HomeMy WebLinkAbout07060006 Application
City of Carmel/Clay Township Permit #: a7a ~ OOt'J&
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings)
BUILDER
OF
RECORD:
PHONE:
FAX;
STATE:
.-
73-1/00
ZIP:
G/t .2~
c....eLA ---
0"1 - 3 S- 1
FAX:
573- ?t{)lj
ZIP:
~z'O
00 <iJ;.f:l?
BUILDER'S EMAIL ADDRESS:
IN i"<"tS:::.A,)
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME:
U, c::..",'l... L CLJ.--.
~I,s.
STATE:
.::rN .
LOCATION
& PROJECT
INFO:
STREET AD ESS:
9'1)// U. Ille
ADDRESS OF CONSTRUCTION:
&9D !-
J.., S,,;k
II (.,4-1.. s4-t.".,J.
SUITE #: (If Applicable)
/fe,o
Address of Shell Building: (If different than Address of Construction)
Lot # and Subdivision: (If Applicable)
SEWER UTIliTY
PROVIDER:
(.,00
TAX MAP PARCEL #:
STATE COMMERCIAL
DESIGN RELEASE #: 3;2 (p 3~O
SCOPE(S) OF 0 FON 0 STR ~ ARCH II!, MECH ""
RELEASE: .\ig ELEC ~ SPKLR OTHER(S):
WATER LJTILITY
pROVIDER: CA ~... ~
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ~ s: 00 0
PLAN COMMISSION I 6ZA I 6PW DOCKET NUMBERS; ANDjOR
CQUN1Y WEll AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors: ( Elevator or Uft: P YES Q)\ BLDG. CONSTRUcnON TYPE: ,t - ~ &'P OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: IS" P . . P MPROVEMENT: PROlE INFORMATION:
;r€J COMMERCIAL 0, CO~\, '3-\\ \ep N~,g;rRUcruRE Early Release
(Privately 0~i\alse~e~i'(")06e9-'\JJfo[ntiQlll Permit: _Y ~
offic ~~6t\1.G'3- -N 'OS "F,G;';b\lt~om(s) Lot Split: _Y '\7:.
. ~o ,.'3-'0 ';-\\\' ~O\l''O Pocch -CN
\~UnItIPallF'U~II~~0 :J':i \ 0 Mezzanine or Deck
. ~ Scho&" cP "\ \ C ' 0 REMODEL
. q",c~c~~ X\\.,fI'2.v~. ~i>- ~NEW TENANT FINISH
o MUL~'fA:~ Cl" \~Vf" 0 ACCESSORY BUILDING
NumJl,X\"< : _ 0 DETACHED GARAGE
V ,0 ATTACHED GARAGE
FOUNDATION TYPE: (Chec~ all which 0 CELL TOWER (New)
apply for the new construction area) 0 CELL TOWER CO,LOCATE
Jii11 SLAB 0 CRAWL SPACE 0 DEMOUTION
o POST& BEAM _PIER 0 BASEMENT (WALKOUT:_Y--,-N)
B
o
Sump Pump:
v{N
- Y ;;..-;;
Manufactured
Trusses:
FLOOD ZONE AREA DESIGNATIONCSl FOR THIS PROPERTY:
/\(vV r 1_ n ~c;hcd0;i{
PLUMBING CONTRACTOR:
7rdr()'UVkb''':: J
Plumber's Indiana State License #:
CoSCIOO I '30
~
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) tegarding 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 ill comply w" h, and confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - I993~ (Z~289) and amendments, \"
ad thority 0 I. ~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
onnected sani er. further certify that the construction wiJl not be used or occupied until a Certjficate of OCCllpa.I1CY ac Sllbstantial Completion has been
issued. the ep me C m "ty Services, Carmel, Indiana. '
-,;;;;;f lt1()D~~'^-> Vt\St>J
~ I
()~e I r-i
D.te
'-::e use ONLY: ************************************************************************
, INSPECTIONS REQUIRED: Filing Fees: (j; 14 . 0 0
? 075 .00
, Of)
:33.00
.~g Lower Foo~der Slab
~~ Meter Base ~ Site
\..t\n""~\r\ llllU 4,.10b7
ed: Dept oC Community servicd (Date)
'1MERCIAl
Base Inspections:
Cert, of Occupancy: