HomeMy WebLinkAbout07010115 Application
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Permit #: 6701 otf5-
City of Carmel/Clay Township
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, 80. Accessory Buildings)
BUILDER
OF
RECORD:
NAME:
STREET ADDRESS:
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
$011II
-..t:..-hcY\ ,
PHONE:
FAX:
N
STREET ADDRESS:
o E.. ",1# Sr
LOCATION
&. PROJECT
INFO:
BUILDING, PROJECT, OR TENANT NAME:
PHONE:
OTY:
STATE:
ZIP:
"Z-
CITY:
STATE:
J:
ZIP:
--
zo
',.So
SUITE #: (If Applicable)
C>
Lot # and SubdMsion:. (If Applicable)
TAX MAP PARCEL #:
STATE COMMEROAL
DESIGN RELEASE #:
SCOPE(S) OF 0 FDN ,.. ~. .~ 0 ARCH 0 MECH 0 PLUM
RELEASE: 0 ELEC 0 sPKLR OTHER(s):
SQUARE r'1~
FOOTAGE: ,~
WATER lJT1UTY
PROVIDER:
SEWER UmITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ../I is; ace
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If AppUcable):
# of Floors:
"'Elevator or Uft: 0 YES
BLDG. CQNSTRUcnON TYPE:
TYPE OF CONSTRUCTION: PE OF IMPROVEMENT:
~ COMMEROAL ',- 'cAliL"t::" A <' 0 NEW STRUCTURE
(Pnvate~ owned ~~iS!r\'cJlme@"~ C:-.-Q ADDmON
offices/centers are commerdalb c " ,,'/7 0rO Room(s)
o INSTITlillONALf) 0/ S' C"I/J/I,'~,~' 01~POrm
o Mun~c 1fP6BiiCj6ldg _ fOlt! r.i-l .. '>r.. ['v0 ~Meciarit~or:6ed<
O Sch '/'7";.. t....Jt.. r.... ( r' ~ I, I
" r 0- . ..~,'~. OC>REMODEL<\){'I .. -' ..
o Church r- C",; I.j ': V: 1\ 9,:,.NEW TENANT ;'Ii-uSH'"
o MULTI-FAMILY ., 'V,',~'L b~~AtCESSORY,~V}LDING
Number of units: IN)' ,/p.. (DETACHED'GARAGE,
. Ui/Q' ,'ATIACHED'CjARAGE'
FOUNDATION TYPE: (Chec~ all whIch 0 '1CEl.l TOWER tl':ew)i~
apply for the new construction area) 0 CELL TOWER CO. LOCATE
[)g:...sl.AB 0 CRAWL SPACE 0 DEMOUTION
o POST&_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
OCCUPANCY ClASSIFICATION:
PROJECT INFORMATION:
Early Release V
Permit: Y "N
Lot Split: Y .;?{N
Manufactured
Trusses:
Sump Pump:
Y~
-Y~
FLOOD ZONE AREA DESIGNATIONfSl FOR THIS PROPERTY:
X-()...ns~
PLUMBING CONTRACTOR:
M<.(.>pl''I vVI-lt~ I-Jlr4,l
Plumber's Indiana State license #:
C 05'"0" <!X::x:><f J
,
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 11) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any const IOn, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures requested by
Iy with, onform to, all applicable laws of the State of Indiana, and the MZoning Ordinance of Carmel Indiana - 1993ft (Z~289) and amendments,
of I.c. 36- et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. 1 further certify that only kitchen, bath, and floor drains are
sewer. further certify that the construction will not be used or occupied until a Certificate of Occupancy or SubstJUJtia] Completion has been
nt of mmuoi<y S<<vices, C..md, Iod'",.. ___ \ /
~...w. Y't~ '/'Zb7
Print ~
OFFICE USE ONLY: ************************~*********************'****7********************
INSPECTIONS REQUIRED: U Filing Fees: ,OJ. "C) 0
Lower Footing I J~ ~ Base Inspections: ?-o 0 . 0(::)
Cert. of Occupancy:_ () 0 Q
'8/~ . 00
T
Fee R
Date