HomeMy WebLinkAbout07040109 Application
City of Carmel/Clay Township Permit #: 0 7 ();...,/ 0 JO!
COMMERCIAL/INSTITUTIONAL/MOL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
.;;i
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
STREET ADDRESS: CITY: STATE:
-401 PGNN.S'IL\J A,Ni ^ PM2:XWA I bIA~IH=t;_JS. IN
BUILDER'S EMAIL ADDRESS:.MVe.VI +; fl1~ ); C{ BEST METHOD OF CONTACT:
mlierrCUY>L L.tC\.ci';Lo..uth.ne.;L G.NlA-IL
NAME: PHONE:
Nk IDU>CN Nlbt')Ic..AL As<:;oo T- 0 lLL.
STREET ADDRESS: CITY:
401 PG"'f'-'SVLilANIA P"-l2..l(\\J/eV INI 'ANA-POU,
NAME:
1 AUlli
:ONSTICL'CTIOI\J , LLC,
ADDRESS OF CONSTRUCTION:
/21 B8 .- A r-J.e:nl Mev DIMJ STlZ.b8~
Address of Shell Building: (If different than Address of Construction)
~*"'10 1\-", />; ,VG
BUILDING, PROJECf, OR TENANT NAME:
OI2.C /IN ir HrccALTH
STATE COMMERCIAL
DESIGN RELEASE #: 32.4899
PHONE:
C:3ltj 848.. &SOO
FAX:
(3ir') 845.-(.,511
ZIP:
4{.,2OO
'5&4 -6/46
STATE:
ZIP:
4 . Leo
IN
SUITE #:
c...fteMbL 1M
Lot # and Subdivision: (If Applicable)
Nur
ZONING:
D
SCOPE(S) OF 0 FDN 0 STR 'j1j ARCH iJi( MECH U/J'
RELEASE: tI\ ELEC 0 SPKLR OTHER(S):
APPLlCAtsL!.::
SQUARE r-
FOOTAGE: CJ I I :::, r-
WATER UTILITY
PROVIDER: C,Ae.ME::-L
SEWER UllLfTY
PROVIDER: G A.(CJ'vl<f: L
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors:
:3
Elevator or lift: ):'I: YES
[) NO
BLDG. CONSTRUmON TYPE: f:.)(:s,.) ,5PK
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
Cli COMMERCIAL 0 NEW STRUClURE
(Privately owned hospitals and medical 0 ADDmON
offices/centers are commercial) 0 Room(s)
o INSlTTUTIONAL 0 Porch
o Municipal/Public Bldg 0 Mezzanine Or Deck
o School 0 REMODEL
MWl.t~~D FOR CONSTR~D"!iE0M:NANT FINISH
o "",-,""~<,; "'ts^:'lmc,l;ancp '<'11th all rQ. ul~~ORY BUILDING
1'IUm""~wU'" : ~ ~ LJ DETACHED GARAGE
of State and Local Codrt:J. t-DhO!ED GARAGE
FO~N~A~E<!'':''~_~B',.\"IPi'l~~hTY S [[ffiVQ:EiJ;:~WER (New)
app y o';.."ITYewOF~~R'~'!?; r1"r'i AY T6),Mr;;gt:l,~ER CO-LOCATE
1st! SLJ\llI ~ CRAWL SPACE ' tJ"b~~O(fuON
, NnIAr-JA
o POST &_BEAM ~1'J'El{ O' BASEMENT (WALKOUT:_Y_N)
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE) fl, 10> 354,00
OCCUPANCY CLASSIFICATION:
B, ~E-M
PROJECT INFORMATION:
Early Release
Permit: _Y ~N
Lot Split: _ Y -.-2LN
Manufactured
Trusses: _Y ~N
Sump Pump: _Y l...N
FLOOD ZONE AREA DESIGNATlONISl FOR THIS PROPERTY:
NOT
Pc pp,- I G A:ft,Li'-:c
PLUMBING CONTRACTOR:
CS 'l-M
MbC-dA"-' ,'-AL-
Plumber's Indiana State License #:
CPF\ lo{~4?' 'in
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 further certify that only kitchen, bath, and floor drains are
connected to the sanit sewer. I further certify that the construction will not be used or occupied until a Certificate of Occupancy or Substllntial Completion has been
issued by the De of Co . Services, Carmel, Indiana.
64fA/tIJ
Print
f1a1r>v
5"hfr9-
oale
OFFICE USE ONLY: *************************it*~~******************************************
INSPECTIONS REQUIRED: (/ '( Filing Fees: /f7~. 7J7
Upper Footing Lower Footing Under Slab ~ \19 Base Inspections: 'i-O '3' , 00
Cert of occupancy:'; 1/ . 0 0
Anal ,~ ~
TOTAL: 'fI' r s, ;Zv
007
Fee Received by:
Date
Reviewed/Appro ed: Dept. of Community Service
S:Permlts/Forms/ILP COMMERCIAL