HomeMy WebLinkAbout06100053 Application
City of Carmel! Clay Township Permit #: Ole 100063
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, 8r. Accessory Buildings)
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME:
Mf"llDltW Dul~du:>
STREIT ADDRESS:
BUILDER'S EMAIL ADDRESS:
~\.\.vc."-. \>\w ""U'" e.- G,,^..~L. LD""
NAME:
PHONE:
~I ,3:J>-014'1
CITY:
FAX:
~.." 'bc..l . ""311. 'b
STATE: ZIP:
=w '-\(.,0''/
~i:l
BEST METHOD OF CONTACT:
3. 39-01'-11
PHONE:
FAX:
~'r..'IYL
l?02>-bODl>
CITY:
::rl.ot:>"~
b..,ll.l< ~EA-fN
STREET ADDRESS:
l.oo ~ "II.""' ';'T,
ADDRESS OF CONSTRUCTION:
qln~ l\..l, "',<.\,-,..",-" ~
Address of Shell Building: (If different than Address of Construction)
~..~
BUILDING, PROJECT, OR TENANT NAME:
~""E'E\ 1:l~M"\.~ l"\~~
STATE COMMERCIAL
DESIGN RELEASE #:
WATER UTILITY
PROVIDER:
LE:'U1\2\?...
STATE:
-.:;u
ZIP:
'-tl.1..4C>
SUITE #: (If Applicable)
\>.D
ZONING:
Lot # and Subdivision: (If Applicable)
o MECH
, 011000 <j I. ooD
SQUARE
FOOTAGE: c.fJOO
SCOPE(S) OF 0 FDN 0 STR 0 ARCH
RELEASE: 0 ELEC 0 SPKLR OTHER(S):
SEWER LfTILITY
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Roars: I Elevator or Uft: 0 YES BLDG. CONSTRUcnON TYPE: OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
lZl' COMMERCIAL 0 NEW STRUCTURE Early .Release ~'
(Privately owned hospitals and medical 0 ADDmON Permit: _Y
offices/centers are commercial) 0 Room(s)
o INSTTTUT10NAL 0 Porch Lot Split: _ Y Sump Pump:
o Municipal/Public 81dg 0 Mezzanine or Deck
o School 0 REMODEL
o churchlELEASED F rzf NEW TENANT FINISH
o MULTI-FAMIL~UbJe ( ,?R (8:'Ac:CZE~@~Y]~Ih'?'NG
Number of umts: ~ comr:vnccGJ,,'t'DETACHED GARAGE
~ Of Sf8!f> ,"'~ L,D 'ilTIACHEO'Gi>.RAGE
FOUNDATION TYPE: (9'e~ia!I,~hl,C~rl' 0'/ CELi?'fOWER (New)
~PPI r the newconstruction area)' v, iv1 U '8 T'CElL!-TOWER<::&LOCATE
LAB J '[5 OfRAr;:,:;SPACfL / lCD-ADEIJ16uiiciN~~0
,. ~, 'vVVi~::;HIP
o POST&_BEAM _PIER (!DJeBAsEMENT (WALKOUT:_Y_N)
o PLUM
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) -Is l..r, .ooo~
Manufactured
Trusses:
~~
FLOOD ZONE AREA DESIGNATlONCSl FOR THIS PROPERTY:
)G -- U/fZ~ h3A ed
.- , .
PLUMBING CONTRACTOR:
-". -
.:c~"~M.. \-'\"'~""' .rne....
Plumber's Indiana State License #: -.:-::::::: '~:;:\'!~. f,' -. \
~~-I~""I' ~x' "
~"-,$lt=.~ \\( _: :;:;j \~ \
?D\OC>\D~(ff?..~'~1 0\\ \\1
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Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding ~tati 0 time frames for be i' ~.\\ \.'
. . complet~ngconstruc~ion. \ \\) ll.-~,~ \ \ "\ \.). '
1, th, UOd<talgO,d, 'g'" that any ooomu,,"oo, monmuttion, tnI,,;g,m'nt, tdoc"mn, Ot ,Jt",tmn of, "ruttu", or 'ny ,hang, m t11< \\e?( ~..nc1.lite ue"ed by\) ,~- \
this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of canneJ\I~~~ \i W.~~~11G)~d am WI:e~, \
adopted under authority of I.c. 36-7 et seq, Gen.eral Assembly of the S~te o~ Indiana, and all Acts am~ndato,! theret~. ,I further cerVo/, tMfzrl~1qtche~, bat~}lld . are \ ~
connected to the sanitary sewer. I funher certify that the construction WIll not be used or occupied until a Certihcate of Occu~c)L&.S,jb~.eompJetJOn has been~ J-
i"u,d by th, D'p",em,ot of Community S,tviC<S,C",md, Indi",', \ L ~
LA-- \~t.-- ('~"-t\<~ ~ ....,\'-'....~r ' \U--:,'Ob
Signature of OWner or Authorized Agent Print - Date
Upper Footing Lower Footing Under Slab
Meter Base ~ Site
Base Inspections:
Cert, of Occupancy:
Reviewed/ A roved: ept. of Community Services
S:Permits/FormS/ LP COMMERCIAL
Date