HomeMy WebLinkAbout07070114 Application
COt "C lie" 'T' h" Permit #: n701o IIJj
t Y oJ arme .ay .J. owns tp
i' COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDING, PROJECT, OR TENANT NAME:
'U'
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME:
PHONE:
FAX:
311-SYlD
'(::noN ~\Lt.~
STATE: ZIP:
IN
\Yv&N
CITY:
~'i:.)...
'2..
BEST METHOD OF CONTACT:
.i\!
'<-
FAX:
3i1-
'2-\<i;dL
NAME:
PHONE:
-z.,-\<lOb
CITY:
STATE:
ZIP:
(c-22..D
IN
SUITE #: (If Applicable)
,
Address of Shell Building: (If different than Address of Construction)
000
STATE COMMEROAL
DESIGN RELEASE #:
SQUARE
FOOTAGE: 3WO Sl="
WATER lfTlLITY
PROVIDER:
SCOPE(S) OF 0 FDN 0 STR .'lI. ARCH q(MECH
RELEASE: ')1< ELEC 0 SPKLR cfrHER(S):
SEWER UTILrp'"(
PROVIDER:
ESTIMATED COST OF CONSTRUcnOf'./j//)
(EXCLUDING LAND VALUE) /..7 -'/
6'C
0_
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors: Elevator or Ufl:: Q YES ~ NO BLDG. CONSTRUCTION TYPE: \, g OCCUPANCY CLASSIFICATION: IvJ,
TYPE OF CONSTRUCTION: TYPEO~F IMPROVEMENT: PROJECT INFORMATION:
B COMMERCIAL 0 NEW STRUCTURE Early Release Manufactured
(Privately owned hospItals and medical 0 ADDmON Permit: _ Y X-N Trusses:
officesjcenters are commerdal) 0 Room(s) \I'
o INSTITUTIONAL 1111 1 h 2007 0 Porch Lot Split: _v a-N
o MunicipaWPlJl3lic Blir'g 0 .. .f'1ezzanlne or Deck
o School 0 !lf~ti!'L FLOOD ZONE AREA DESIGNATIONISl FOR THIS PROPERTY:
0' Church "~CNEW\'/iEt<Jo.NT FINISH
o MULTI-FAMILV ",c.;\0 (AC€ESSORV BUILDING
Number_ol units: _ f"l cc. " ~ ,d" 'DETACHEP,YARAGE
cO". ",\\' .(3"e'i\TrAcHED ~GE
FOUNDATION TYPE: (~all~!Jidf' c;S' 't;JC.'Ci:tLTOwJlt'tNew)
apply for the ne:t{~'ti9"\ar~~,t \.0 \\~ -'-\C~'tbWER CO-LOCATE
.8f SLAB ?\ 'o,&3~ 11R'4wt Sp,:l.&-J I;-\C m.( DEMOLmON
0;:,0' o,-c--rOI". )Y'
o P05T&_BEA~\4:lE~~Sl\..~~NT (WALKOUT:_V_N)
-VI
Sump Pump:
_VX-N
_VX-.N
PLUMBING CONTRACTOR:
'wn\Al-J?l Um6il\'i:'
Plumber's Indiana State License #:
C_ P ?fIlrIXXY?:/L
Class I structure.E.~ subject to t/he General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
\,j\ \ ' completmg constructlon
I, the undersigned, agree t t any constru Ion, reconstruction, enlargement, relocatIOn, or alteratlon of a structure, or any change m the use of land or structures requested by
this applicatIOn WIll campI ~th' and c orm to, all applicable laws of the State of IndIana, and the ~Zonmg Ordmance of Carmel Indiana - 1993~ (Z-289) and amendments,
adopted under a 0 36-7 et eq, General Assembly of the State of Indiana, and all Acts amendatory thereto I further certify that only kitchen, bath, and floor drams are
connected t e sanl 'er I f her certify that the constructIOn wdl not be used or occupied until a CertJ!jca.te of Occupancy or Subsca.ntJaJ Camp/coon has been
Issued by e Depar e ,: Co umty ServIces, Carmel, Indiana I j
I I ~lo-\N \riVE..l'l.~U~ '7 'iJ~/.J7
Signature of Own or Au on Print - ~ .
OFFICEUSEONLY:************************************************************************
, INSPEcnONS REQUIRED: Filing Fees: 9 ~Jj. () 0
~o g,O ()
/,00
,00
Upper ~QQ~ Lower Footing
.~ ~) Meter Base
~:~.
Reviewed/Approve: Dept. of Community Services
S:Pennits/FormsJILP co MEROAl
Under Slab
Base Inspections:
Date
Cert. ~f ~CCU7:
TOT~~
Fee Received by:
007