HomeMy WebLinkAbout07050011 Application
C't ifC IIC" 'T' h' permit#:1'J7bSI":Jt81f
,yo arme .ay .lowns 'P I '
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y lMPROVEMENT LOCATION PERMIT
APPLICATION (~or New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
NAME: D~,- f::::-
PHONE: FAX:
't cP.0/' -00 f'-G, 000
BUILDER'S EMAIL ADDRESS:
I\J ; Li LJl
~A-L\ . L
PROPERTY
OWNER:
NAME:
{(
L.
LOCATION
&. PROJECT
INFO:
STREET ADDRESS:
L! 00 2:'.
ADDRESS OF CONSTRUcrrON:
I'd ~"a N, m-c-r:d,O--
Address of Shell Building: (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
t \ ec .0 Q. \ '\---
STATE:
~
BEST METHOD OF CONTACT:
e ,"'^-0-- ~ \
FAX:
o~ 0 .:'\
STATE:
:r:::.--v
c)
(If Applicable)
00
nd SUbdivis:onC(?~SeS -.3
TAX MAP PARCEL #:
(fc - {j C; ;!" -00 ""L6/&3
eX'MECH 0 PLUM SQUARE
FOOTAGE: () 3 I
ESTlMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUEl$ ,
STATE COMMERCIAL
DESIGN RELEASE #:
o STR fJO ARCH
o SPKLR OtHER(S):
# of Floo", Elevator or Lift, YES Q NO BLDG, CONSTRUCTION TYPE, \ \ _~ ""~V-. OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
-BQ: COMMERCIAL 0 NEW STRUCTURE
(Privately owned hospitals and medical 0 ADOmON
offices/centers are commercial) 0 Room(s)
o INSTITUTIONAL 0 Porch
is ~~e~t\giE~d~OR CO~T~~~eorDeck
o CigJat!jIBct to compliance wl0 aINEWltl!p/;,f(f1l'INISH
o MULTI-FAMILY of State and Locao::;O\MSSORY BUILDING
Number 08'~~:, Ur GOMMUNJ~ $E:~re~G~
FOUNDATION JX:8!it\;(c;;I!@!:lraJll!'Y~L / ClJ:AY~_)
apply for the neW'Consb1Jctldl1\\/, iW CELL TOWER CO-LOCATE
~ SLAB 0 CRAWL S~ IAN'Ll DEMOliTION
o POST & BEAM PIER 0 BASEMENT (WALKOUT:
'-
--:::;;--r;~.~\~ ~:, ' _ .~
~~ ,'-:.I.".Ii',-.
Indiana State 'License '#:
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Class I structure permits are subject to the General Administrative Rules of tbe State of Indiana (See 675 lAC 12) regarding ex~Jatlci~"time frames for beginningaii"d
completing construction. \\\ \\'. _------ ..----
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the ~se of hind orsrructures reque~d by---
this application will comply with, and conform to, all applicable laws of the State ofIndiana, and the "Zoning Ordinance of Carmel Indiana - 1993~ (Z-289) and amendments,
adopted under authority of LC 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only kitchen,bat~nd 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 ~~SubSiintial Completion has been
issued by the Department of ommunity Services, Carmel, Indiana.
SCOPE(S) OF 0 FDN
RELEASE: ~ELEC
SEWER UTIlITY
PROVIDER: Q,
PLAN COMMISSION / 8ZA / W DOCKET UMBERS: AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
Y
/ c3AJ Y 4-
Print
o
~, ~"'f'\
Early Release 1/
Permit: _Y ----i-N
Lot Split: _Y--"C-N
Manufactured
Trusses:
_Y XN
_yLN
Sump Pump:
FLOOD ZONE AREA DESIGNATIONrSl FOR THIS PROPERTY:
XC .r UA\ s'V-U3dlU cL
,/
,
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?Sj()l
\ ,:'~-" \
N)
~cl'-NG-
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D...
OFFICEUSEONLY:*********************************************!!*************************
INSPECTIONS REQUIRED: VI Filing Fees: 0 71f. r'J? 0
Upper g Lower Footing Under Slab ~ Base Inspections: '7--0 'f). 0 0
~ Cert. of Occupancy:
Rough In Meter Base ~ Site 0 00
TOTAL:
Reviewed/ Appr
S:Permits/Forms/ILP
Fee Receiv
Date