HomeMy WebLinkAbout06090104 Application
City of Carmel/Clay Township Permit #:~~
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, lit Accessory Buildings
BUILDER of NAME PHONE 51::J- G.3"f ""01 FAX "1. T a.c,,'4 02,-...",
RECORD: ~"'MM..-r CoN~It."'C.TION Co. ,,.Jc.
STREET ADDRESS CITY STATE ZIP
Ilo~ ~...at>$A-,- 71L"''' IN!>/4-NA,...,-, ~ '''' '"ffDii.og
BUILDER'S EMAlL ADDRESS BEST METHOD OF CONTACT:
"bo",&"'-3C.oLt'P -;;....,.... -r CO N~. CD"", E:,o-\A-.L.
PROPERTY NAME PHONE 3. ~ $11'... - -:rS 1<, FAX 1. T S8""- T1fi/.~
OWNER: <.,.-. 1/. /OJ ~& N~ /' A. rz-, ~ L. t-k> 17, r""-
STREET ADDRESS CITY STATE ZIP
I ~ ~..,<:> N. t""l~a., 1>' ~ .,.,. -. - . EL- IN Ii {Po 3;1.
LOCATION ADDRESS OF CONSTRUCTION SUITE # (If Applicable)
&. PROJECT '<:5<;>0 oJ. ........ef2.,-plA-N "'Sr.
INFO: Address of Shell Building (If different than Address of Construction) lot # and SubdivisIon (If Applicable)
BUILDING, PROJECT, OR TENANT NAME: I ZONING: II TAX MAP PARCEL #:
t.OW"'.-'Z- '-eveL- CDN~-"'CG- f2.=>.... S B-cP I ':f-o"fDiSoooc> 00 I DO ~
STATE COMMEROAL SCOPE(S) OF o FDN o STR a- ARCH l8r MECH ;iiC PLUM I SQUARE
DESIGN RELEASE #: '3~o'f3'B RELEASE: ~ ELEC g $PKLR OTHER(S): FOOTAGE: /( 'l?"1
WATER llTILITY GJ-<- ~ SEWER llTILITY I ESIlMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: c~~/.- (EXCLUDING LAND VALUE) it I I 0 , <:> <:>0
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR ..I (A
COUNl'I WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roars: I Elevator or Uft: 0 YES I!jr NO I BLDG. CONSTRUCTION 'TYPE: ex"'" ->71<.. I OCCUPANCY CLASSIFICATION: I-;;t T2GJO'\
TYPE OF CONSTRUCTION: TYPE Or IMPROVEMENT:
~ COMMEROAL 0 CON'GJrN~,Si-RUGtuRE
(Prlvatelyowned hosPitals' \,0" ' ',\,0\\ ADDmaN
d ed I ffl"" - -. I 8 'N '
an m a..o, ~centers ....\.,l.f\\, '~Oc.\.t5J Room(~
are commer'dal) \. to CO\f\' ) \ LOC'3.\ U c CD,\JPOrdi-
o INSTITUTIONAll\8C \ ,,\,,1(" d,\l ,\'0/ ",10 M _'1,,0 D k
- C\ :-1"- .,...,,\\'"\l \ l \ ezzar;1f.le<or ec
o Munrapal/Public Bldg'OloiIW'u' .S{REMODE'L'-
o Schopl,cP1 Or ""'fl-L I C'o' NEWTI:NANTFINISH
o ChurCh ('\1" Cf',h\ ,,- \p..tctJ. ACCESSORY BUILDING
FOUNDATION TYPJ;i;'caletk all which \NO 0 DETACHED GARAGE
apply for lhe newconslructlon area) 0 ATTACHED GARAGE "5........'-.....~ ..... ",oO'L.E
~ SLAB 0 CRAWL SPACE 0 CELL TOWER (New) Plumber's Indiana state Licen_~e #,: :., , . ,.'
o POST & BEAM ..... BASEMENT 0 CELL TOWER CO-LOCATI: " - , -- "'. " 'I
(or POST & PIER) ~ALKOlJT:_Y_N 0 DEMOUTION C'?S' 003\ Y~:~:;,l(}, -- - _0 ':-\\\\
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) r~~ expiration ~ for \.::< \
beginning and completing construction. \.4\ ~ \ c.,\ c.~~ V .---/ . )
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any ch~e;in the-use"dtrand or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordih,~f,of Farmel Ind1ana'-:i99r (Z' ~_.- ,--
289) and amendments, adopted under authority of LC. 36--7 et seq, General Assembly of the State of Indiana, and all Acts amen~t~ thyeto. 1 further certify ~at only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupiid\JritiJ a Certiljcate-of
Occup""cy or Substantial Comftfoj\ ~been ",med by the Department of Community Services, Cannel, Indiana. \ \ ______./
~~ ~~ ~4-NISL- la. =1Ie:iZ/3f::c...<- \~.:----' &f~;1o/"c..
Signature of OWner or Authorized Agent Print Da I
PROJECT INFORMATION:
Earty Release Manufactured
Permit: _Y..KN Trusses: _Y ><N
Lot Split: _Y.KN Sump Pump: _Y XN
Does any part of the property lie within a special Flood
designation area: _Y >< N
PLUMBING CONTRACTOR:
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: IZ Filing Fees: 5"" ot5. q I
~tb 'J /'V"l """0 # Charged Re-
Upper Footing Lower Footing Under Slab l\ (I:: Base Inspections: "-I,fi../ , Co' ReViews
c9 -- e ... Ce<).:~/ocy ;jj:/~ _~,_
T~~~~ . .
Reviewed! Fee Received by:
S:PermIts/Form