HomeMy WebLinkAbout06110125 Application
City of Carmel/Clay Township Permit #: {)(~l/lJr).O
COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings)
Address of Shell Building: (If different than Address of Construction)
S~~- Aeolf~
BUILDING, PROJECT, OR TENANT NAME:
..j '" rv\ I\) &u e_OL 0(::>
STATE COMMERCIAL
DESIGN RELEASE #: 322'3>'34
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME;
LAL)'l-i Ce'l'-&i"-UCTIO"-l, L.LC.
P~K\~'i
461
BUILDER'S EMAIL ADDRESS:
m\le.n c;"'m L,'c.. 0.) LAtJT'1.1.N,sT"
NAME:
iVIL'-e-l DI J>.N M<='DI 'IJ
STREET ADDRESS:
401 (-'2""-,,, LVA-NIA PA-IO-1(WP<,/
ADDRESS OF CONSTRUcrrON:
12/ ,,>8-A
No (2J1-l
M bl2-l b A.N
SCOPE(S) OF 0 FDN
RELEASE: '\iQ. ELEC
o STR
o SPKLR
WATER UTIUTY
PROVIDER: C,AeME: L..
SEWER UTILITY
PROVIDER: C.,A-l2...I'VliOo= l-.
PLAN COMMISSION I BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: 3 Elevator or lift:: 1,>.( YES Q NO BLDG. CONSTRUCTION TYPE: bx '1ST I..S:. PK OCCUPANCY CLASSIFICATION: B I
TYP~ OF CONSTRUCTION: Cv OF IMPROV~ ~NT: PROJ~CT INFORMATION:
~ COMM~RCIAL,,'r('''\S\?'\) \\\a\'KlJ'SNEW STRUCTUR~ ~arty Release
!lpnvate, ~~ospttlls~~\Io<ldl9r 0 ADDmON Permit: _y)( N
~\Jiii e ~'Rn~\l.1 Cooes- ,J\Cf.S 0 Room(s) Lot Split: _Y 'X N
f'<- ......0 ....<\ LOC " 'Sf.I"" ~,61 Porch
S\l'o\6u.u- I ~allt'Ob11,\!!.~rx_-O!J'lMS"'tJ MellOnlne or Deck
Do '9I>hW\\'J\V I.J"'! \ R~MODEL FLOOD ZON~ AR~A DESIGNATION(Sl FOR THIS PROPERTY:
""01;) (jlIiul.!l'r' f.\..-I C NEW TENANT FINISH
Q)U'll\i~~I\""\'J\ O\f>.~f>. 0 ACC~SSORY BUILDING N f>'l MPl -' CA 19 {.-.
C\1'f r Units: ~. 0 DETACHED GARAGE PLUMBING CONTRACTOR:
. 0 A TT ACH~D GARAGE
FOUNDATION TYPE: (Chec~ all which 0 CELL TOWER (New)
apply for the new constructIon area) 0 CELL TOWER CO-LOCATE
97.) SLAB 0 CRAWL SPACE 0 DEMOlIT!ON'
o POST &_B~M _PIER 0 BASEMENT (WALKOLrr:_Y_N)
PHONE: FAA:
,48.-(.,5CO 31'1)- 846 -- &,511
CITY: STATE: ZIP;
blA-t..S IS IN
BEST METHOD OF CONTACT:
E":-tv\I>.;'L
4(,,250
PHONE:
(..31 '1- 575-2>/40
FAX:
,311 5(,,+- 3140
ZIP:
4& 2. 9()
CITY:
IN Dl AN A.-PC> us,
STATE:
IN
8::;T.
sum #: (If Applicable) :3 ;Z 0
MUS Ir-J 32
D
lot # and Subdivision: (If Applicable)
100. -PPLlc...A~
TAX MAP PARCEL #:
ZONING:
5(0
1;( ARCH I<i MECH
OTHER(S):
illl PLUM
SQUARE
FOOTAGE:
3,60 12..SF
ESTIMATED COST OF CONSTRurnON:
(EXCLUDING LAND VALUE) <IJ, 2- I " I 4CO.CO
&('v\
Manufactured
Trusses:
_Y 'X N
_ Y x...N
Sump Pump:
E:;"-lO<=e....P P-\:":e:
e:oL<=C1TjC-l\i '!- Me:.GftllcN ICAL
Plumber's Indiana State License #:
PC I OZ00429
Class 1 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 Cannel Indiana - 1993" (Z- 289) and amendmerits,
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 ~s are
connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certil1ca.re of Occupancy or Substantial Completion has been
issued by tbe Department of Community Services, Carmel, Indiana.
~~L- .~/ '....;.s:C
Signablre of Owner or Authorized Agent
M A1I7-1r:::--v.. )
Print
i//~", IV/I(::; 1.1;::'
II /?+ /err
Date '
OFFICE USE ONLY: * ** * ** * ** * * * ** * * ** **** ** ** ** ** ** ** * * * *** * * ** * **** * * ** * * *** *** * *** ** *** * *
INSPECTIONS REQUIRED: Filing Fees: 9; / . 9 0
700.00
j 07. 00
I "J~ ~/ff 0
'//1/ f
jL!/r:'~
Base Inspections:
Cert. of Occupancy:
I
%
ting Lower FO~;der Slab
Meter Base Fina Site
OO~
Reviewe /Approved: Dept. of Community Services
S:PermitsjfOrms,tILP COMMEROAL
(Date)
Date