HomeMy WebLinkAbout06120097 Application
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City a/Carmel/Clay Township Permit #: (lIS /;)/Ju Y7
COMMERCIAL/INSTlTUTlONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
STREET ADDRESS:
.)02 /NI~
BUILDER'S EMAIl ADDRESS:
PHONE:
~'1<._ .:;/'( - ]03 :;-
CITY:
.1-'7
FAX:
9z'l-3tJ~()
BUILDER
OF
RECORD:
NAME:
M 'c.-kc.L1 l<urI<
ZIP:
'-I~ Z,,~
BUILDING, PROJECT, OR TENANT NAME:
.56 V' I 0..+ T ~ ( Ce.nt.--e.
STATE COMMEROAL SCOPE(S) OF P FDN 0 STR
DESIGN RELEASE #: .1 AA. RELEASE: f6 ELEe 0 SPKlR
SEWER lJTI
PROVIDER:
I. ...~
PROPERTY
OWNER:
ZIP:
<{.
LOCATION (IfAp Iicabl';k:3 ~
&. PROJECT
INFO:
?Ll &~
C)OO
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) j 's-:~' a o. {J Ii
PLAN COMMiSSION I BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WElL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors: I Elevator or Uft: 0 YES )ij NO BLDG. CONSTRUcnON TYPE: OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
l'i1I COMMERCIAL 0 Ntw STRUCTURE Early Release / Manufactured
T (Privately owned hospitals .and medical 0 - ADOmON Permit: Y N Trusses:
offices/centers are commercial) 0 Room(s) I
o INSTITUTIONAL 0 Porch I Lot Split: Y ~N/ Sump Pump:
o Municipal/Public ~idg D EC 2 7 2(d) Mezz~ni~eor Deck
o School ,I i ~ REMODEL ,J!!
o Ch\l[ch '""', . 0 Ntw TENANT-FINISH
o MULTI-FAilrifiLE:A "CD';'- -- --o~CESS6RY B~Ii.DING
Numberct)~,~." ". ',-,",'". "? Cn[;j"..Q,EJA.CHED,GAR,i,GE
j l,,{ l0.eonr~:r.;r;:;)----:,P~"1ATttA~lDfG . GE
FOUNDATION TYPE: (Ch~ii\I~~h~C~ '0: ""',t'J'~ltE~L..[1;pW~~W)
apply for the neWJl:!>.itSf>'~\l,~~a} (I L"ca(l]:Olq,gifTl:5Wrn~1!o'LoCATE
M SLAB CITY (jj= f!AWtJSPA't'BJi\il/fD SD~~OLTTlON
o POST & _BEAM ~tl~11E:EI t8As~~;rr.O':'(w,*fK~_Y_N)
rNO 1'1 l ' VVNSH
~
Y N
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FLOOD Z
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PLUMBING CONTRACTOR:
N~,'+( (2..',.(/ M-.(c~C", c..1
d(
( LJ1(
Plumber's Indiana State License #:
Class I structure permits are subject to the General Administnttive 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 Carmel Indiana - I993~ (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 cenify that only kitchen, bath, and floor drains are
connected 0 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
issue y e Dep tment of Community Services, Carmel, Indiana.
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Print
I 2-/2 ~/6 io
Date.
OFFICE USE ONLY: * * * * ** * * * * * * * * ** * * * ** * ** * * ** ** ** * * ** ** * * * * ** * * ** * * ** * * * *~ ** * * ** *** ** * * *
INSPEcnONS REQUIRED: OJ & Filing Fees: I / -;. (). :53
I I Base Inspections: ? f) (3 , 0 0
Lower Footing
Cert. of OcclJPancy: / () 7 . 0 0
~~~:7'5J
fee ReceIved by:
Site
Reviewed/A roved: Dept. of Community Services
S:PermitsfFormS/ LP COMMERCIAL
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