HomeMy WebLinkAbout06120019 Application
City of Carmel/Clay Township Permit #: (Xe 1?f)()!1
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, 8r. Accessory :BuildingS
NAME
\J
FAX
BUILDER of
RECORD:
8 0/\ B
leiS g S)loo
\
STATE
BUILDER'S EMAIL ADDRESS l_
'I P (O~ It,~''rllS\'\
,
PHONE
FAX
PROPERTY
OWNER:
ZIP
30
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V/L.<-,Lf
,[,
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ADDRESS OF CONSTRUCTION
6-0/
" SUITE # (If Applicable)
1L//LA-4.(
LOCATION
& PROJECT
INFO:
{~,:A..M.LJI
Address of Shell Building (If different than Address of Construction)
Lot # and Subdivision (If Applicable)
ZONING:
TAX MAP PARCEL #:
SCOPE(S) OF 0 FDN 0 STR 0 ARCH 0 MECH 0 PLUM
REUEASE: 0 ELEC 0 SPKLR OlliER(S):
SQUARE
FOOTAGE:
WATER UTILITY
PROVIDER:
SEWER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) /
L
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
--:B I ~
-h
e
OCCUPANCY CLASSIFICATION:
# of Floors: Elevator or Lift: Q YES Q N!f, . BLDG. CONSTRUCTION TYPE:
,r". 1\'\1
TYPE OF CONSTR!!CJIGN:-", CO~. ,,:' ',:1f\,E.oUMPROVEMENT:
,.-, c:"c;'-<.t:.~;, ~- . d';\,~'iirF.....:;l"
qB- ~!!Il\II!RCIf-! ",o'11\:.\\<;:nC\8 W', cnd8S.O NEW STRUCTURE
s~~~owne~_ti~P5a.',~ \..O\:,a\._...J -c.r::r:~,(!\P6lTION
and medl~l,offices/ce~tersf1 IJ" q r\ v,..:' \_- j' " si" ' ~oom(s)
arecommerdal)("c)\'I.~!t ' '., ~c,-,',rJN'- rp'Orch
O ~_._~' .. . I" IV'
I 'ON~~, ,.._. '.' t, r:: '\ I C L.. .... \ 0 Mezzanine or Deck
I>!uJlldR9VPubllC'BI~9 ^ ',,{l.. 0 REMODEL
~ool .. IND\t"" 0 NEWTENANTFINISH
o Church 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all Whi~ 0 DETACHED GARAGE
apply for the new construction area 0 ATTACHED GARAGE
o SLA~' ... r4.rzt-cI~PAC 0 CELL TOWER (New)
o PO B ~~AS ENT 0 CELL TOWER CO-LOCATE
(or POST ER) WALKO. :_Y_N 0 DEMOUllON
PROJECT INFORMATION: (jJ:a
Early Release )C Manufactured
Permit: _Y {'N Trusses: _Y~N
Lot Split: _y]QN Sump Pump: _Y ~
Does any part of the property lie within a special Flood
designation area: _Y->>
PLUMBING CONTRACTOR:
JUO)../G
Plumber's Indiana State License #:
,
dass I structure pennits 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 structur;es
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"1 (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
Oce or Substantial Completion has been issued by the Department of Community Services, Carmel, Indiana.
S+e.~" ~\\Q.~7.L
Print
I 1)../1P/014
Date
r or Authorized Agent
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: AI ~ fL, ~ <<'
, . -J ""0 tJ /") # Charged Re-
Upper Footing Lower Footmg Under Slab Base Inspections: ,AU. L/ Reviews
~.;; .... ~~ ~ _ Co". of 0=,,",,, ~f) 7" O~
~ 7/.3 '8 Additional Fees
TOTALj '/Y... ,. '.-
~AI~ 1-7. /-, L/C/ /JA(
Fee Received by: I J /
I:?-/ /I 0 4?
Reviewed/Ap roved: Dept. of Community Services
S:PermIts/Forms/I COMMERCIAL