HomeMy WebLinkAbout06100159 Application
City of Carmel/Clay Township Permit #:CJ~tOofq
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APpLiCATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, 8< Accessory Buildings
BUILDER of
RECORD:
STREET ADDRESS
70n
PHONE
317 gJ3. 1)730
FAX ~?tJ
311 ~?" j 70
CITY
);,diMl4 Ii
STATE
iN
ZIP
L(/p;( 3{."
PROPERTY
OWNER:
BUILDER'S EMAIL ADO
SLolf- ' a I
NAME O~ ~o1J-
STREET ADDRESS
&00 E q{, ;I, 9..
LOCATION
&. PROJECT
INFO:
Address of Shell Building (If different than Address of Construction)
Pf,,(/7t.(
PHONE
iOr: &i.(?'t
FAX
S'Ol? 6702
~:J
ZIP
:1'10
BUILDING, PROJECT, OR TENANT NAME:
. e ' 5().Jl-es
STATE COMMEROAL 115'1 rg
DESIGN RELEASE #: ;15'( 1
WATER UTILTIY /' II
PROVIDER: (.LMMA.<X
TAX MAP PARCEL #:
-/1-07-(x}.tX)-OJCf. 000
o FDN 0 STR N: AROl p\ MECH fJ<I.' PLUM SQUARE / L1 LJ /1/\ it
ELEC 0 SPKLR '6THER(S): FOOTAGE: -I, -,W T
ESTIMATED COST OF CONSTRumON,(
CLUDING LAND VALUE) .)00 I 000
(;,fee
SCOPE(S) OF
RELEASE:
SEWER UTILTIY ~ n
PROVIDER: .kV ~" f - C
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
ZONING:
# of Floors:
Elevator or Lift: Q YES (I( NO
~~. CONSTRUmON TYPEJI/3.<1I Ex.>T
OCCUPANCY CLASSIFICATION: f1 efM
PE F CONSTR ON: r,'. ,c-Tn'PE OF'IM'p'ROVEMENT:
.,.-.__,"-' r. :, ,. .J'J\'~
COMM.~Clt4-, C, fJ)' \ .' 'El ' -NEW STRUCTURE
(Privately owned hospitals ,- t' 0;. ADDmON
an'Liit~~\~L?ffiCes/ce~te:rs . '. ',"', '! . :,\"El'- ~1'{1(S)
arecommeraalti, u ,'.1 .... '.- , .Oo'.POrch
o INSTITUTI,?~L{', -: . \ :, ,{ \ U \i J 0 Mezzanine or Deck
o tf:1~",apaI/P,:!bllc Bldg. ,J . 0 REMODEL
D_.SPl,oql)r \.">,,,,, . '0\.o..\-..\fo.. ~ NEWTENANTFINISH
D....Cl1urd1 \!' 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
f1'il SlAB 0 CRAWL SPACE 0 CELL TOWER (New)
Lf) POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT: Y N 0 DEMOLITION
PROJECT INFORMATION:
Early Release rx. Manufactured
permit: y '\ N Trusses: _ Y IX N
Lot Split: Y c< N Sump Pump: _ Y ~N
Does any part of the property lie within a special Flood
designation area: _ Y IX:....N
PLUMBING CONTRACTOR:
Kf R Pfu.wJi(J Co I Nc.
Plumber's Indiana State License #:.
P8ftcxX17 .. . <f:I'\J'<>
. .., - ,
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regai-ding~piratio~e ames (or
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 Cirme! Indiana' ~ 1993" (Z~
289) and amendments, adopted under authority of l.c. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory tnereto.. I ~rther certify th~t oilly
kitchen, bath, and f1o~r drain are connected to the sanitary sewer. I further certify that the construction will not be used o. r occupied Until a Certifici1.te of
OccuJNU!.cy or Substan' Co leti:n has been issued by the Department of Community Services, Carmel, Indiana. //
0v.sfiV\ Vtvhect . /~b.O/()c,
. a of Owner or Authorized Agent Print Da '
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: b JFiling Fees: -:3 O/q. () 0
.. YY> ....,., () /-----> # Charged Re-
Upper Footing Lower FootIng Under Slab r 0 \.. Base Inspections: AOO. '---"" Reviews
~ Meter Base ~ Site 0 . 00
~ .;;:} '2 ~ Additional Fees
':>J . vv
2-00(,
Review Approve: Dept. of Community Services (Date)
S:Permits/FdrlTls!ILP COMMERC!Al