HomeMy WebLinkAbout06090027 Application
COt if/> IIC" 'T"_" Permit#: o(p[f1oo~7
t y 0 o..-arme lay -' ownsmp I
COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMfIl
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
STATE:
tJ
BEST METHOD OF CONTACT:
Ul bY! ,CfJ ~~Irqg.
NAME: ~M~M-.d{~ ~NE: 3nr(ptg"-,')-~1
CITY: unvlU STATE:{ AJ
BUILDER
OF
RECORD:
BUILDER;; EM,,!L ADDRESS:
/1\.'5 \ efr\.U"S
PROPERTY
OWNER:
STREET ADDRESS:
1 '100 10. fi/krldiN'l
LOCATION
& PROJECT
INFO:
Address of Shell Building: (If different than Address of Construction)
PHONE: -z
JI
FAX:
CITY:
IMr
ZIP:
FAX:
ZIP:
,+W3d-.
SUITE #: (If Applicable)
00
lot # and Subdivision: (If Applicable)
STATE COMMERCIAL
DESIGN RELEASE #:
3?eLf'3S
o STR i:!CARCH %:. MECH )rCPLUM
o SPKLR 6THER(S):
SQUARE
FOOTAGE:
# of Floors: Elevator or Uft: ~YES Q NO BLDG. CONSTRUCTION TYPE: OCCUPANCY ClASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
~ COMMEROAL 0 N6W..l'TRUCTURE Early Release V
(privateIYOWnedhOSPjtalsand~~B~1AbdITrON Permit: _Y ~
offices/cente:ii!\ero~~iD. . v. \ . e~'J\a\\0'5 Room(s) Lot Split: _Y 'VC.
o INg~,':' c8 '<J\\D a\ ; ~ 0 Porch -f:'"
, "I~~!'IJ!lhC'B1(f~ OCt'll GOOI{:;.. "Rg<ezzanine or Deck
gill)\'SE ,do \e o\\'j .- ~"REr:ioD~'"
o Chule s\a \'.1\,\1'1'01,,1\\'1 ;W~t1!PJANTANISH
o Mum:~U;j\' 0::;,. "'L I C\J\ 'i oJ ACCESSORY BUILDING
Nu~ Of...L\llIl(,~ \.' 0 DETACHED GARAGE
(",IT':{ ur ,-,,\\1\1\1"'" 0 ATTACHED GARAGE
FOUNDATION TYPE: (Chec~ aI' w'll1ch 0 CEll TOWER (New)
apply for the new construction area) 0 CELL TOWER CO-lOCATE
~LAB 0 CRAWL SPACE 0 DEMOLITION
o POST &_BEAM _PIER )i'[ BASEMENT (WALKOUT:_yLN)
SCOPE(S) OF 0 FDN
RELEASE: ~EUEC
SEWER UTILITY
PROVIDER: c....--r
PLAN COMMISSION I BZA / PW DOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTIC PERMIT #'5 (If Applicable):
ESTIMATED COST OF CON51lUcnON:
(EXCLUDING LAND VALUE) '\> DO DO 0
Manufactured
Trusses:
-y~
_Y .lCN.
Sump Pump:
)0
PLUMBING CONTRACTOR:
S(ZU\t:;"Jn~~ rV
Plumber's Indiana State License #:
10 \C,<N;o
Class I structure permits ate 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 - 1993ft (Z- 289) and amendments,
adopted un r authority of r.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 .. the sanitary sewer. J further certify that the construction will not be used or occupied until a Certificate of Occupancy or SubstantiaJ Completion has been
;"uedby h,D'pu'ffi<utof nity S<tVim, Cumd, Indim.. ~~ M. SI:ewt<..tS ~
Si Print Date
SEONLY:************************************************************************
INSPECTIONS REQUIRED: ft Filing Fees: /~7 .3 , ~ 7
Upper Footing Lower Footing Under Slab q/I'J. Base Inspections: 200,{)O
cert~ oOccupan: /0 7,00
TOTAL: /-~ ~.~7
.12..'200" ~/
Reviewed/Ap roved: Dept, of Community Services (Date) ~
S:Permits/forms/ P COMMERCIAL Fee Received by: Date