HomeMy WebLinkAbout06100160 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
City of Carmel/Clay Township Permit #: tJlglOO{(f. ()
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings)
NAMERNNACU LAePGAlTRY PHONfJJ !J73o FAX: '?C2~ .5?qO
STREET AODRESS: CITY: STATE: ZIP:
7aJ 7 Buri aSS [} .:r~l (is iN 'I6<2JG
BUILDER'S EMAIL ADDRESS: . 'usfin. /t(fb~de BEST METHOD OF CONTACT:
.scolf_ 'l\Y1tJc.fe<2~dwri" liIc1m real, . U}1I1
NAME: Dole /k1; PHONE: gog _ '"" 47$1 FAX: :jCfl.OOJ
CITY:
.1yvJ-/)a.A/l1>. Ii)
STATE:
IN
ZIP:
JIJQ
SUITE #: (If Applicable)
110 IJO NO
ADDRESS OF CONSTRUcrrON:
qe fI). fJ..,ch . ~ RJ.
(, Sou Il1
Address of Shell Building: (If different than Address of Construction)
ZONING: B-3
.000
SCOPE(S) OF 0 FDN 0 STR .6(ARCH p( MECH ~ PLUM SQUARE / 11M m
RELEASE: G(ELEC 0 SPKLR b'THER(S): FOOTAGE: lP1fW r
SEWER UTIlITY ~. .. _ II fr-r1D II i ESTIMATED COST OF CONSTRumo"" ') /I' '~O()
PROVIDER: ~.AA.<A LA f-i^I ( EXCLUDING LAND VALUE) r;l.o, (/1
WATER UTllITY{" _h
PROVIDER: ~
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEmc PERMIT #'$ (If Applicable):
# of Floors: ( Elevator or Uft: 0 YES tpCNO BLDG. CONSTRUmON lYPE: 1JB,SAI' EXSr OCCUPANCY CLAS~!fIcATION: f'I.1 .
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION: //
~ COMMEROAL 0 NEW STRUCTURE Early Release N /Manufactured
(Privately owned hospitals and medical 0 ADOmON Permit: Y ~-N Trusses:
offices/centers are commercial) 0 Room(s) -............-
o INSTITUTION!\L"', FA ~ i=f) -0 [J Porch Lot Split: _Y..li..N Sump Pump:
o Munigpal/P~bt~c ~ldg'- r /1 COI\I?Ol!Memni~'9r;Deck
o School,uDJec\~" CC'-'f_ ."~,,G '~IREMODEl : , .".~
o Church (;1' _,:.'. "j l~i~EI:V,TENANt'ANiSH
o MULTHAMI4YiEPT Cr:-:-'n' ,0. ._ACc;ESSq~X!!U!LDING
Numberafc:mts:. , ,\:,,':': )'''0' DETACHED GARAGE
I I Y Ur l..h"}".,:cL. /.0 /,ATTACHEDGARAGs,
FOUNDATION TYPE: (Chec~ all whlc~, o' CELi. TOWEif(NeiN)
apply for the new construction area) NOIAbD, CELL TOWER CO-LOCATE
~ SLAB 0 CRAWL SPACE 0 DEMOLITION
o POST&_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
/-
fEM
_Y~N
_Y~N
ROPERTY:
THI
PLUMBING CONTRACTOR:
fH P/~l"'J (,). JvtL.
Plumber's Indiana State License #:
FfggO~ ?
-'.\ : ~ - ....
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding exp.iiatiori" time frames "ror -~ginning ~d \
completing construction. ! / I : ; \ \ 1
I. the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in;the 'use of land )2[,.:>tr\}ftu~s ~~ted by. l Ii'
this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the uZoning Ordinance of Cannel IndjaD~ + 199JO~ l89)@i4)unthdlnents, , ,\ I J i
adopted under authority of r.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify thar only kitchen. bath, and floor drains ~/ 1
connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of OcCUpaDcy or SubstJlJJtial Comple~.2..n h~.!>een t
issued the Departm t of m 'ty 'ces, Carmel, Indiana. L__ -. - ..-- --- -- I
,J<< Sf-i VI 11 eg.be de -1.:?!o?O/()/~-'- ___J
Print Dite I
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: @\~ Filing Fees: /Ii q If . nO
Upper Footing Lower Footing Under Slab ,0, Base Inspections: ADO. DO
. . ______ Cert. of Occupan ' 00
/' Rough In TOT tJ_O
00(,
Date
ReYiewedjApp ayed: Dept. of Communi
S:PermitslForrrl!/ILP COMMERCIAL
Fee Received by: