HomeMy WebLinkAbout06090113 Application
BUILDER of
RECORD:
City of Carmel/Clay Township I
COMMERCIAL or INSTITUTIONAL IMPROVEMENT 'LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Add" ~hS, ~dels, Tenant Finishes, &. Accessory Buildings
, \, gr r. 7l " L{,~
\ ~ PHOE317 eJ3,5730 317.g}b,5791
\) CITY STATE ZIP ~
Jvdil.lMCI ob /IV '-I(,)J~ Q>
Ph iYV'--{ ~
~~i~r6113
NAME S'
STREET ADDRESS I
70;)7 &-1A1 (aSS Or.
PROPERTY
OWNER:
BEST METHOD OF CONTACT:
'iASt,Vl'.verbe ~ II
PHONE80(,,!o '-17 f
FAX
80f (p 7()).
LOCATION
& PROJECT
INFO:
STREET ADDRESS
(,,00 f, w- 5/-,
ADDRESS OF C,?NSTRUCTION ~
03 N ttliUli
CITY
:Jv,JiIMM{ 01; 5
STATE
IN
ZIP
LJb2'10
&Zp, /
tlMfd.
SUITE # (If Applicable)
/30
SEWER UTIUTY
PROVIDER:
en.. JI.. ESTIMATED COST OF CONSTRUCTION:
:-r I ~v (EXCLUDING LAND VALUE)
SQUARE
FOOTAGE:
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
uJh itefux fn
STATE COMMERCIAL 3 ( 64 fC
DESIGN RELEASE #: 3 I) 1/
WATER UTIUTY /., fI
PROVIDER: UVf ~
.s~+ UeCU/'A5 ZONING: 13- 3
SCOPE(S) OF 0 FDN 0 STR MARCH 0 MECH 0 PLUM
RELEASE: 'ELEC 0 SPKLR OTHER(S):
PIAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
1L~13
# of Floors: Elevator or Uft: CI YES ~ NO BLDG. CONSTRUcnON TYPE: OCCUPANCY CLASSIFICATION: M Rf" M
TYPE OF CONSTRUCTION: TY.~E"OF IMPROVEMENT: PROJECT INFORMATION:
fJii.. COMMEROAL ',GJi NEW STRUCTURE ' Ear!Y Release 0( Manufactured
v (Privately owned hospitals ',' 0; ADRftll)N2 1 2006 ' , Permit: Y 1'1 Trusses: _ Y t'( N
and medical offices/centers ' ,i IT' Room(s) . . IV
are commercial) , , 0 Porch ,: .L~t'SPlit: Y =:=N Sump Pump: _Y.QL..N
o INSTITIJT10NAL r. --"0-- -Meiianine or" Deck ..1 '- 'D'o~s any part of the property lie within a special Flood
o Munidpal/Public Bldg 0 REMODEL ' N
o School '~-'NEW\rENANTFlNISH._.' . d~lgnation area: _Y.i':LN 1f
o Church " .D)\~CESs'<i,~y BUILDING PLUMBING CONTRACTOR: 1/ /, .
FOUNDATION TYPE: (Chec~ all whIch \,\SD) ,[)ETACHED GARAGE /1$/ /I
apply for the new construction area),., CO.. (2), "ATTACHED GARAGE
~ f":r\'i" '\(~\' ,-c. ..-,,-
()L'l. SLAB 0 CRAWL SPACE:c" '!';\ GbcCE~UO~ER'V'!~) Plumber's Indiana state License #:
o POST & BEAM <on!' ['BASEMENT"" \ DC') c::J "CElnOWE~:CO.LOCATE
(or POST & PIERj;<---:WALKOUT:",8<{'). :N\~'iD 'DE~OIlTlON
,....,'f'\\v- .~'7.,,-~~~,-, f'."- \
....... '-',.-. I '\ ~ , i ,\-' .
Class I structure pennits arefubject to,-th~r General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for
. {""\y?\ ':' (",.:.S-\\~\ ~>, {.'\\;::""\~l-'. beginning and compl~ting construction. .
I. the underSigned, agree. that any,constructlO{l.:-recOnstructIon, enlargement, relocatIon, or alteration of a structure, or any change m the use of land or structures
requested by this appIieat~ ~n comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 199r (Z~
289) and amendments~'dopted 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 c nnected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Deeupane orSubstantial~SUed hythe Deparonen:E:+:~ey V;;b~d Indiana, rle!! / /~ (;
f Owner or Authorized Agent Print Dare J
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: e Filing Fees: /1 for;{, 'i ()
". I I 0 # Charged Re.
Upper Footing Lower Footmg Under Slab q ~ Base Inspections: ::{O # Ot() ReVIews
MeterBase ~ Site Cert.ofOccupancy jt) '"1 ' 00
T / ",-, -1fi (;:S: ""IrJ ~,-,-
,2-2.J.OO~ ikr~ce:g)dU~
ate) Fee Received by:
proved: Dept of Community Services
ILP COMMERQAL