HomeMy WebLinkAbout07040147 Application
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C't ifc [fel 'T' h' Permit #: 070 t{,Of.!:f1
tyo arme ay .Lowns tp I
COMMERCIAL/INSTITUTIONAL/MOL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings>1
BUILDER
OF
RECORD:
NAME:
L3~. ,.--r-..,J
cr1t>
FAX;
16~
77<7 /3 q'7
ZIP:
~6Cih <I
STREET ADDRESS:
751 ~5
(PO[) t-Jes.,-
STREET ADDRESS:
I 22:20 ,,).
BUILDfR'S EMAIL ADDRESS: .
Cl.lJen -Lei:.€bril~ C!..-, JlaM
NAME: PHONE:
5filAi'6b1C jv{A2k€.-('"J,'i/:a~A~(d, '574- F12.L
'f!Rli)/c>J )at-fG 100 c~tJ.RH6L ~
\Sl!lI!':!: j!CAp~licable)J
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
FAX:
5
l/ -7 7i7
ZIP: I
'Ib 0 (3:J-
LOCATION
8< PROJECT
INFO:
ADDRESS OF CONSTRUcno~;
7D lQ tV,
(~~
At!~
Address of Shell Building: (If different than Address of Construction)
Lot # and Subdivision: (If Applicable)
rzr MECH
J
BUILDING, PROJECT, OR TENANT NAME:
'5 (1 ^ , C 6\ J f'I\. Aetce~ '\Z6s G-A-
STATE COMMERCIAL SCOPE(S) OF
DESIGN RELEASE #: '3 OJ. S I S RELEASE:
WATER UllUTY E /?
PROVIDER: (t; 4 /l-fI cj<
PLAN COMMISSION! BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTIC PERMIT #'S (If Applicable):
ZONING:
SQUARE
FOOTAGE:
'taco
ESTIMATED COST OF CONSTRUCTlON:
(EXCLUDING LAND VALUE) Zg q I ~ -
# of Floors: Z- Elevator or Lift: Q YES O~O BLDG. CONSTRUcnON 1YPE: bJOD D OCCUPANCY CLASSIFICATION: ~
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
J2f COMMEROAL 0 NEW STRUCT1JRE Early Release ____ Manufactured
(Privately owned hospitals and medical 0 ADDmON Permit: _Y r _N___---Trusses:
offices/centers are commerCial) 0 Room(s) ~
o INSTTTUT10~~ 1 01107 0 Porch Lot Split: _Y _N Sump Pump:
o Mun~iPavPublil Bldg 0 Mezzanine or Deck
o School~D REMODEL.,.\(\\'\
o 'Church . . , ;;a Ns.I?'--T~NAN1'}J~{!;H
o MULTI.FAMILY Q\At;:CESS:OR]'WILDING
NUmber. of units: _ _ _. ,..-g,1:0ETACHED GARAGo:::
(;c{2"b~'ArrACI:II:'i> GAIqi,GE"
FOUNOATION TYPE: (Chec~ al~~fj,~:(\rOCEt('rolVi:R'(NeW)0\?
apply for the new constr.!:l~jI:..re~>'i('i,'\' 'lcF\~~t(TOWER,(:b-'tBCATE
% SLAB ~'(:;CRAWI:'SR'cE!c\ l>\\r':IJ;).\\OE,M,otlTiOi1
~0'OY'" o:\. '.:, f)'\.,\" ("',1.,,",
o POST&_BEAM ~PI~o8C~~r~~~~W~KOUT:_Y_N)
-Z~r-1
Y N
-Y~'
FLOOD ZONE AREA OESIGNATIONrS) FOR THIS PROPERTY:
PLUMBING CONTRA):
Goi7h~,,-
Plumber's Indiana State license #:
f()t, 'I?' I~
class I structure permits are ~ ....the General dministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
C\ completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or aJteration 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 AssembJ of t te of Indiana, and all Acts amendatory thereto_ I further certify that only kitchen. bath, and floor drains are
connected to the sanitary sewer. I fumer cert" e constructio will not be used or occupied until a Certificate of Occupancy or Substantial Completion has been
issued by the Department of Com ity Services, Carmel, Indian "
s;gn~~::Ori:': Agent
~,bU',s c: 3~;JrJe-1"]
Print
~J7/o7
o.te
OFFICE USE ONLY: ************************************************************************
INSPECTIONS REQUIRED: ~ Filing Fees: / g '1 If ' 0-0
Upper Footing Lower ~~er Slab L-j{ Base Inspections: '?JJ 'D . 0 0
JJp Cert of Occupancy: / / I ' (J 0
Meter Bas Final ite
13.DO
Reviewed/Appro ed: Dept. of Community Services
S:Permlts/FormS/ILP MMEROAL