HomeMy WebLinkAbout07010152 Application
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C't .I'C IIC" 'T' h' Permit #: () 7n (0 /5J.
t Y oJ arme .ay .J. owns tp
COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
PHONE: FAX:
BEST MErnOD OF CONTACT:
>fA Lv. / w- 711.7-
PHONE:
BUILDER'S EMAIL AODRESS:
PROPERTY
OWNER:
NAME:
FAX:
LOCATION
& PROJECT
INFO:
STATE:
ZIP:
e-l
SUITE #: (If Applicable)
Address of Shell Building: (If different than Address of Construction)
lot # and Subdivision: (If Applicable)
ZONING:
5--.1.
TAX MAP PARCEL #:
P",'"
SCOPE(S) OF . 2!P FDN )If; 5TR
RELEASE: .PC ELEC 0 SPKLR
X ARCH )lr MECH )<l:" PLUM
OTHER(S):
SQUARE
FOOTAGE:
~qCt;
WATER lITlLITY
PROVIDER: Ii.
SEWER UTIUTY
PROVIDER: C /.
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) L.
PLAN COMMISSION / BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTIC PERMIT #'5 (If Applicable):
13
# of Floors: Elevator or lift: Q YES ~ NO BLDG. CQNSTRUCTlON TYPE: OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
lid COMMERCIAL ~. NEW STRUCTURE Early Release
W (Privately owned hospitals and medical tJ A. .DDWON 'r:T\ON Permit: _Y LN
offices/centers are commercial).. '-0'" r:O~Q" R6b,\;(i) . c V
"Ef. INSTITUl10NALcl==\ EASeD r - n '>' ..(>;hiPOr'cl1iu1a\lono Lot Split: _Y--f'-N
~MuniciPa~"Wslifi6l!'\9J comp\ian~O ,:::R:\!:1~;.nine or Deck
o School U I t State f1n>lD-('RE.MOPFL,~q\/IGES
o Church 0 ~i(4JjiNEW.Ij'ENANTnN'SI1...\'
o MULTI-FAMILY DEPT OF CO~ PI \~C~~OttY.,'BtJILIDiNi:;;IP
Number of umlst r' OF CARMEE)i DETACHED GARAGE
I 1 _ \t~ig\?Al'TlIcHED GARAGE
FOUNDATION TYPE: (Chec~ all whIch 0 CELL TOWER (New)
apply for the new constructIon area) 0 CELL TOWER CO-LOCATE
~ SLAB 0 CRAWL SPACE 0 DEMOLmON
o POST &_BEAM _PIER 0 BASEMENT (WALKOlJT:_Y_N)
Manufactured
Trusses:
Sump Pump:
.kY _N
_Y YN
FLOOD ZONE AREA DESIGNATIONISl FOR THIS PROPERTY:
X - u-n5hBdo~
PLUMBING CONTRACTOR:
(J, T jJ E
Plumber's Indiana State License #:
L 1'][ II?I.) ~d)
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 I.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 Substantia} Completion has been
issued by the Department of Community Services, Carmel, Indiana.
Si.nak::ori'edA.en.
S-I-evt..
Print
;::;:J'^"''''
) /Ldi?7
Date' .
Lower Footing Under Slab
cF:v
~\Pp. r V~d: . Dept of Community Services
'sill? COMMERCIAL
"J
OFFICE USE ONLY: ********************************** ************************
Filing Fees:
'Wf LJ~) Base Inspections:
11>~ .,~tt Cert of Occupancy:
WJ" TOTAL:
001