HomeMy WebLinkAbout07050058 Application
"", " "'" CJ '7 (l ") tJ J:\ ro-J
< C'.'~"'"".."'" C't o.I'C IIC" 'T' h' Permit #: U0 0
(,\.' , .,. \ _ . t Y:I arme lay .I. owns tp
" . ~) COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
I," .. APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
PROPERTY
.OWNER:
LOCATION
&: PROJECT
INFO:
47~-I)-Y+
STATE:
\:~ :eN
ZIP,
" (;)0 'I
cm,
.::Lrl D/" NJ.A.
BUILDER'S EMAIL ADDRESS: BEST MEll-iQD OF CONTACT:
S<3.~\Jo..U"Q '&Jc.X:.tNU, !-\AM -CO. LfJM
6lS. -Z'-\- \?~4-
em.
\ uA-t'\l"p,~. ~I::),
~(]VI.~
NAME:
Cl;c.j.- (Q3~
e.tt
STREET ADDRESS:
33.3 N, ~~~S
ADDRESS OF CONSTRUcnON:
01 6;15 01
Lot # and Subdivision: (If Applicable)
Add~ Shell Building: (If different than Address of Construction)
'\--"t.OVI~OC: rz:-~
au DING, PROJECT, OR TENANT NAME: ZONING:
~ I ~
STATE COMMERCIAL SCOPE(S) OF FJ FDN 0 STR
DESIGN RELEASE #, 'Q;;I ~?l I RELEASE' Iii' ELEC 0 SPKLR
WATER UTlUTY " .. . .... SEWER UTILITY I' ~ 11 ~A..IL
PROVIDER' ~cc.L-- PROVIDER, L..-I'\:1"'H...,!...-
;;;:>,107S
/lS,OOO :
TAX MAP PARCEL #:
SQUARE
FOOTAGE:
ESTlMATED COST OF CONSTRUCTION:Jl
(EXCLUDING LAND VALUE) 'P
PLAN COMMISSION / BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable);
Elevator or Lift; Q YES ~o
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
Co/'COMMERCIAL 0 NEW STRU RE
(Privately owned hospitals and medical S!;;:h
offices/centers are.>-'l'Il"fei'?\ CON ,Tn at\~S(s)
o INSTI<!fl'l\!,~St:.U e witl~ a\1 re Porch
O'~\ll\,qp~~8~n~ cat CodesO Me",,",ne or Deck
o ~h\l8t' 0\ State ?nd LO ' ::...J~Jclll.~~
o Church C01\ll~^UN\ I i';:::r'"flffi~~flINISH
o MULTl-Wf!W"IOF I cvr::J -r~'ll1l.Y.IiUILDING
Numbcff'fi(5F C AR~~~If'J-lpg ~~:~~~~ ~~~~ PLUMBING CONTRACTOR:
FO~N~ATION TYPE: (Chec~ all wHi~tr 0 CELL TO,wER (New) . ~ ~~,. ',' \ .1\" _ . " , _I', "kL
app y or the new construction area) 0 CELL TOWER CO-LOCATE ~.".... - ~ ~~. '"
~LAB 0 CRAWL SPACE 0 DEMOLITION Plumber's Indiana State License #:
o POST &_BEAM _PIER 0 BASEMENT (WALKOLJT:-Y--.. N) P O~ DOO ,.(j
~ ~ I
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 constru tion.
I, the undersigned, agree that any construction, reCJ;Jt1struction, enlargement, relocation, or alter tion of a structure, or any change in the use of land or structures requested by
this application WIll comply WIth, and conform tpH applicable laws of the State of Ipdl~a, an the ~Zonmg Ordmance of Cannel Indiana - I993~ (Z~289) and amendments,
adopted under authonry of I C 6-7 et seq'te ral Assembly of the State of Indiana,~ ~l A amendatory thereto I further certify that only kitchen, bath, and floor drams are
connected to sanItary se e I further c tlfy that the construct n wItI not be used 0 occupied until a Ccrtincate of Occupancy or SubstalJoaJ Completion has been
,",ned by t pattment mmnUtty etv>O<S, Catmel: In ,an r ) . ~/q /07
Signa wner or Au orized Agent '-- Pri Date {
# of Floors~
l
BLDG. CONSTRUCTION TYPE:
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release
Permit: _Y t./N
Lot Split: _Y ~
Manufactured
Trusses:
_Y"""--N
Sump Pump:
_Y ----N
Filing Fees:
Base Inspections:
Cert. of Occupancy:
TOT~L:
Date