HomeMy WebLinkAbout07020067 Application
Permit #: 0 7v:u')()~ r;
City of Carmel! Clay Township
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
Ff0I.: 5-7 3 - '1 tUG
CITY: STATE' ZIP- LI/
tJ, fllJeiltJ/4''''' S:i-, J"~' Is, :J/J ' -ICu)&P
BEST METHOD OF CONTACT: c.... e.. j I r h G,..., e...
t;. UtCO,l, ~O"" L-/oCf-3,85/
NAME: c:-
z::- UIC-O'C
STREET AD RESS:
SUtle2o;)- 9011
cO\',s~ L \J cf/" '"
BUILDER'S EMAIL ADDRES~:
j( lJ'J ",,:)0,0
NAME: III -/'" '
\9 Sh,ee+
STREET ADDRESS:
Su.lc..,?O;l- <YOII
Ce",~k LJ-C--
;J Metlel,; I" S.\-,
ADDRESS OF CQNSTRUCTlON:
8'10 L, '~I"" Shc.c+
Address of Shell Building: (If different than Address of Construction)
BUilDING, PROJECf, OR TENANT NAME: 11
f'lVOI\
s
SCOPE(S) OF 0 FDN 0 STR 'd ARCH "6 MECH
RELEASE: ~ ELEC 0 SPKLR OTHER(S):
I'ltL
STATE COMMERCIAL
DESIGN RELEASE #: 3:.2 3818
WATER lITIllTY SEWER lJTIUTY
PROVIDER: CClilt1'\d l\Jr\T'2-'l. PROVIDER: CCi'~M..J CJ~
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o COMMEROAL 0 NEW STRUCTURE
(Privately owned hospitals and medical 0 ADDmON
offices/centers are commercial) 0 Room(s)
o INSTITUTIONAL 0 Porch
o Municipal/Public Bldg 0 Mezzanine or Deck
o School 0 REMODEL
o Church ~ NEW TENANT FINISH
o MULTI-FAMILY 0 ACCESSORY BUILDING
NumbF/e!'t'I!!)\:S ' 0 DETACHED GARAGE
FOUNDATIO~ (Ch~RafQtiic:h.:ON~, R,,I''-lIas;HED GARAGE
c 'v c "o..~'''" , . 'TI '€W-f/i1NR (New)
apply for the new conSb'~~oncarea).e With "f"re""",;r,Cl\IJ~R CO-LOCATE
o SLAB DEPT ~0~wrsPA2E:aICgi;~oiffi(:jN
o P05lGJIY...alW'Jt:/'~~[~ M Cl',! 1~~@T\.(l@&I\9UT:_Y_N)
"vl<-L I CU c.. ^
Class I structure permits are su DdAt.teperal Administrative uIes of the State of Indiana (See 675 lAC 12) regarding expiration time frames fot 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 - 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 itary sewer. I further certify that the construction will not be used or occupied until a Certificate of Occupancy or Substantial Completion has been
,D "'tm'"t~ Co mutySt"",,,,C"'mtl.Ind;,",~ '~1Jj)/.1 IJJl4iS6,,) .2 /R/Dl
~ Signature of er r Auth eel Agent Print ( Date
~ \OFFICEUSEONLY:***********************************************~~******(j*************
\ INSPECTIONS REQUIRED: Filing Fees: ~ 3. 19
'Ipper Base Inspections: 1 on ' () 0
\~" Cert, of Occupancy: I ()7, tJO
'~h In Site i La. O. 00
# of Floors:
Elevator or uft: Q YES Q NO
BLDG. CONSTRUcnON TYPE: -
PHONE:
573-8/00
PHONE:
Ff0I.:
~-73-9/00
513- 8/00
CnY:
STATE: _ . I
1. f\J ,
L/(,z(" D
ZIP:
'::Tn ,{ Is,
SUITE #:
(If Appl.lcable) </' 0
",., /
; .If
I,"
ZONING:
Lot ~UbdiVi~~9~('/(~fl~PPllca~8
i "
,
......TAX MAP PARCEL #:
...,....
"....,
-,
VOl
SQUARE._ .....,....,.......... 1-; "
FOOTAGE=':3QOO.J "<,
ESTIMATED COST OF CONSTRUCTION: -,~... '-., ;'
(EXCLUDING LAND VALUE) '7~ - 000 "9' i
-srI<-
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y_N
Manufactured
Trusses:
_Y_N
_Y_N
Sump Pump:
FLOOD ZONE AREA DESIGNATIONrSJ FOR THIS PROPERTY:
kYl6ncokd
)<1
PLUMBING CONTRACTOR:
lke. W\ec.l-.
Plumber's Indiana State License #:
C p 3 <0 30 ($ C? :5 Lf
'0 ved: Dept. of Community Services
'LP COMMERCIAL
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