HomeMy WebLinkAbout06120106 Application
City of Carmel/ Clay TlJWnship Permit #: 0 Cd 't ;z(} 12..f.e
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLIC'ATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &; Accessory Buildings
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to.
PHONE > I -=r (p~'f - ~ II Ol.
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CITY
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FAX ~I:r ~""-j!~0I.'t
BUILDER of
RECORD:
NAME
p~""
STATE
IN
ZIP I
If (, ;Z 0 'Ir
PROPERTY
OWNER:
BUILDER'S EMAlL ADDRESS
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NAME PHONE J I +-
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STREET ADDRESS CITY STATE
I'3SDO ,..). oI'1.~n-'~lo4-N' ~... c.~!!OL- IN
ADDRESS OF CONSTRumON sum # (If Applicable)
c> N. M~IZ.. ]>..a..,I ~.. ~+~~ ... ,'"
BEST METHOD OF CONTACT:
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<;ffil- -'rS'I" FAX 7.1-
S!?;.1-"1~a"l
ZIP
~ (,D3~
LOCATION
8r. PROJECT
INFO:
'fIoO~d..
Address of Shell Building (If different than Address of Construction)
Lot # and Subdivision (If Applicable)
BUILDING, PROJECT, OR TENANT NAME: l"f' ...00
v....-A-S"~~ ;;L -t ~
STATE COMMERCIAL
DESIGN RELEASE #: 3 01.. ~ 0 ~O
WATER UTILTIY
PROVIDER: C A-/l.""'~L
SCOPE(S) OF 0 FDN
RELEASE: ~ ELEC
o STR )<( ARCH ~\ MECH
o SPKLR OlHER(S): "
TAX MAP PARCEL #:
1'1-0'f d.. 5000000 I OC>d.
i& PLUM SQUARE
FOOTAGE: 3. 'ii' 0"1
SEWER UTILTIY
PROVIDER: C. A-IZ-t fE L--
PlAN COMMISSION / BZA I BPW DOCKEr NUMBERS; AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'S (II Applicable):
# 01 Floors: Elevator or Uft: Q YES 4NO BLDG. CONSTRUmON TYPE: 11-13 o;PK OCCUPANCY CLASSIFICATION: 13 JZ.G..-1
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
]2f COMMERCIAL . 0: N~ STRUCTURE Early Release Manufactured
(Privately owned hosp~als 0: ADDmON Permit: Y XN Trusses: _Y X N
and medical offlces/cl'{ltef' 2 8 2006 .:: Cl ~(s) -
arecommeldal) ut\., ';\,;}'~. ';\Yorch Lot Split: _Y XN Sump Pump: _Y K...N
o INSlTTUT10 M ON~LI/P bl' Bid ,.,,,~~ . . {;\Me~mne or Deck Does any part of the property lie within a special Flood
umapa _~ IC ~ :\\-""W" -.,'R DEL _ . .
o School ~t\ to CQ'l<\\\;;J (NEWT);~INISH deslg~ation area: _Y XN
o CtJllr~~~~OI'l'?\\~6 \:.OC,;'bQ:iACi.(cSS'QRf!lWl1DING PLUMBING CONTRACTOR:
FOUNDATION ~ @\:1<Q,'brt.~iJ:hl' N\B 'Oft<<lt1~GE ,/
apply for the new &1\ cti9\1'are~N\i\l\,j, q,..'iAttA~HEDGARAGE C-, +-"'" M12Cr+4Nl c..."h-
Jl!{ SLAB ,-OI"')~L fP'ACE'2.\..1 Gel" CELL TOWER (New) Plumber's Indiana State License #:
o POST & BEAM ~r ll4SE~-\"" Oll"-\Q]>o. CELL TOWER CO-LOCATE
(or POST & PIER) ~~L't<<:lUT: Y \~~ 0 DEMOLITION C P 'ill () ,,'-/ '3 :rO
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE) ~5o, OO()
Class 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, Ot 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 Carmel Indiana - 1993" (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 th!lt 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 as been issued by the Department of Conununity Services, Cannel, Indiana.
J/4-N'Ie; '-
Print
12-. OV ER~€c.-I'-
la/~/O(p
Date' I
Signature of Owner or Authorized Agent
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: / () 0 & _ 7/
,.., 0 0 # Charged Re-
Upper Footing Lower Footing Under Slab Base Inspections: NO 0, Reviews
~ Meter B~se ~ Site Cert. of Occupancy: 0, 0 0
~ TOT " .3 /.3 Additional Fees
00"1
Review Approved: . Dept. of Community Services
S:PermItsfFormS/ILP COMMEROAL