HomeMy WebLinkAbout07060026 Application
City of Carmel/Clay Township Permit #: 0 704:fJ6:( (0
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
NAME:
tI" \ ~
STREET ADDRES?:
1f6y (,. I':
'3 3. ro. St.
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
Address of Shell Building: (If different tha
PHOi~ g -'100<:'
FAX:
Y"I ~ - "1 o8'~
STATE: ZIP:
Uf:,
CI1Y:
ob(
BEST METHOD OF CONTACT:
. GO,^" e-
PHONE:
31J<<L\~
FAX:
1, I 'l~Lf
ZIP:
'-1. (" z. '-I 0
3n
t\ s ST:!DJ
CI1Y:
lot # and Subdivision: (If Applicable)
o
rc{
TAX MAP PARCEL #:
BUILDING, PROJECT, OR TENANT NAME:
-\Lt..
STATE COMMERCIAL 7 -, CI J"" j')
DESIGN RELEASE #: z> (..... T\ L- ~
MD,^". A is:
SCOPE(S) OF 0 FDN
RELEASE: 0 ELEC
ZONING:
(2.-2..-
o STR ~ fl.RCH 0 MECH
o SPKLR OTHER(S):
~
""It.
WATER UTlLI1Y SEWER UTlLlT(
PROVIDER: PROVI O~
PLAN COMMISSION / BZA / BPW DOCKET '!'.(J:l ; A'lIlAQjl.I>\1
COUNTY WELL AND/OR SEPTIC P ~€;S.{t( '\'(PjtI\3b~ .
# of Floors: t ~IE\l\':C. I!]if;
TYPE OF \e 'l:Rj
o CO~nva~~~:O~jp~~~~~~~
offic~te~ ~ll1ner"\~Q
o INSlllJ..lROtlAl!'
o ~hiclpal/PubliC Bldg
o School
o Church
)Q MULTI-FAMILY C
Number of units: _
SQUARE
FOOTAGE:
9&
ESTIMATED COST OF CONSTRU
(EXCLUDING LAND VALUE)
000
~\'i!NSTRumONTYPE: V-I>
OCCUPANCY CLASSIFICATION:
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 Cannel 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
connec cd to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of Occupancy or Substantial Completion has been
issue y t ep of coz.munity Services, Carmel, Indiana.
A>'\.A,...,
Signature of Owner or Authorized Agent Print
FOUNOATION TYPE: (Check all which
apply for the new con~uction area)
~SLAB 0'. CRAWLSPACE
o POST & _BEAM _PIER 0
PROVEMENT:
NEW STRUClURE
ADDmON
o Roam{s)
o Porch
~ 0 Mezzanine or Deck
REMODEL
NEW TENANT FINISH
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o CELL TOWER (New)
o CELL TOWER CO-LOCATE
o DEMOLITION
BASEMENT (WALKOUT:_Y_N)
PROJECT INFORMATION:
Early Release 'v
Permit: _Y ~N
Lot Split: _YX-N
Manufactured
Trusses:
Sump Pump:
_Y 2LN
_Y~N
FLOOD ZONE AREA DESIGNATIONfSl FOR THIS PROPERTY:
PLUMBING CONTRACTOR:
AJ/A
Plumber's Indiana State License #:
AliA
\ (;~b6'1
D~j4!DI
OFFICEUSEONLY:***************************~********************************************
C INSPECTIONS.; REQUIRED: 1~OY'- ;T~fFiling Fees: -:3 I 3, ;ZO
\ If I'M ~~ _ L eqlt- -. 0
pper FOOting~.;eer Footing i ~r Sla ~ l-li' tl Base Inspections: 2 D 8'.. CJ
.c"'"7\ .~. ,^J Cert. of Occupancy: / II 00
. oughI Meter Base ~ Site ~. J (e 3;!,
TOTAL: , ;;<,0
Reviewed/A roved: Dept. of Community Services
S:PermitsjFormS/ILP COMMERCIAL
Fee Received by:
Date