HomeMy WebLinkAbout07030238 Application
City of Carmel/Clay Township Permit #: () 7o'YJ ')..,?j)
COMMERCIAL/INSTITUTIONAL/MOL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
PROPERlY
OWNER:
LOCATION
8r. PROJECT
INFO:
NAME: b '^-- ~ e Qo~ PHONE: p di'T- - FAX: 31~-
L. . go!?- {,ooo ~o~-L,
STREET ADDRESS: c; [,.~ <S+ CITY: STATE: ZIP:
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BUILDER'S EMAlL ADDRESS:
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N~
L
, CITY:
S~-e-~
S+,
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STREET ADDRESS:
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ADDRESS OF CONSTRUc:!lqN:
l~ q DO {V, rY\€(';clia"
Address of Shell Building: (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
'Q~
h-b
YY\.o...
$COPE(S) OF 0 FDN 0 STR
RELEASE: ~LEC ~KLR
STATE COMMERCIAL
DESIGN RELEASE #: 3 d L{C 0 (,
WATER UTILITY ('j
PROVIDER: l/ 0...
SEWER UTILITY n
PROVIDER: V
PLAN COMMISSION I BZA / BP DOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTIC PERMIT #'5 (If Applicable):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
)<t COMMERCIAL 0 l"~~UCTURE
(Privately owned hospitals and mediCjl~C:~ AD~~~!l
offlces/centersarecom.me<,~PCO""'" . egut:!d-\ Room(s)
o INSTITU11~~I=O \"V' '13 ~,if[\ al\ ~. 0 Porch
'b~Bi' nC ~ooe5, ,...,
~' ~6~J"" d9 \ oc3\ v' "Q,r,~mne or Deck
dS,~gc1t , \8 arId - n~EREMOtiEL,..\\1'
o 'CnOrch 01 SUI '~!I\J\'l\ ON~~ANT ANISH
o MULTI-FA!jAA Of CO\~'_ I CiYi!J '\ ACCESSORY BUILDING
Numbe{)lt:Uriits: C~?'~}'U- NIIP DETACHED GARAGE .
ti*~ Or ,,,\\\\N '0 ATTACHED GARAGE
FOUNDATION rpf: ~hec~ all wltitlf 0 CELL TOWER (New)
apply for the new construction area) 0 CELL TOWER CO-LOCATE
o SLAB 0 CRAWL SPACE' 0 DEMOLITiON
Q( POST&_BEAM _PIERW~'\BAs'E~t(WAL~O~:J-Y_N)
"'\ \ \ r:.. Id ~- ,
Class I structure permits are subject to th~ Ge~Jral AdkiJi~tra~iv~ Rules ofthe St.:.te of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
\\\ \\\..... _~~~,.completingconstruction.
I, ~he un~e~igne~, agree that:my constructio1'\ \e.co~~vu.ction,_enlargement, relocatio~, or alteration of a.structu~e, or any change in t?e use of l~d or structures requested by
thiS application will comply With, and confonn ~,,"-aU apB-licable laws of the State of Inmana. and the ~Zonmg Ordmance of Cannel Indiana - 1993 (Z-289) and amendments,
adopted under authority of I.c. 36-7 et seq, Genenu 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 Occupancy or Substantial Completion has been
issued by the Department of Com unity Servic~me(fndiana.
# of Floors:
Elevator or Uft: 0 YES 0 NO
BLDG. CONSTRUcnON lYPE:
OFFICE USE ONLY: ************************************************************************
Filing Fees: /6Y;? f?(p
Base Inspections: ;:?p 0 , 0 CJ
Cert, of Occupancy: ~ tJ f' CJ 0
TOTAL: if ~ _Z' C6&
Q,2.007 ?0frY1 ~
Fee ReceIved by:
Upper Footing
-r; "l'{ a
Print
INSPECTIONS REQUIRED:
Lower Footing
Under Slab
Reviewed/Ap roved: Dep. of Community Services
S:Permlts/Forms,l COMMEROAl
~ rl'\ 0...'"
FAX: .sl=l-
YOi?-Go
ZIP:
~
o
9
STATE:
Is
SUITE #: (If Applicable)
( ~O
ZONING: e ~
il( ARCH ~ECH
OTHER(S):
TAX MAP PARCEL #:
/ -() 7'- .),(,-OC-OO-O/b.
OJeLUM
OCCUPANCY ClASSIFICATION:
PROJECT INFORMATION:
Early Release /J
Permit: _Y..AN
Lot Split: _y-k-N
Manufactured
Trusses:
_Y~N
_Y d-N
Sump Pump:
FLOOD ZONE AREA DESIGNATIONCSl FOR THIS PROPERTY:
PC'!-MBING CONTRACTOR: . .
() ~rJ fY\<::.'-.kL'^-:
(cJ
Plumber's Indiana State license #:
J c..lo,J, ^()(\:~,.('
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