HomeMy WebLinkAbout04120030 Application
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"ty of Carmel/Clay Township 0~;:0-- Permit #: 0 1 JAVV
COMMERCIAL or INSTITUTIONAL IMPROVEMENT L A TION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & ACcesso~ Buildings
BUILDER of
RECORD:
NAME
fnP\-'>lI"'" Se.n.vl<.~ LLL
PHONE
3'r -J-'1o - \0"00
FAX
311-J'1.o -\O~\
STREET ADDRESS CITY STATE ZIP
G:.S""OO N. VIOf\J(ko S"-k T,voPLS IV ""ffo;)..'" 'ir'
BUILDER'S EMAlL ADDRESS BEST METHOD OF CONTAcr: C a II T1J:JI /.... I/o
lJc.~"'''-Oi\c~BLG-LD LoiVet '31'l-d-qo-\O~ "t'
NAME PHONE FAX
G-le", c../(' 1Ja...-+rv.!US' ".pkJ~;tC~.tu..<15"" d U( '112-!'!oo 't72.-ffo?.-
PROPERTY
OWNER:
STREET ADDRESS
'10 IF !.,"'..... .!+r,,-<--I
ADDRESS OF CONSTRUCT/ON .J ~
4::/3~ 0
LOCATION
& PROJECT
INFO:
U 'on/ Lot # and SubdMslon (If Applicable)
regu ations Lv C \ ~\
eST ",-,-,...,.. y ~
BUILDING,PROJ~cr,ORI!'NANTNAME:DEPT OF COMMUNITY SE
",l';L~l!:\'.=J'~~'. :
STATE COMMERCIAL SCOPE(S) OF.. nQ. ~Q'" 0 STR
DESIGN RELEASE #: 30t.. "\ 'b lp RELEASE: Il~!fit'f\o SPKLR
WATER LmLTIY SewER LmLTIY
PROVIDER: -:{'wp LS of WI\7l:r- PROVIDER: c...L~
PlAN COMMISSION I BZA I BPW DOCKET NUMBERS; ANDIOR
COUNTY WELL ANDIOR SEPTIC PERMIT #'S (Ir Applicable):
# of Roors:
Elevator or Uft: Q YES III NO
TYPE OF CONSTRUCTION:
<tlQ COMMEROAl
(Privately owned hospitals
and medical offices/centers
are commercial)
o INSTITUTJONAl
o MunidpaljPublic Bldg
o School Vi'Jl>"......
o Church ~o "-
FOUNDATION TYPE: (Check all which
apply for the new construction area)
~ SLAB [) CRAINlSPACE
[) POST & BEAM [) BASEMENT
(or POST & PIER) INALKOLrr:_Y_N
CITY
I"Op,-S
STATE
Y\J
ZIP
'-1(.,)..20
SUITE # (Ir Applicable)
qOo
TAX MAP PARCEL #:
17.-13-o1-06-rl .OoZ..OCb
'" ARCH
OTHER(S):
(!S. MECH
~ PLUM
SQUARE
FOOTAGE: J
"4000
ESTIMATED COST OF CONSTRUCT/ON:
(EXCLUDING LANO VALUE) If. ;) 5 (J(JO
BLDG. CONSTRUcnON TYPE: [T\e~\ ~\~.~ OCCUPANCY CLASSIFICATION:
TYPE OF IMPROVEMENT:
o NEW STRUcnJRE
o AODmON
o Room(s)
o Pordl
o Mezzanine or Deck
o REMODEL
~ NEW TENANT FINISH
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
[) CEll TOINER(New)
o CEll TOINER CO-lOCATE
o DEMOUTION
PROJECT INFORMATION:
Early Release /' Manufactured
Permit: JL...Y N Trusses: _Y ~N
Lot Split: _Y i/"N' Sump Pump: _Y-'1l.-N
Does any part of the property lie within a special Flobd
designation area: _Y ~N.
PLUMBING CONTRACTOR:
E",,~~r-R.lse tIle,!,,,,.. I <1/>1'"<:'<:",<..../ C>>.
Plumber's Indiana State LiCeje #:
Co'p c.P30Jcxx,/1 ,_ ?c..ID.;l 00 'f:l,
Class I structure pennits 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
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.e. 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
Occ y or Substantial Completion has been issued by the Department of Community Services, Cannel, Indiana.
~
re of OWner or Authorized Agent
INSPECTIONS REQUIRED:
J'efL'--1 Q,A OV'~oA-
Print
OFFICEUSEONLY:************************************************************************
Filing Fees: 9 <;l 5" ~ t) ()
Base Inspections: I 73 7 I () 0
Cert. of Occupancy: / 0 () , 0 0
TOTAL: ib I A 7?. DO
~ ". ~ ::, /'//~~
Fee~~ ~..
(Date)
/).-7-0'/
Date
# ~ed Re-
V'" lews
Additional Fees