HomeMy WebLinkAbout07050104 Application
C't .Fe IIC" 'T' h' Permit #: (j 7 (}fJ()/oL/
I Y OJ arme .ay .L owns Ip I
COMMERCIAL/INSTITUTIONAL/MULTI-FAMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings) I
FAX: I
?IJ-S7M
I
j
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME'gLf1iY::; O~vc.-+t;'" .:r:;ONE:~ /7-rgo -jao
STREET ADDRESS~
/OL.'/I
STATE:
ZIP:
CITY:
1€ ..:z:;
~ la2-e -I;'C . CO
N-
BUILDER'S EMAIL ADDRESS:
me;;:
NAME:
/r
~
BEST METHOD OF CONTACT:
Cell-S'90 - ~<r2.6
FAX:
PHONE:
L?C S7o/-
CITY:
CO"IH
~oO
STATE:
r.A/
ZIP: I
~ q..?Z
I 17~...
,-7C
Sf- .
ADDRESS OF CONSTRUcnON:
216 e S+.
Address of Shell Building: (If different than Address of Construction)
BUILDING, PROJECf, OR. TENANT NAME:
Fa" ~d (c/'>' tJ/
STATE COMMERCIAL
DESIGN RELEASE #:
fJ
SCOPE(S) OF 0 FDN 0 STR 0 ARCH 0 MECH 0 PLUM
RELEASE: 0 ELEC 0 $PKLR OTHER(S):
SQUARE
FOOTAGE:
WATER UTlUTY .
PROVIDER: C; Q ,,',v. Q:; I (,1bh.
SEWER UTILITY
PROVIDER: C:;/a Wacf<2
PLAN COMMISSION / BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If App.Hcable):
# of Floors:
Elevator or Uft: Q YES Q NO
BLDG. CONSTRUCTION TYPE:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
e:r-COMMERCIAL 0 NF.I"(IWRUCTURE
(Privately owned hospitals and mediC~"'f'.~CADDtii9N
officeS/centers are commercieo~l,~ 1. \'"" .....,J.\B.@-r'~oom(s)
o INSTITU110NA~\,"\ fOt' ,'\f' 0\\ Tn" 0 Porch
Q.o~.ljl6PliIlf'Ub~~\l!l-Qg:" J'i: \ c,OclES. ,P.I"~zzanine or Oeck
ljFSc .0 COli" DO LC,Cc\ . 4;ll.\.flEMO)?1Ol,p
I9.l rclj.,\ s\e\"" \\I\UN,\\( ~\~NT FINISH
o MULTl-FAMILy;"f 001'J',: t'" .p:{[]UI\CCESSORY BUILDING
Num~"s' ~\::.\...I '-,\. 0 DETACHED GARAGE
FOUNDATIO~.-JEP<;-f? t:1 \l>i.'iiir\"j:\ . 0 ATTACHED GARAGE
~ (C ec. a l"N 0 CELL TOWER (New)
apply for the ew construction area) 0 CELL TOWER CO-LOCATE
\D{SLAB 0 CRAWL SPACE 0 DEMOLmON
~ POST&_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
(If Applicable) r
200 f znZ
Lot # and SubdivIsion: (If Applicable)
?u(?
TAX MAP PARCEL #:
ESTIMATED COST OF CONSTRUCTION: Qp
(EXCLUDING LANO VALUE) .3'0.0 eo -
;tI
OCCUPANCY CLASSIFICATION:
'A
PROlE INFORMATION:
Early Release / Manufactured
Permit: _Y _N Trusses:
Lot Split: _ Y ~ Sump Pump:
_Y,..,.r:;
_Y ,.-1\j
FLOOD ZONE AREA DESIGNATIONrSl FOR THIS PROPERTY:
X -11- n5 h ec{(LcL 1
PLUMBING CONTRACTOR:
11/ ) f:J
!
Plumber's Indiana State License #:
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 construction.
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 Carmel Indiana - 1993" (Z-289) and amendments,
adopted under authority of I.e 36-7 et seq, General Assembly of the State of Indiana. and all Acts amendatory thereto, I further certify that only kitchen, bath, and floor drains are
connected to the s itary sewer. I furrh ertify that the construction will not be used or occupied until a Certificare of Occupancy or Subst!ill1tial Completion has been
issued by D aItme . ces, Carmel, Indiana.
Print
Signature of Owner or Authorized Age
ue-/ ~
s:. (p..-'7
Date
OFFICE USE ONLY: *******************************************************:;***************
INSPECTIONS REQUIRED: Filing Fees: q; f. 0
1--()"fJ , () 0
/ (f , 00
,
.31,J-fO
Upper Footing Lower Footing Under Slab
Meter BaseG) Site
Base Inspections:
Cert of Occupancy: