Permits/Forms/I P COMMEROAL