HomeMy WebLinkAbout07030103 Application
I
i
\
,
C't ifC IIC" 'T' h' Permit #: () 7 tJ ,")0 If) 3
I Y 0 arme .ay .l owns Ip
'"
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
NAME/t/ ~
STREET ADDRESS:
/3'19/ ,t::;,v&S'8C1
-
PHONE:
-:=lZ~ - >?-==t (
FAX:
cm:
e,
STATE:
;G?- :rAt'
BEST METHOD OF CONTACT:
t3/~./Z-
ZIP:
-/~o32
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
.ZR'~
FAX:
LLC
STREET ADDRESS:
/ I~N~S3t.1.
t)~.
cm:
C :C.L
STATE:
.:LA!'
ZIP:
<-/(;&3'2
LOCATION
& PROJECT
INFO:
ADDRESS OF CONSTRUCTION:
2H.f :3r_ L
SUITE #: (If Applicable)
'iRd3Z
Address of Shell Building: (If different than Address of Construction)
Lot # and Subdivision: (If Applicable)
BUILDING, PROJECT, OR TENANT NAME:
'DuB'S C rt1=6
ZONING:
ez.
STATE COMMERCIAL
DESIGN RELEASE #: 3 Z'Il((j$
SCOPE(S) OF 0 FDN 0 STR ""ARCH 0 MECH 0
RELEASE: 0 ELEC 0 SPKLR OTHER(S):
WATER lJT1LITY SEWER UTIUTY
PROVIDER: C ~ E..<.... PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'$ (If Applicable):
C~L..
~2J!{ 6-:w~':::t
ESTIMATED COST OF CONSTRUcrrON:
(EXCLUDING LAND VALUE) tJif' / ~ ~
# of Floors: Elevator or Uft: Q YES BLDG, CONSTRUrnON TYPE: f?,cgT... OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
~ COMMERCIAL 0 NEW STRUCTURE
(Privately owned hospitals and medical lJ't ADOmON
offices/centers are commercial) gtl, Room{s)
o INSTITUTIONAL lU"' Porch
o Municipal/Public Bldg ~ Mezzanine or Deck ,,'
o School Cia' REMODEL .,.?-UC1i1(0'oo ZONE AREA DESIGNATIONISl FOR THIS PROPERTY:
o Church 0 NEY! AJil'Jl\I'l:cJ\llliSH Ula.tiO(1S
o MULTI.FAMILY ~€.'l!l=~'(!il\I;lINll (e9 X UtJSt-Ht.'f>6C:>
Number of units: _ R€.\.€.~ Ii~-&A lCodes. ';.~c, ~"i7 -,. it~
'ecO? 'P; ED' .. . c.'E.r:'JI"'!ljM~NG CONTRACTOR: '?--"""O' -
FOUNDATION TYPE: (Check all whic!SU'o\ \ ~et ~.TO\N !lQ' '.;:) ,- NS\-\~
apply for the new construction area) ~1tZ611lTGW,fRtt,~i1-"u'\N ""-Ol!-f;.VSl-I, - '. ~
o SLAB 0 CRAWL SPACiOEP E:f e~\II1'ION f>,Nf>, Plumber's Indiana s~ti! L!cense #:
o POST & BEAM PIER C{j\~~ENT (WAL~\ Y N) /.:J C. " \ /:z I : I,
\'-" l V: i',
class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) r~~ludJ~g exp tlOn time frames fod~g~~hiiig ~d
completing construction. \ i \ \ \ " _ _ ~__.--~~- - \
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any cHange-iLl the.use of liiid or structures requested by.l
this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel hlcliana - 1993" (Z- 289) an5! amendmeritS,"
adopted under authority of J.e. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I furth'er certify that only.kitchen;oaih. 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 OcrupancyOiSubstantia} Completion has been
issued by the Department of Community Services, Carmel, Indiana. / ./ / /
~~ f?~ 3/tel s/(o-=r
Print t' ~
UV, CJ>~~/t3V,O-=lO"2C!OI? V
A - z. f2.8<..{
Early Release yo
Permit: _Y ~N
Lot Split: _Y.LN
Manufactured
Trusses:
Sump Pump:
_y.K.N
_Y..,;t:..N
Base Inspections:
Cert. of Occupancy:
TAL:
2l-IS-o
ReviewedfAp roved: Dept. of Community Services (Date)
S:Permits/formsl P COMMERCIAL
Fee Recei
Date