HomeMy WebLinkAbout07040118 Application
City of Carmel/Clay Township Permit #: ZJ 7t[)F!o flCJ
COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)'
(
I
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME:
LLC,
'10
BUILDER'S EMAIl ADDRESS:
NAME: ~)
LAl
r~Q.AcE
PMi:
ADDRESS OF CONSTRUCTION:
il..('1"~O ,"
Lv!),
Address of Shell Building: (If different than Address of Construction)
VI 1:.- 2.
BUILDING, PROJECT, OR TENANT NAME:
ol.l\ N
STATE COMMERCIAL
DESIGN RELEASE #:
WATER UTIUTY
PROVIDER:
tAfl.to-.t.L
SCOPE(S) OF ttJ, ~ FDN IQ STR
RELEASE: v-r'- ElEe tJIt SPKlR
S!::WER UTILITY
PROVIDER:
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
C-AJrq....EL
# of Floors:
~8-e,,~oo
ZIP:
CITY:
I,..:JDtMlA OL!,
STATE:
..J
I.
2.W
CITY:
STATE:
lrJ
SUITE #: (If Applicable)
'2?O
ZIP:
Lot # and SubdIvision: (If Applicable)
ZONING:
PiJI>
.2i ARCH
OTHER(S):
TAX MAP PARCEL #:
SQUARE
FOOTAGE:
;1..lao ,Jt.w
i I ~&O RE.J;,}k(I..,J
t.3'j
)
ESTIMATED COST OF CONSTRUcnON:i.
(EXCLUDING LAND VALUE) c/lc'iUU. aD
Elevator or Uft: Q YES ~ NO
BLDG. CONSTRUcnON TYPE: .1l 13 5
OCCUPANCY CLASSIFICATION: fv\ A P })
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ COMMEROAL eI)JC'If)O~ STRUCTURE
(Privately owne,d hOSpl~~&1'i~ j\9.\\~mON
offices/centers~~~'a,15\i $,\\ {Q9 0 Room(s)
o INS1IWf!!~J~A~ " <:Ice ~\\, Cooes. ~orch
",€.'Qj.~ufi&JlaI,\Pii1\I~ ~I@g,i:\\ SE-I'\\J\C ezzanine or Deck
S\.\~C\Sd\OO\.a\e 0.\"1 ~ ~\\'i "~' EL
'b cfiilrtB OW',~NJ ":-I \~ NEW TENANT FINISH
o MU~iP{!lfYC '~c\.-I C\J" 0 ACCESSORY BUILDING
~ eOr o~~?\\ \p..~p.. 0 DETACHED GARAGE
_.~ IN\) . 0 ATTACHED GARAGE
FOUNDAI:tON'TYPE: (Chec~ all which 0 CELL TOWER (New)
apply for the new construction area) 0 CELL TOWER CO-LOCATE
Il!:l SLAB 0 CRAWL SPACE 0 DEMOllTlON
o POST &_BEAM _PIER 0 BASEMENT (WALKOllT:_Y_N)
PROJECT INFORMATION:
Early Release ~ Manufactured
Permit: _Y N Trusses:
Lot Split: _Y N Sump Pump:
FLOOD ZONE AREA DESIGNATION S
_y)GN
_Y-XN
- 1.A-(L5
PLUMBING CONTRACTOR: ~
tf/k '-'~-~'_r
Plumber's Indiana State License #:
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12)reg~ding tvqpi!Jt-tiOP tjmdram~s for beginning and
completing construction. . Al-Il 0 {VU/
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or.ariychange in the use of land or structures requested by
this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993n (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_ ~ funher cenify that only kitchen, batb, 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 Community Services, Carmel, Indiana. '-.-.-. - - .
C/'}.Jt'/ i=: ~
Signature of Owner or Authorized Agent
DA.1J-
Print
r
CA,,J
.
'1-/&"07
Date
OFFICE USE ONLY: *************************~*,;!J!I1A*ft':J******~**********************
crrONS REQUIRED' ~ Fees: ~ 1: 3 f b' 0 ()
0-\l5'1..f-f. iiI fJO
Base Inspections: <
~~. f}j:O
TOT ~?J7 3.00
~.a ' (~
Fee Received by:
Reviewed/Appro ed: Dept. of Community Services
S:PermitsJForms/ILP MMERClAL
Date