HomeMy WebLinkAbout06110077 Application
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City of Carmel/Clay Township Permit #: f)(P lico 77
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERk
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)!
BUILDER NAME: k~,... ~l..IILO"'-~ PHONE: FAX:
OF 317- 67'2.-<'/181 3\7- 33,-/-01'{(,
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
'5333 w. !3Ct ,j;J <2::.T. I~PIANAPO'-1S \>...\ '-1(,2(, B
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
J B\2.IDE:N~TI"'\86l "''''',-I3I.1\\.4lE.I>S. COM etvI A-IL.. ~ i'HDt-lE.
PROPERTY NAME: ~SAL...TY PHONE: FAX:
OWNER: D\A~ "511- Bog- c-ooo 011- 806-&776
STREET ADDRESS: , CITY: STATE: ZIP:
(Ptx:; E. qc,72!.. 'ST. \NVIA...lAi'oL..\~ Ir--i ,-/(p l.<{O
LOCATION Aq87 ~F cotTuM~:~ \ (,AoJ SUITE #: (If Applicable)
& PROJECT RD. ;lhOO
INFO: Address of Shell Building: (If different than Address of Construction) I Lot # and Subdivision: (If Applicable)
,
Br~I~~ :r~ECT ~;:~ NAME: ZONING: TAX MAP PARCEL #:
~-.a \[- \"-07 -00-2'1-003: 000
STATE COMMERCIAL 3U089- SCOPE(S) OF o FDN o STR \lI. ARCH 'f:< MECH ~ PLUM SQUARE 2308
DESIGN RELEASE #: RELEASE: '" ELEC o SPKlR OTHER(S): FOOTAGE:
WATER UTILITY SEWER UTILITY Ci,eW 0 I ESTIMATED COST OF CONSTRUCTION:
PROVIDER: {We., PROVIDER: (EXCLUDING LAND VALUE) ~ ISo coll
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: \ Elevator or Lift: Q YES ')l NO I BLDG. CONSTRUCTION TYPE: E..^,"" I OCCUPANCY CLASSIFICATION: B
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ADDmON
o Roomes)
o Porch
o Mezzanine or Deck
o REMODEL FLOOD ZONE AREA DESIGNATIONCSl FOR THIS PROPERTY:
. J:&. ~~~~iON
" ,-,r"-"'" g-~ ~~'atiOns
",8..: ... D. ATTACHEDGARA1SE ..' .'. PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Chec~ i\I!.Y"J1i~h '; ,:'q ?CELLTOWER'(Ney;j'\W'~~S' tJ\ (1 l'l\
apply for the new construct,o,\'area) '~'~., Q\t,a:~~jT,OWER C9.-~O.t.ilT~S',.W~ \' \(, UJ. \l-t>1 'C..U-III-N lUlL...
~ SlAB 0 CRAt)e.~ACE" ,\- '9:. P:~M91JT'!91'! f :-" I . Plumber's Indian State License #:
o POST&_BEAM ~(Q\~BA5E'ME~t,&~~~9.L(f:_Y_N) rrc8 I D'S 7'-10(,
""-.\
TYPE OF CONSTRUCTION:
~ COMMERCIAL
(Privately owned hospitals and medical
officeS/centers are commercial)
o INSTITlJIlONAL
o Municipal/Public Bldg
o School
o Church
o MULT1-FAMIL Y
Number of units:
PROJECT INFORMATION:
Early Release j
Permit: y ~PJ
Lot Split: _y...i...N
Manufactured
Trusses:
Sump Pump:
Y iN
-Y/N
Class I structure permits ate 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 - I993~ (Z-289) and amendments,
adopted 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
connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of Occupancy or Substantial Completion has been
iss ed by the Dep ent of Community Services, Carmel, Indiana.
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Print
OFFICE USE ONLY: **********************************************;S7*********************
INSPECTIONS REQUIRED: &. Filing Fees: 7-- ~ .5:J-.,
\~\ Base Inspections: '300.. 00
Cert. of Occupancy: / () 7, [) 0
TOTAL: ~ 1111 , 5J.
~tu./Vt . 1 .rJiI14~
FeeR ive y: 111;).'1//)(:7-
Upper Footing
~9h~
Lower Footing Under Slab
(fi4 Site
No
ReviewedjAp roved: Dept. of COmmunity Services
S:Permits/Forms,lILP COMMERQAL
(Date)
Date