HomeMy WebLinkAbout06120018 Application
City of Carmel/Clay Township Permit#: ()~ I~ () 0/<3
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, 8< Accessory Buildings
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SCOPE(S) OF p.-FDN 0 STR
RELEASE: "" ELEC 0 SPKLR
'\"
1'."
SEWER lJ1lLITY
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors:
Elevator or Uft: 0 YES
BUDG. CONSTRUCTION TYPE:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
(Privately owned hospitals 0 ADOmON
:~ ~~~f25e'?'OR CONSTR~s:g~~~(S)
o INsrrnm8~~ to.c;:mpli;;n:e witr~ ~'IY,rY!1lLl!9tj(M~anme or Deck
o rwnrapal/~ullIlc;.BLdg'ld I ncal;C e'REMODEL
o 5ch I t]l"...LI....\;:....~ --' , Wt
"",- qQ:r 0 C' cr'] M r:./ U 1" '"ry El,:: r~SVfc:ffi{lY'IT FINISH
o UlUich, r,. I " ., 0 ACCESSOII.~UILDING
FOUNDATIOIl4Jil!'~: @h~ ~1!,w,I!!g. f CU\'(O COE1'AGJ:Iro GARAGE
aep~y for the new construction a~~bIAt~A 0 ATTACHED GARAGE
~SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOUllON
TYPE OFA:ONSTRUCTION:
if COMMERCIAL
PHONE
FAX
BEST METliOD OF CONTACT:
FAX
SUITE # (If Applicable)
Lot # and Subdivision (If Applicable)
ESTIMATED COST OF CONSTRU ON:
(EXCLUDING LAND VALUE) 0
'):..jf' 1-/9 'I ?1~
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release"'/\ Manufactured~'
Permit: Y 'N Trusses: Y
Lot Split: y'l!-N Sump Pump: _Y ON
Does any part of the pro~ lie within a special Flood
designation area: _Y 'N
PLUMBING CONTRACTO :
J~\\ VIlJmDirc ,:tf~\ee,\r\('_.
Plumber'~ license #:
~"6~ro)p4~
Reviewed! A proved: Dept:Of Community Services
S:Permits/form 11P COMMEROAL
# Charged Re.
Reviews