HomeMy WebLinkAbout07030090 Application
Permit #:
(!J 7p ~0090
,
City of Cannel/Clay Township
COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME;
-,,~\
~>\: 'f~t\-\OII/HONE: 31+s
FAX:
'5 cr't r 3f15:t'f5'f If 2..-
j
\3 2-'-l:cl( 0 X- T
(z.. ~k \ C(."'l. \kJc. (.Q
, ~ 115'0 CITY:
lo'i.<:> W\~n l\ n?: :.:':C \ "12
ADDRESS OF CONSTRUCTION:.. ....,~-".::(~: \ ~:~':'.., \~'" \\\"\
....\- ~\:'~i' \ -<....\ \
l 033 3 Wlt:-r(G{3"';"'.~\, \Z 1-7...-
Address of Shell BUlldJri9~(if,dlfferenH~;nAddress of Con~iO~\
"-." \Co?;::;/ ~ \\\ \
\ -;-,,\;:..."""- \\ \\V
BUILDING, PR~JE~, OR TENAt;O:,.NAME: \,''0 \ '
kh.-1l<>11.2-1 Yl;Cu:0;\'
\' \ \
STATE COMMERCIAL \ \\5
DESIGN RELEASE #: .
NAME:
e, ~\2..
STREET ADDRESS:
PLAN COMMISSION / aZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'$ (If Applicable):
# of Floors:
Elevator or Lift: Q YES p( NO
BLDG. CONSlRUCTION TYPE: $ -rE"6 L--
OCCUPANCY CLASSIFICATION: B... IZE: f\/\
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
(Privately owned hospitals and medical Q ADDmON
offices/centers are comme"rda,1) C\\O~ 0 Roomes)
o INSlTTUTlONAL " c:\?- U . OI\S 0 Porch
o MuniCi~p~~ ~\ ~e9\J.\a\\ 0 Mezzanine or Deck
D,.lie\1~OI" _.~\~I> eS, ~~EMODEL
".c' C ~'€Wu,r,<;\l,I\enea eel GOO \J\ac:~~ TENANT FINISH
OJ'"~!,!-:F~I~~ enO \-0. 'I\'{ St.~,,~'\"IfinSSORY BUILDING
S\l'-MJmbO'i QNmliS~ :{ ,\U--rl- DETACHED GARAGE
filii rD' I r.\~ 0 ATTACHED GARAGE
FOUND e- \~all'W, ch 0 CELL TOWER (New)
apply ~~~~~~fl\'f8 0 CELL TOWER CO-LOCATE
o ~ "".0 CRAWL SPACE 0 DEMOLITION
o 'POST&_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
TYPE OF CONSTRUCTION:
.~ COMMERCIAL
ZIP:
'-{ ~ 'L yO
BEST MEniOD OF CONTACT:
e (Y'I~ \
PHONE:
FAX:
STATE:
liJ
ZIP:
L{('Z-10
SUITE #: (If Applicable)
lot # and Subdivision: (If Applicable)
.TAXMAP PARCEL #: _
1 _ -,
1(P~ 1'3-11-00 -00 - 012-.00
WPLUM
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) <50(')60
PROJECT INFORMATION:
Early Release /,
Permit: _Y _N
Lot Split: _ Y -LN
Manufactured
Trusses: _Y ./ N
Sump Pump: _Y .,/ N
FLOOD ZONE AREA DESIGNATIONrSl FOR THIS PROPERTY:
X - tU'l5h1'l J nJ.
,
PLUMBING CONTRACTOR: 0
~(4 VlI\WAtVli"tY-
Plumber's Indiana State License #:
_LVo' (l ")1'i\(lp
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 Carmel Indiana - 1993ft (Z-289) and amendments,
adopted under authority of LC 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 funher certify that the construction will not be used or occupied until a Certificate of Occupancy or Substantial Completion has been
issued by the De of Community Services, Carmel, Indiana.
Signature
-:X:M '\t-o~"'SCfY',
Print
ihiLOl-
Oate
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: II-f?- '3 . eJO
Upper Footing Lower Footing Under Slab Base Inspections: ?-- f:) () , CJ 0
~ Cert. of Occupancy: . I () 0
Meter Base ~ Site # () 'FlIfI
TOTAL: . t/LJ
Reviewed/Ap oved: Dept. of Community Services
S:Permits/Forms{IL COMMERCIAL
Fee Received by:
Date