HomeMy WebLinkAbout04120084 Application
City of Carmel/Clay Township Permit #:rfj,l.fl-ZCi{Jl;J.-j
COMMERCIAL\or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT PLIC1\ TION
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For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, l!r. Accessory Buildings
BUILDER of
RECORD:
PHONE
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FAX
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ZIP
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METliOO OF CONTACT:
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STATE
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PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
ADDRESS OF CONSTRUCTION
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STATEX
sum # (If Applicable)
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Address of Shell Building (If different than Address of Construction)
Lot # and Subdivision (If Applicable)
BUILDING, PROJECT, OR TENANT NAME/
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STATE COMMERCIAL;:> ~ SCOPE(S) OF 0 FDN 0 STR ~H
DESIGN RELEASE #: '-.-x:/C:,J,.? RELEASE: -= 0 SPKLR OTHER(S):
WATER UT1LTIY . SEWER UT1LTIY I
PROVIDER: Co.-I' Wl eI PROVIDER: C a:.. r 111 e.-
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
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ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ..3
ow
# of Roors: Elevator or Lift: [) YES BLDG. OCCUPANCY CLASSIFICATION: A -2
TYPE OF CONSTRUCTION: 5E : ROJ INFORMATION:
lZI" COMMEROAL P.E\..E{>: co~ia~'~~~~\J\CES.~r1YRelease .
I' " (Privately owned hOSPilalsc.Ubiect to sta,\@Je. N' s"C. ...,s\-\~rmlt: -'--V X N
and medical offJces/cente~ 0\ "^ !l\X>IN)"<"O'J'J'"
arecommerdal) ,.OrCO OIce<Wf" \ Lot Split: _YLN Sump Pump: _Y-'xN
o IN~~i~~~I/PUbIiC BldOEP Or c"tl\'JIC:~rnine or Deck Do~s an~ part of the property lie within a special Flood
o School C\i'< ]1fi[ 'rEW TENANT FINISH desIgnatIon area: _Y )( N
o Church 0 ACCESSORY BUILDING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE ""\" -., /
apply for the new construction area) 0 ATTACHED GARAGE 0O<;.s'''''''' /.../ Pi'll(
M SLAB 0 CRAWL SPACE 0 CEll TOWER (New) Plumber's Indiana SU:te li{.,nse #:
o P05T&BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE ~'TO DO',..., ? c 7
(or P05T & PIER) WALKOUT:_Y_N 0 DEMOlITION ~_ tr oGL,d.. 7 _/
Manufactured ,K
Trusses: _Y _N
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 - 1993"' (Z~
289) and amendments, adopted under authority of I.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I funher 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' ubs 'aJ Completion has been issued by the Department of Community Services, Cannel,lndiana.
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Print /
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Date
EUSEONLY:************************************************************************
. INSPECTIONS REQUIRED: Filing Fees: 109.00
/07 () 0 # Charged Re-
Upper Footing Lower Footing Under Slab Base Inspections: 0' / Reviews
~~ Meter Base Q Site Cert. of Occupancy: 0 0 I () 0 ,/' _
, Of) Additional Fees
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ReViewed/ proved: Dept. of Community Services (Date)
S:PermIts/Forms{ILP COMMERaAL
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Fee