HomeMy WebLinkAbout07050159 Application
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&: PROJECT
INFO:
C. ifC' lie" 'T' h' Permit #: t) '7D$0101
tty 0 arme ,ay .l owns tp , "'-J I
COMMERCIAL/INSTITUTIONAL/MULTI-FAMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
NAME: PHONE:
t'tJ~ ~lElopfttellT f- CiJJif>'rft fVlc11v<T ~S'1 2..'1 z. SSbfJ
FAX:
?S'l 2.'12 SSl!'S
STREET ADDRESS:
1&0 E fl-,fEfl-CGI</TCFt (JLV'/i 5if/TC II/JO
CITY:
ceJ l,tf GT811J
STATE:
/<-8V
ZIP:
4/Qfl
BUILDER'S EMAIl ADDRESS:
T IfcE1<S'rNJ e CtJfI-I' Nlef. ' ~
BEST MElliOD OF CONTACT:
hntow ~'" GEU- I'd ?S'7 a,s:3 97f>
NAME:
Pr~ 5~ 5ft7><:1S CU/'JJ5
STREET ADDRESS:
/ ()O G fl< (bit- CENcrL J'>L W 5111 n= II dO
ADDRESS OF CONSTRUCTION:
)3eo EM'T <Jb rn S~T
PHONE:
8.>1 J-.'iz.~
FAX:
a's<t 2'12 SSIJ'l
ZIP:
STATE:
;<.ev TV
CITY:
CrN1~
f-Ior/
SUITE #: (If Applicable)
Address of Shell Building: (If different than Address of Construction)
Lot # and Subdivision: (If Applicable)
BUILDING, PROJECT, OR TENANT NAME:
H(,€ ~ $~ CLlI6
ZONING:
SQUARE
FOOTAGE:
~ k-rav
/0 oallSF
It 3M) ~
J ,
~~~~~~S~~~!O~~t~~P~~ri:.~U(7fB;~;~~ect to COmpliance with all regulations
of p ~
Elev.tororUft:~YES dJSP @Il;.~~'l1~fi~m:
" :j CLA'f~~~ATION:
o NEW STRUcru~DIANA Early Release . \/\-,
o ADDmON Permit: Y --1";
o Room(s) L t S rt. - Y -' /..
o Porch Opl._.:......2S..DI
~ 0 Mezzanine or Deck
8 REMODEL FLOOD ZONE AREA DESIGNATIONrSl FOR THIS PROPERTY:
o NEW TENANT ANISH Y <. 1-. ~.J _I
o ACCESSORY BUILDING / \ - WU\..--..J U CV\ C? VI...
o DETACHED GARAGE
o ATTACHED GARAGE PLUMBING CONTRACTOR: 1/1>7 seu:;c:rEYJ
o CELL TOWER (New)
o CELL TOWER CO-LOCATE
o DEMOLlTION
BASEMENT (WALKOUT:_Y_N)
TYPE OF CONSTRUCTION:
X COMMERCIAL
(Privately owned hospitals and medical
offices/centers are commercial)
o INSTITUTIONAL
o Municipal/Public Bldg
o School
o Church
o MULTI-FAMILY
Number of units: _
STATE COMMEROAL
DESIGN RElEASE #:
WATER lJTILITY
PROVIDER:
# of Floors:
TAX MAP PARCEL #:
32 S724-
SCOPE(S) OF \.,..0 FDN 0 STR ~ ARCH J1{ MECH
RElEASE: "I! ElEe 0 SPKLR OtHER(S):
SEWER UTIlITY
PRO
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE)
:z
OCCUPANCY CLASSIFICATION:
11-3
Manufactured
Trusses:
_y~
_Y)C.N
Sump Pump:
Ye:I '5.
Tl;~
FOUNDATION TYPE: (Check all which
apply for the new construction area)
.&;/' SLAB 0 CRAWL SPACE
.,-b"'POST&_BEAM _PIER 0
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 11) regaiding-e~ion tim7~~ 'for begin~in:g and
completing construction, ~\\ L-_'. II '.- ~ '... \'.\
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 Cann~ljridiba - 1993" (Z-289) and amendment;5. \
adopted under authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I funher certuy\tbat on!>:.lti{rhe!f, b~h, ~r drams are~
connect to the sanitouy sewer. l f her certify that the construction will not be used or occupied until a Certificate of oCcu~cy or ~D"..l COmptetioD has ~n': .
issue the De artment of Co uni S ices, Carmel, Indiana. ~ \ \ \ \ \ . .._ ~ J ".---' I
/rN~ J I'J-Me'> /frJf:J!-$tM-- ----S!IS/07 \
S;gnatu"'ofOWne,,,, Print CE2<.. P/ft:JA.E. flS'! 6S" 3 3. 715 __.._-"~~'
OFFICE USE 0
Plumber's Indiana State License #:
Y:************************************************************************
C Filing Fees: ?^ '11-/, 00
O/J..'+ Base Inspections: ;1,0 f) .00
Cert. of Occupancy: / I / . 0 0
TOTAL: -tJ; ~/(713.00 .
FeeRec~P h-,-I/~{A( -6}~~7
INSPECTIONS REQUIRED:
Upper
~
ting Lower Footing Under Slab
.Meter Base~ Site