HomeMy WebLinkAbout07070009 Application
City of Carmel! Clay Township Permit #: l"91'/' 0 7 ()('fJ,'l
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
NAME:DlA
STREET ADDRESS:
iJO 2'
~ f.c~S.k,,-,
BUILDER'S EMAIl ADDRESS:
PROPERTY
OWNER:
NAME:
K"'-G-l+' L P
'7 Co -n., S --k-<::.""--+
LA K~
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
,Dc> C:.
ADDRESS OF CONSTRUCTION:
q()O
"-'
Address of Shell Building: (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
,
STATE COMM RCAL SCOPE(S) OF 0 FDN 0 STR
DESIGN RELEASE': .3 J ~ -9 3 I RELEASE: R ELEC R. SPKLR
WATER UTILIf': \ SEWER UTILITY
PROVIDER: l i /l C"-- PROVIDER:
PLAN COMMISSION I BZA Bf>V'I DOCK NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
FAX:
I!() 0
:3 {1- -?o ",-H'i 1-
3
e f'Y\O-c'
FAX:
317- -f?ul?-('9-'7
ZIP:
.{" 600
cm:
S'
,:; +e.
[00
SUITE #: (If Applicable)
I+S-
Lot # and Subdivision: (If Applicable)
TAX MAP PARCEL #:
_ / 3 - /). -00 - 00 '0 13. 00
SQUARE / 9 9
FOOTAGE: (P f 3 ' '
ZONINGi3 ~
!J{ ARCH SJ(MECH
OTHER(S):
# of Floors:
Elevator or Uft: 0 YES
BLDG. CONSTRUCTION TYPE:
o NO
TYPE OF CONSTRUCTION: ,e1> MPROVEMENT:
y\'\.J- ~\.
~ COMMERCIAL ~(';\' QQ,@- NEW STRUCTURE
(Privately owned hosPltaf5'€nd:mediCal\ D ADOmON
offices/centers are~rneraQ~}.\\:0 G ocF.J::J .Cr- 0~om(s)
o INS11TU110~ 1( ,,,:0(,0 0(,2' _' ,'\ Porch
o JW!!!dpal/~phc ~dg .. ~"" 0 Mezzanine or Deck
~'1sthoOI('O \0 '1>" .~0"'" REMODEL
~r-~~, S\'1> O\ll\~' \ A@-" /!i;r} NEW TENANTFINISH
o Ml$ '~AMILYC\", G . ~\;.\.. . "",I>- 't'J"-ACCESSORY BUILDING
Number ot-t:1{1,n., _ ,,\\\'l' ~\\)\r 0 DETACHED GARAGE
<\\;.'" ~(- ~\\--: 0 ATTACHED GARAGE
FOUNDATION~:~heck all whIch 0 CELL TOWER (New)
ap~IY for the '6 onstruct.on area) 0 CELL TOWER CO-LOCATE
fl.-sLAB 0 CRAWL SPACE 0 DEMOlITlON
o POST & BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
. ,.
ESTIMATED COST OF CONSTRUCTION: --, -, ' - "'I
(EXCLUDING LAND VALUE) / U ') 0 O!/~ "
, . TO(,~ III
.1 "j
!'I iI'l
i IL/:, I
i
JUL
2 2007
?CCUPANCY' CLASSIFICATION:--..J
PROJECT INFORMATION:
Early Release V
Permit: _Y ~N
Lot Split: _ Y KN
Manufactured
Trusses:
Sump Pump:
_yJ:;.N
_yLN
FLOOD ZONE AREA DESIGNATIONISl FOR THIS PROPERTY:
PLUMBING CONTRACTOR:
-K ~ 1\ 0, ~O r rJ
I b ~.J L'
P urn er's Indiana State Icense 1!:
C pqg , (5 I '+ I d-
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 -199r (Z~289) and amendments,
adopted under authority of l.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 ot occupied until a Certificate of Occupancy or Substantial Completion has been
issue_dlry the Department of Commu?ity Services, Carmel, Indiana.
c:::::..;=:.U=---.~_ c1.\ ..... J..'
Signature of Owner or Au~t\Orli:ed Agent
o
Print
nrJy'''
~'Cr-r) ,^'I'-
+ -,) -0'7-
Date
Upper Footing Lower Footing Under Slab
Meter Base @ Site
Base Inspections:
Cert, of
7
~ ~eviewed/APpro ed: De . of Community Services
~ \:p""mi"/Focm"ILP MMERGAL
Fee Received by:
Date