HomeMy WebLinkAbout07030178 Application
" City of Carmel/Clay Township Permit #: CJ 70~A 178"
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: )Le ~e.. ~tA-nJ~~E:
STREET ADDRESS:
In ? :-V=<A,^-
FAX:
Lo'Z,fJ - t loO
'0 II - (.,'S/P- Z-c1Q()
-JTATE:
\~ .4-M
ZIP:
y L.. GO
CITY:
.-=
....L-
~
0-0 /IA.
BEST METliOD OF CONTACT:
2- Nt,.'\ 6::1'h=Pb..e
-~
~tUATE:
ZIP:
L{l"Zz,
FAX:
NAME:
?VA-b LL
Q
STREIT ADDRESS:
1R20 W b,"2-'W-e-,
ADD~-3C~~~ ~~
Address of Shell Building: (If different than Address of Construction)
SUITE #: (If Applicable)
Lot # and Subdivision: (If Applicable)
ZONING:
000
eu LDING, PROJECT, OR TENANT NAME:
LL-C-
1-13
TAX MAP PARCEL #;
STATE CQMMEROAL _
DESIGN RELEASE #: '37..."-\2 qb
WATER UTIlITY
PROVIDER:
SCOPE(S) OF 0 FDN 0 STR -6 ARCH '" MECH 0
RELEASE: % ELEC p--SPKLR OTHER(S):
~
ESTIMATED COST OF CONSTRUCTlON: I'
(EXCLUDING LAND VALUE) 50 '-
SEWER UTILITY
PROVIDER:
PLAN COMMISSION I BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
\ Elevator or Uft: 0 YES ~O
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~OMMERCIAL 0 NEW STRUCTURE
(Privately owned hospitals and medical 0 ADDmON
offices/centers are commercial) 0 Room(s)
o INSTITUl10NAL 0 Porch
8 ~~h:IPaI/Public Bldg ~6~~zzanine or Deck
o Church co~S ~w.~fJiINT FINISH
o MULTI-FN-1P-'f..$E.O rOR G \~I\\'\' fa CCESSORV BUILDING
Num~\',;!;,rg, COr"p\llll\C ....1 OQ5la~ARAGE
~.'hiaC\ ,U . UJd LO"~~ ""AGE
FOUNDATION'I"f'l11!: (q,\l8l~w 'ffi \1'11" 'eN' )
apply for the nevv COrt.~~io!.1)Gl Y' 1 c' \~ TOWER CO~~OCATE
~ SLAB eE-? bf \9ll'IV<<M~~F>-N,c.P DEMOLmON
o POST & C\~M _PIERI~ BASEMENT (WALKOUT:_V_N)
# of Floors:
BLDG. CONSTRUCTION TYPE:
OCCUPANCY ClASSIFICATION:
PROJECT INFORMATION:
Early Release
Permit: ,/1 _N
Lot Split: _V_N
Manufactured
Trusses:
_VKN
_V,&N
Sump Pump:
FLOOD ZONE AREA DESIGNATIONrSl FOR THIS PROPERTY:
U n:sh ('ld~d
v
(
PLUMBING CONTRACTOR:
-!!i:ff.,s Indiana State License #:
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,
adop d under authority of I.c. 36-7 et seq. General Assembly of the State of Indiana, and all Acts amendatory thereto_ I further cenify that only kitchen, bath, and floor drains are
co ed to the sanitary sewe. u er certify that the construction will not be used or occupied until a Certificate of Occupancy or Substantial CompJeo'on has been
j, , ym'D'v ,"'0 itySm'm,C",md,Iodima. ~C>\.V\. Vv\ ~VV\.. CZJ7/Jlo7
Sig ture of Owner or Authorized Agent Print ~
OFF CE USE ONLY: ************************************************************************
INSPECTIONS REQUIRED: Filing Fees: ~ ((2 ~, O?)
Base Inspections: '?J!) CJ ' 0 0
Celt. of Occupancy: / () -; , 0 "tJ
TOT~ ;j 1lJ:: () D
W-k-&)'J.
Fee Received by:
Date