HomeMy WebLinkAbout07040124 Application
City of Carmel/Clay Township Permit #: () 701./ OI2Lj
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLlqATION
for Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of
RECORD:
NA:s'
6UILb
STREET ADDRESS
~
BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
Address of Shell Building (If different than Address of Construction)
,(PD
STATE
/AJ
ZIP
'I&2.<QU
sum # (If Applicable)
10
Lot # and Subdivision (If Applicable)
ZONING:
TAX MAP PARCEL #:
o STR Cl ARCH .)If MECH ~ PLUM
-,.; SPKLR OTHER(S):
. Class I structure pennits are subject to the Q:~eral Administrative~~,qs of the'St1te of Indiana (See 675 lAC 12) regarding expiration time frames for
I " \~\ \ l dlmi~ artdJ\;ijmpletmg construction.
I, the undersigned, agree that any construction,lreconstructiit'lh}&largement, relocation~ or-alteration of a structure, or any change in the use of land or structures
requested by this application will complywith)~d ~~_Monn to, all applica~kJaws ofthe State of Indiana, and the ~Zoning Ordinance of Carmel Indiana ~ 1991'7 (Z~
289) and amendments, adopted under authority',,ofl.C.\~~?:.~t seq,General Assembly of the Stai~ 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 Jhat the construction will not be used or occupied until a Certificate of
Oc~or bsc. 'al C 'Pli on has beeh issued by th~p'epartment 'of (:9mmunity Services;Carmel; Indiana.
~.....--~ l____-- _________~ <' t! T1 (); 'l,;~-. .~. Date'-l-;{9 - en
Signature of Owner or Authorized Agent p~ ~6 )
./"
************************************************
-'1-&1.00 I
'/ /'\ 0 () 0 # Charged Re-
Base Inspections: AJJ 0 , Reviews
Cert. of Occupancy: ...----:::~/=;, V-?9~. ;
TOTAL : ~ J.) 0 'B 3~onal Fees
~..".--r-
. CONSTRUCTlON lYPE:
o
PROVEMENT:
NEW STRUCTURE
ADDmON
o Roomes)
o Porch
o Mezzanine or Deck
o CRAWL SPACE
o BASEMENT
WALKOUT:_Y_N
OFfICE USE ONLY: *********
INSPECTIONS REQUIRED:
Filing-Fees:
Upper Footing Lower Footing Under Slab
Meter Base c9 Site
Fee Received by:
SQUARE ..,-,.
FOOTAGE: .2 3 5" O~ 1"
E5T1MATED COST OF CONSTRUC)j!ON:
(EXCLUDING LAND VALUE) 11 ~
~oD
OCCUPANCY CLASSIFICATION:
,
.
PROJECT INFORMATION:
Early Release V Manufactured X.
Permit: _Y ~N Trusses: _Y _N
Lot Split: _yXN Sump Pump: _yXN
Does any part of the property lie within a special Flood
designation area: _Y~.
PLUMBING CONTRACTOR:
Sc.HuI...e:e P,-UIY\1":,I,.J(-"2
Plumber's Indiana State License #:
8IDSS-~ c:::