HomeMy WebLinkAbout06120067 Application
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City of Carmel/Clay Township
COMMERCIAL/INSTITUTIONAL/MULTI-FAMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings)
Permit #: Vf.e l~b~7
BUILDER
OF
RECORD:
NAME:b
STREET ADDRESS:
00
[ FAX:
g-08"'- &, Odo
21 +-?-cJJ' -
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c; Go 1;:,
STATE:
"7yJ
ZIP:
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS:
L-e0:
NA~
jJv..~<:.
BEST METHOD OF CONTACT:
f.I".".
.] If.-
o
o
F-
FAX:.3I"+ -f:'Oli' -
& ?:-9 +-
ZIP:
'-66 ~y 0
(If ~pllcable)
-1P -S-O
PHONE:
STATE:
if.oi>..
LOCATION
8r. PROJECT
INFO:
ADDRESS OF CONSTRUCTION:
L- C"
';)0 L.
'[p'1),
Address of Shell Building: (If different than Address of Construction
l!;~-()
SCOPE(S) OF FDN 0 STR
RELEASE: fi\ ELEC 0 SPKlR
SEWER UTIlITY
PROVIDER: llirmd
ZON~:
Iif( AROi
OTHER(S):
ll("MEOi 0
TAX MAP PARCEL #:
It" -/3'//-o'l-/7-oo/.o0}
~.
SQUARE
FOOTAGE:S. .J 3
WATER UTIlITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTlON:
(EXCLUDING LAND VALUE) .!t 00
00
PLAN COMMISSION / BZA I BPW DOCK NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors:
Elevator or lift: 0 YES Q NO
BLDG. CONSTRUCTION TYPE: \ \ -'6
OCCUPANCY ClASSIFICATION: \3
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
?l COMMERCIAL ' 0 NEW STRUCTURE
(Privately owned hospitals and medical 0 ADDmON
offices/centers are commel'"Slal) ,.".. " _Q Room(s)
o ~ 1;;0R r:ONSTRUCTIl.t!:'l Porch
~Le,':...~I~~!h';Wi~'h~~!V.'ith "all (ag0atidiil; Mezzanine or Deck
U"",v.>a1OOf , " ,." '!"I'Cd ~ REMODEL
o cllllr&ate, a,~d, LOca,. '0 .,e D: )iFY!/. TENANT FINISH
o M~~~PCQM,MUN" '.IT'{SE!t!J'I'-AEtE'sSORY BUILDING
'Num \l(1its:., '-L '('LAYTr./i;llIl~EDGARAGE
CI1Y l;AtiIVIC I.~ -0 ATTACHED GARAGE
FOUNDATION TYPE: (Che~leYi}"(N9l! 0 CELL TOWER (New)
apply for the new constru&on area) . 0 CELL TOWER CO-LOCATE
9\ SLAB 0 CRAWL SPACE 0 DEMOUTION
o POST&_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
PROJECT INFORMATION:
Early Release ill
Permit: _Y ~N
Lot Split: _ Y A-N
Manufactured
Trusses:
Sump Pump:
_Y~N
_Y~N
FLOOD ZONE AREA DESIGNATIONCSl FOR THIS PROPERTY:
PLUMBING CONTRACTOR:
Plumber's Indiana State License #:
Class I structure permits are subject to the General Administrative Rules of the Srate of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
complering 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 kZoning Ordinance of Carmel Indiana - 1993M (Z~289) and amendmentS,
adopted under authority of LC 36~7 et seq, General Assembly of the State of Indiana. and all ActS amendatory thereto. I further cenify that only kitchen, bath. and floor drains are
connected to the sanitary sewer. I fu her certify that the construction will not be used or occupied until a Certilica.u of Occupancy or Substantial Completion has been
issued by the Department of Com nity Services, Carmel, Indiana.
~.fIi'in
Print
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{d. -{ t;"-oCo
Do..
OFFICE USE ONLY: ***************************************************~******************
INSPECTIONS REQUIRED: Filing Fees: I A. q . I, 1/
Base Inspections: ;;(,0 f) lOb
Upper Footing Lower Footing Under Slab -
Meter Base ~~Slte 007J () 0
/'
Reviewed/ Ap oved: Dept of Community Services
S:Permits/formslIL? COMMEROAL