HomeMy WebLinkAbout07050041 Application
. Ci-:yofCarmel/Clay Township Permit#: 07VS004{
COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
NAME:
'~FFf;tz~
FAX:
CITY:
Zoo
STATE:
ZIP:
STREET ADDRESS:
io
"7,f~ teN I4'tfcfPY.:
BUILDER'S EMAIL ADDRESS:
BEST METHOD OF CO
PHONE:
tfl..
CITY:
STATE:
ZIP:
\3
SUITE #: (If Applicable)
Lot # and Subdivision: (If Applicable)
BUILDING, PROJECT, OR TENANT NAME:
D
TAXMAPPARCEL#: \b-tQ-~\-OO-<:::O- 3G-C<l
\~~(~I_""n_t.r;_<,,44 _~
~-- ;:;. 0 -- _c >
STATE COMMERCIAL '? ~\E01 ~ 32~4o
DESIGN RELEASE #:
SCOPE(S) OF )( FDN ~ STIl 'l6 ARCH ~ MECH )IQ. PLUM
RELEASE: ~ ELEC 0 SPKLR OTHER(S):
SQUARE
FOOTAGE:
\ '6S",
,
Sf. (} A,
)t]Do '11
"11'1::'
,~
WATER VTIUTY
PROVIDER:
SEWER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) 4t
PLAN COMMISSION / BZA I BPW DOCKET NUMBERS; AND/OR l I
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable): i)<X-tt.t:"T No 0 -
0'0'"3,0002
# of Floors: \
TYPE OF CONSTRUCTION: TYPE O~~tOVEMENT:
)"[ COMMERCIAL :\(li,l))CN U~{~UCTURE
(Pnvately owned hosPltaIS,il(l~~\5 ~g<Am)'ttl6N
offices/centers il'ti~G~1t -. Jlt'n -all 0 Room(s)
o INS1Jll{I]OpiAtt "ffill,W,nce'l' \ CodeS. ,i;if'.lbIih
~\::rlrilnI"'P'WP,~~~ ~m \..oca:~'t'\'t~r:~~lne or Deck
q,~) 0\ '0\'3\8 ""UN\ bl5ft ..
o Church r COW\ C\. EW TENANT FINISH
o MUL;:;pre 0 {>..'(\\,^'2.\.-1 ~I(>.. 0 ACCESSORY BUILDING
Numb :0..~'tJ'i'~ \ND\(>..\~ 0 DETACHED GARAGE
rr:fV- ' . 0 AlTACHED GARAGE
FOUNDATIO PE: (Chec~ all whIch 0 CELL TOWER (New)
apply for the new constructIon area) 0 CELL TOWER CO-LOCATE
~SLAB 0 CRAWL SPACE 0 DEMOLmON
o POST&_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
Elevator or Uft: Q YES )( NO
BLDG. CONSTRucnON TYPE:
V-B
OCCUPANCY CLASSIFICATION:
A-z.
~
PROJECT INFORMATION:
Early Release ~
Permit: _Y N
Lot Split: _Y_N
Manufactured
Trusses:
Sump Pump:
_YAN
_yXN
FLOOD ZONE AREA DESIGNA1l0NrS) FOR THIS PROPERTY:
)( -iA_l75h?d e.d
PLUMBING CONTRACTOR: ~ IZ O~.
Plumber's Indiana State License #:
Class 1 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 - 199r (2-289) and amendments,
adopted under authority of I.c. 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 sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of Occupancy or Substantial Completion has been
issued b he Department of Community Services, Carmel, Indiana.
4Jdp
bO/\/4 { C.
(!
MQc:y(€
6/2/07
~
Signature of Owner or Authorized Agent
Print
Date
OFFICEUSEONLY:**********************~~***~~********************~****[)**************
EONS REQUIRED" (J-. \ ~ Filing Fees; 7 7_. 0
5 I Base Inspections: S AO . of)
Cert. of Occupancy: 1t.. I~ / . 0 t)
TOTAL: _ / _OS: 00
7
Reviewed/ App
S:PermitsfFormS/IL
Date
Fee Received by: