HomeMy WebLinkAbout06110041 Application
City of Carmel/Clay Township Permit #: O~llOOL{ (
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
PROPERTY
OWNER:
STREET ADDRESS
Lo 00 Z
(pi::,
STATE
~
FAX:::J /~
8'o<f - 4.
ZIP
yrad
BUILDER of
RECORD:
NAMEb
~Q
PHONE :) i 1-
8'D 1( G, 000
BUILDER'S EMAIL ADDRESS
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BEST METHOD OF CONTACT:
o e
LOCATION
& PROJECT
INFO:
LA
STRj'ET ADDRESS,
lo 00 ?
ADDRESS OF CONSTRumON
[fao rV~
0'6>-
CITY
'*c<C..t.:# 00 ~
STATE
ZIP
V-c"J-
y#
m~,;c1t'o.A 'I'
sum # (If Applicable)
60
WATER UTIlITY
PROVIDER:
Lot # and Subdfvlslon (If Applicable)
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
F ~ c...):: Mo ~ro
STATE COMMERCIAL
DESIGN RELEASE #:
,^-"-c-a + ~ ,C-"
SCOPE(S) OF 0 FDN 0 STR
RELEASE: ~ ElEC 0 SPKLR
SEWER UTIlITY
PROVIDER:
TAX MAP PARCEL #:
-.;lid -00 -00-01
SQUARE D-,l - <--I
FOOTAGE: (J <-.) 7
PLAN COMMISSION / B / BPW D CKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roors: ~~ , CONSTRUmON TYPE:
TYPE OF CONSTRUcnO~'O?- CO '\'(\ 80\\ IMPROVEMENT:
OQ CO~S~\) t:\\\8o(\Ce ~\ \ cooeb, ,~UCTURE
owne<l-I!Jlli\..Ts 0 \..OCa. S~"
~':~~w-.IJ~\i'i ,O'J'l Room(s)
me COw-. Cv-.'i 0 Porch
o IN~~~r 1Ii~\..1 0 Mezzanme or Deck
O~" Ip,,/e;'/l-I\il>. ~\n\p..~p.. )l:l REMODEL
O':-~r \r"V 0 NEWTENANTFlNISH
~~rch 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
ap~for the new construction area) 0 ATTACHED GARAGE
~SLAB [] CRAVVLSPACE [] CELL TOVVER(New)
~ POST & BEAM 0 BASEMENT 0 CELL TOVVER CO-LOCATE
(or POST & PIER) VVALKOUT:_Y_N 0 DEM0LIT10N
OCCUPANCY CLASSIFICATION: '0 \<E.
PROJECT INFORMATION:
Early Release Manufactured v
Permit: _Y 1N Trusses: _Y..2..N
Lot Split: _Y....L.N Sump Pump: _Y-">;;N
Does any part of the property lie within a special Flood
designation area: _Y LN' ~ ,') UdI-L.
PLUMBING CONTRACTOR: ....... rf IGD a Y L
Plumber's Indiana State License #:
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for
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 Carmel Indiana - 1993'" (Z'
289) and amendments, adopted under authority ofI.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 connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a CertiBca.te of
Occupancy or Substantial Completion has been issued by the Department of Community servi~ces Cannel, Indiana.
~ p' ~ I
l .) o--,.--~ ~ ,\ 1 0 rJ 1- a. rc.L",!) 11- < --D~
Signature of Owner or Authorized Agent Q Print Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: C Filing Fees: ~ !;). ()5', ;zA7
<'7 .n # Charged Re-
Upper Footing Lower Footing Under Slab 11f/S- Base Inspections: ,AVO ,00 Reviews
~ Site Cert of Occupancy: ' t>'G)
~ 'r-j J . '7 / _ Additional Fees
TOTAL: Q p<..;-lO