HomeMy WebLinkAbout07050211 Application
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C't ifc IIC" '" h' Permit#: n7nsO"AI\
I y 0 arme lay .L owns Ip ,
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMll.. Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
NAME: WD ?Al2::IN~t<..s '!o j!ff jJiu,(}5 PHON &/'-(
STREET ADDRESS: n A.. CITY: '"
r-"''t b,.>u>vCf2.( bIll)) UV
I$"'1
FAX:
&1'1 (.,3'-1- 7777-
elf
ZIP: .
L.f.~OI 'f-
STATE:
L/N
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS:
.Je..f"'-( ..J.. cobs8 VI) PMTf\I[{lS .. Lc, M
NAME: f' \
u- PJ> II" G.
BEST METHOD OF CONTACT:
t- M4tt.. Op.. Pu..,,'!;:
FAX:
PHONE:
STREET ADDRESS:
5'') 0 -rI
CITY:
SfJ..J
'r MM:.-I see
STATE:
C-A
ZIP:
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION:
3
€ f-.. r,.l\ (, e.
Q SUITE #,f Applicable)
l)~v.D 0
Address of Shell Building: (If different than Address of Construction)
Lot # and Subdivision: (If Applicable)
BOI~, PROJAJ ~R TENANT ~E: GI-A.
STATE COMMERCIAL SCOPE(S) OF 0 FDN 0 STR
DESIGN RELEASE #: 3 d-b OG:- /is RELEASE: IlI/ ELEC 0 SPKLR
ZONING:
TAX MAP PARCEL #:
WATER UTILITY
PROVIDER: LL. f~Vf{J;;,p
SEWER UTILITY
PROVIDER: t.L. l'kJID6'
~ ARCH !;IiI MECH SQUARE 13 q /") 3
OTHER(S): FOOTAGE: , r
ESTIMAli'D COST OF CONSTRurnON:t3A ,... 0 0
(EXCLUDING LAND VALUE) V v ()
I
PLAN COMMISSION I BZA / BPW DOCKET NUMBERS; AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors: J Elevator or Lift: Q YES ]1l NO BLDG. CONSTRUCTION TYPE: OCCUPANCY CLASSIFICATION: .ty1 Gf.t-ltJtr1'l-G
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
9iI COMMERCIAL 0 NEW STRUCllJRE Early Release '- I
(Privately owned hospitals and medical 0 ADOmON Permit: Y N N
offices/centers are commercial) 0 Roomes) 'l\.J
o INSTITUllONAL 0 Porch Lot Split: Y =:;::N
o Municipal/Public Bldg 0 Mezzanine or Deck
RE@~~ FOR CONSTRUcjl~O~E'i:'ANT FINISH
oS~rmt~ANI[)(l1pliance with all regC@tiCAMtESSORY BUILDING
Numbeolif5iniWandLocal Codes, 0 DETACHED GARAGE
FOUNlGfiBii ~/iEQaMM~~ SER\\4r~ACHED GARAGE
". ty ELl..TOWER (New)
applCW\h{)1iiI{);:ll\lf~or ~ TOWtll It'TOWER CO-LOCATE
iXI SLAB/fy;".-,~ q~~ACE 0 DEMOLTTlON
o POST&_BEAM, _PIER 0 BASEMENT (WALKOUT:_Y_N)
Manufactured
Trusses:
Sump Pump:
_yXN
Y~N
FLOOO ZONE AREA DESIGNATlONrSl FOR THIS PROPERTY:
X - u-rtShCl).(Ld
PLUMBING CONTRACTOR: J.o cq ~OaerA
Plumber's Indiana State license #:
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 - 1993M (Z-289) and amendments,
adopted under authority of I.c. 36-7 et seq, General sembly of the State f Inmana, and all Acts amendatory thereto. I further cenify that only kitchen, bath, and floor drains are
connected to the sanitary sewer. I funher certif t t onstruct' '11 not be used or occupied until a Certificate of Occupancy or Substantia./ Completion has been
issued by the Department of Community Se c , C di a.
Signature of Owner or Authorized Agent
j &FF ~A-<..c.O<
Print
~/d'1lq
Date .
OFFICEUSEONLY:************************************************************************
Filing Fees: '3tJ 4, ~ . (; ()
Base Inspections: -Z 0 ~. aO
Cert. of Occupancy: 1// f 0 Q
zool T~~.~ J ~Q
Fe~
INSPEcnONS REQUIRED:
ting Lower Footing Under Slab
Meter Base@ Site
Reviewed/ App
S:PermitsjFormsjIL
7- 3/-07
Date