HomeMy WebLinkAbout06100141 Application
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, ',\ C't ifc IIC" rr h' Permit #: O{"I 00 (Lf 1
! " \ t Y 0 arme lay ,L owns tp
" , ) COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
\':'D:A_~~'/ APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BEST METHOD OF CONTACT:
D a- K:.AJ D iJUI(.O ,
PHONE: )'7 'i - ~ <.f 8()
BUILDER
OF
RECORD:
NAME:
WHf Oefl~/J ItI-iIl DV\...b
STREET ADDRESS:
Ib'17b 6 ') "" ST,
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
.,j /l.LI A'M,'S Re-rn.
DIL.
LOCATION
8< PROJECT
INFO:
BUILDING, PROJECT, OR TENANT NAME: "-
P. j . ' e-efe 5
Aa-t Uouse
STATE COMMERCIAL
DESIGN RELEASE #:
SCDPE(S) OF 0 FDN 0 STR 0 ARCH xr MECH IkJ
RELEASE: )lC ELEC 0 SPKLR OTHER(S):
SQUARE L I 8/V1
FOOTAGE: 7, c.(./
# of Floors:' Elevator or lift: Q YES ~ BLDG. CONSTRUCTION TYPE: t;; OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
(!;(D COMMERCIAL 0 NEW STRUCTURE
(Privately owned hospitals and me91~'\()~lb ADOmON
offices/centers are com~,.at).\JlJ \ ~ -f- 0 Room(s)
o INSTITUT1~&(",O~ : (69\)\3.\\0 ,,, 0 Porch
t'P, C~ICIPal~U~~~.\~I&J s ..... 0 Mezzanine or Deck
'2.\..'2.1'0> r5;c~?OLr.ce ~ra\ Code "I\~~EMODEL
? .'e'}, 0C'Ch.~[cry~c', \c~V -<"1 St'.I'\\1 .' '\t4EW TENANT FINISH
s~\ MUhTHAM!!;Y 01'1\'0\'\\ \ "~I ,O\j'JI <Ej , ACCESSORY BUILDING
Nurr~~r otunrls,. '0- p.:, 0 DETACHED GARAGE
FO' r<XJ,.1" O~ TYPEMt~~i!f/I~ich 0 ATTACHED GARAGE
~ " - ",.." ' 0 CELL TOWER (New)
apll!Yi the new constructIon area) 0 CELL TOWER CO-LOCATE
)*:J SLAB 0 CRAWL SPACE 0 DEM0LTT10N
o POST & BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
\.jV
. , :",
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 l>eginning and
completing construction. ~ _ ' t
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 requesteq by
this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 199r (Z- 289) and amendments,
adopted under authority of r.c 36-7 et seq, General Assembly of the State of Indiana, and aU Acts amendatory thereto. I further certify that only kitchen, bath, and floor drains are
connecte sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of Occupancy or SubsbUltial Completion has been
issu y th epartment of Community Services, Carmel, Indiana.
V~
~
OFFICE USE ONLY: *********************** **********************************************
~ Filing Fees: / /15.. 00
~":,~"ase Inspections: 3 0 0 , 0 0
I: ~v Cert. of occupa, ns;y: / rJ 1 ' .-p .0
tVJf' ,-' 4f / tJ
TOTAL:, /;/'/'J 1 ~/~'._' 0
00(. /4~>d3 ~v ~/-C_
Fee Received by:
WATER lJTILfTY SEWER lJTIUTY
PROVIDER: a~t::t.. PROVIDER: (!..7fllUD
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; ANDIOR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
ANI) <r
Ignatureof
ner or Authorized Agent
Print
Reviewed/Ap oved: Dep!. of Communr
S:Permits/FormS/Il COMMERCIAL
PHONE:
J1 ~qO-l'3~8
FAX:
, rt'Z 3 ~'1'I'Z L/i
i
I
CI1Y:
ZIP:
STATE:
:::r>J
23<"
"s,
StfO- 'JE38
FAX:
CI1Y:
J- Nl>PL-S'.
ZIP:
t.{-z.,fIO
STATE:
.:r:N
ZONING:
13-2
TAX MAP PARCEL #:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
/
Early Release V
Permit: _Y --f:::-N
Lot Split: _y:j:...N
Manufactured
Trusses:
_y~
_Y#
Sump Pump:
,
FLOOD ZONE AREA DESIGNATIONfS) FOR THIS PROPERTY:
X -lA.n5 h?cl red
PLUMBING CONTRACTOR:
JA-f<lH frlvRlliv PL,U... i1/~
,//-\
\
",~~
\';,(\'~
\', '.
Plumber's Indiana State License #:
.J p OB801Q7/
4A,J"'l
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I
Date
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