HomeMy WebLinkAbout06090028 Application
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City of Carmel/Gay Township Permit #:-O(nnqoC) A'O
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
,
BUILDER of NAME
RECORD: f?-cl lOI><J<;;-UtJ&-ftotJ, UC-
SlllEET ADDRESS
(I
r-e/LS CO""
PROPERTY tIC".'
OWNER: --(..
SlllEET ADDRESS
LOCATION
& PROJECT
INFO:
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
A.el~>' Calt1'/"~
PHONE
(5,1)5'7 j-{28 1
FAX
(51'1'))'-13- be5'::;
OTY
?&i:> CIIIZtu-t1...
STATE
ZIP
'llJCJ 3 Z-
BEST METHOD OF CONTACT:
5/7) ~1]-fao47
FAX
/~1- (51:) (pQ,5-i72.<
/,1>.
(, /CJ't
STATE ZIP
Lot # and Subdivi
icable)
ZONING:
2.0 60 ?F
,
TAX MAP PARCEL #:
STATE COMMERCIAL
DESIGN RELEASE #:
52.0 z 1 b
SCOPE(S) OF 0 FDN 0 STR Ij( ARCH
RELEASE: fE[ ELEC 0 SPKIR OTHER(S):
WATER llTIl.IlY
PROVIDER: {',tt,iZ.tUel /(;rra
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Aoors: I
Elevator or UfI:: 0 YES XNO
BLDG. CONSTRUCTIONlYPE: //-$/ 5f'i!. ar DCCUPANCYCLASSIFICATION:
/ZCM
TYPE OF CONSTRUCTION: ~.lC.O~ROVEMENT:
. NS1"
lj1f COMMERQI\.L,-."I"'l FOR CO,," " OJ\<Nt;WISTRUCTURE
~\!>I;c6Wiie(j hospitals .,rB With a" rrG ADDmON
ae.dm,~~! \l!lIcesrcGile'rS .~ ~ _ rei Codes _0 Room(s)
areltbtiimera~I)~..:.to.~e ~.lf'u \.0, Y C c\l',j\U:nSporch
o IN~&~~~v;,6iJN~ ~Jt'1~\~"y ;~'N~~66~anine or Deck
cY CARNk ~ NEWTENANTFINISH
01 INO\ANA 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check al which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
0i3 SlAB 0 CRAWL SPACE 0 CELL TOWER (New)
c:r POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WAlKOUT:_Y_N 0 DEMOUTION
SQUARE
FOOTAGE:
ESTlMATED COST OF CONSTRUCTION:I? ,..., D
(EXCLUDING LAND VALUE) c. ; O,D 0
PROJECT INFORMATION:
Early Release / Manufactured /.
Permit: _Y ~N Trusses: y. N
Lot Split: _Y /N Sump Pump: _Y ~
Does any part of the property lie within a special Flood
designation area: _Y /N
PLUMBING CONTRACTOR:
k'., /?.lL..liok pW/I-</r/tVC
Plumber's Indiana State License #:
5'5/)'95'1; )
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.
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 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
Occupanc >r Substan~alfop'on has been issued by the Department of Conununity Services, Cannel, Indiana.
/...f:Z-- ,L-;-r.,... l. ttUI7J'twv i/,)'~b
Sign re of Owner Authorized Agent Print' Date I
OFFICEUSEONLY:************************************************************************
e Filing Fees: (07<6 . ;J.V
i/rZ Base Inspections: "), 0 0 " 00
Cert. of Occupancy: / () /. 010
dJ a 0 r "? rJ Additional Fees
TOTAL: ~ =L O~;~ .
. _,,6 tUi .lit h 17 1-.., /laJhfiL
FeeR~e~: crj'::3/0U
INSPECTIONS REQUIRED:
Upper Footing
Lower Footing
Under Slab
Meter Base C Final)
Site
2..CXXD
Reviewed/Ap roved: De t. of Community Services
S:Permits/FormS/I COMMEROAL
# Charged Re-
Reviews
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