HomeMy WebLinkAbout06120026 Application
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BUILDER
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PROPERTY
OWNER:
LOCATION
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INFO:
Permit #: () l~ t A ()D :<,{p
City ofCarmellClay Township
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings)
NAME:
PHONE: .7/'7'? S' :1'/73 FAX: 3)7- ??s~ ,f'/7'
c.I,'cY7 '/1
CITY: STATE: ZIP:
-::;r;,c/. 1.5 :::r N Y' b Z / 7
BEST METHOD OF CONTAcr: Ce II ,#
., 7- So/- P6/0
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/731'/
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PHONE:
FAX:
(fOJ'- 6tJov
NAME:
IJI..I
.€e I
STREET ADDRESS:
/POO G'
ADDRESS OF CONSTRumON:
STATE:
ZIP:
Address of Shell BuHdlng: (If different than Address of Construction)
~
~
BUILDING, PROJECT, OR TENANT NAME:
STATE COMMERCIAL
DESIGN RELEASE #:
WATER lJTIUTY
PROVIDER:
o FDN 0 5TR ~ARCH '>vMECH 0 PLUM
ELEC 0 SPKLR 6itiER(S): N '
SQUARE
FOOTAGE: / ..? () 0
ESTIMATED COST OF CONSTRUmON:
(EXCLUDING LAND VALUE) t'
GT
bOO.. 00
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNtY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floo.,;: /
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
;:KJ COMlil~iAL1" r, r 0 NEW STRUCTURE
(~!IIlm own~d_hOSPjta(,'a'rill rIl.~1 ".,.0 ADDmON
office51ce~tersa.recomm.}L,,,~r~iplt) ~.J~,:;.: HUC~}i.90m(S)
o IN~ONAL';t;,-.., 'J":~c INlth all re ul \>1\rch
Q:EfPfP"ni~i~alI;P~ti~iF ~~I~g~-OCal CC:d~:,...g , 'f"1J8ezzanine or Deck
CltPtI ~hool ,:' -;,: ,,! L'f\'{ i' "pi, REMODEL
-- ,tj ~hurch, ,; '/:'1 0j (q;81f\{4!3't-'ENANT FINISH
o MULTI-FAMILY J' I. ",',AV' r'~V,A(:C; ORY BUILDING
Number of units: NOlANA 'd '0'# GARAGE
, 0 ATTACHED GARAGE
FOUNDATION TYPE: (Chec~ all which 0 CELL TOWER (New)
apply for the new construction area) 0 CELL TOWER CO-LOCATE
.8;f SLAB 0 CRAWL SPACE 0 DEMOLmON
o POST &_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
Elevator or Uft: Q YES )J; NO
OCCUPANCY CLASSIFICATION:
BLDG. CONSTRUCTION TYPE:
PROJECT INFORMATION:
Early Release \!)
Permit: Y N
Lot Split: - Y 2N
Manufactured
Trusses:
Sump Pump:
_y2(N
_Y~N
FLOOD ZONE AREA DESIGNATIONrSl FOR THIS PROPERTY:
YJ ~ U nSh& tkfX
PLUMBING CONTRACTOR:
~/4
Plumber's Indiana State License #:
"S/ A
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 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 amendments,
adopted under authority of r.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
issued by the Department of Community Services, Carmel, Indiana
OFFICE USE ONLY: ****************************~.***** ******************** ***(;**************
INSPECTIONS REQUIRED: Filing Fees: !)'"-'5 (!) . /J
Base Inspections: ').LJ (), (!J ()
Cert. of Occupancy: {)~O\
3
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Print '
/2 ,{, () to
Date
Rough In
Date
Site
(Dale)
Reviewed/A roved: Dept. of Community Services
S:Permits/forms,l lP COMMERQAL
Fee Receiv