HomeMy WebLinkAbout07070145 Application
C't ifC IIC" 'T' h' Permit#: 0707(!)/'fs
t y 0 arme ,ay .J. owns tp
, !. 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:
C-~K CfF-.s:v.~
STATE COMMEROAL 7 3
DESIGN RELEASE': '52 . \"'2-
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8r. PROJECT
INFO:
WATER UTILITY
PROVIDER:
NAME: rcc. 'tSJ8-6PI't~ PHONE: 34/6.S<3ou
STRE~7:ESS; NUQ:l~0..!}l,::) DI2~~e-t. STA'Yl~y.....I_ ZI4~3
BUILDER'S EMAll ADDRESS: t'\ ~ST METHOD OF CONTACT: ':::::::.C'\ -. AJAr-..
P-C-Os.~ @..... (Vl4-l L .~ ClLJ I -"-\........'-J \
De-a\> LCe.. PHONE: 582-0~u() FAX:
FAX:
84&8
5
NAME:
STREET ADDRESS: r\. CITY:
I ':::.5 LV .c..A.R-fr\--h US'_
ADDRESS OF CONSTRUCTIO~
fSS W L:-~
~ f1.. STATE4:v _
lJ~
sum #: (If Applicable)
.Jot
Address of Shell Building: (If different than Address of Construction)
\14 ]..0 ~
lot # and Subdivision: (If Applicable)
~6Q M., ~ <:;i.oU,,('l
o PLUM
SQUARE
FOOTAGE:
SCOPE(S) OF 0 FON 0 STR 0 ARCH
RELEASE: 0 ELEC 0 SPKlR OTHER(S):
o MEOi
SEWER UTILITY .
PROVIDER: c....~
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) q 'B Cl()::) e-
PLAN COMMISSION / BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors: Elevator or Uft: BLDG. CONSTRUCTION TYPE: V -\3 ,S,fj C-.
TYPE OF CONSTRUCTION: TYPE OF IMPROV MENT: PROJECT INFORMATION:
r3' COMMERCIAL CJ..cNlWl,~Q; RE Early Release ./
(Privately owned hospitals and medeoNt.2J\ \ ADOmONl:f'\ Permit: Y ~~
offices/centers are com,al..er~~Y\ '\D 3\\ t(t~j"" Room(s) . -~,
o INSTTIUTlQliI\l; D.S'E-V. . !,C8 "JI OO@ R'l"':tt:S Lot Split: _Y_N
o ~bl<\iPaIl"~8IiS,Bfd9'\\e,o 1..00-'\ C C,Q>'\~~MI,\,\~Deck
o S~l1I\ecl \ SleW ;;r \J\,\~.,Mqo~I\'I~" FLOOD ZONE AREA DESIGNATION'S) FOR THIS PROPERTY:
o Cfiurch 0 COlj.WI p..'i'lEW-tl:NANT ANISH X b _I A _A
o MUlTi-FAMIlY:p' Of '~'E-\...I 0 ACCESSORY BUILDING ~"n:c'.. - LLn ~ l'1~
Number ofGIiS. ~.cAI'\\'J Q\p..&- DETACHED GARAGE
.fe\"\'1 ur--- . \N 0 ATTACHED GARAGE PLUMBING CONTRACTOR:
FOUNDATION TY .' tCheckall whIch 0 CEll TOWER (New) \+p,..MI'^-o.6.-c::;;:.u,...) ~ ~ C
apply for the new construction area) 0 CEll TOWER CO-lOCATE
o SUlB 0 CRAWL SPACE 0 DEMOLmON -
o POST &_BEAM _PIER ~SEMENT:(WALKOlir: Y-~
:lr ,\ \;-;(,. J" ; :~__ ~~\
Class I structure permits are subject to the Ge~~faJ Administrative Rules of the Sci~e o'f indiana (See 675 lAC 12) regarding expiration time frames for beginning and
\' ,. i< \ c~w.Rlf:tingconstHICtion.
I, the undersigned, agree that any construction,lreconstructiqq~4nlar&enBnt:~ation,lor~altjeration of a structure, or any change in the use of land or structures requested by
this application will comply with, and conform't'o', alI'applica\!JFllrws 51 tile State of Indi~ and the ~Zoning Ordinance of Cannel Indiana - 1993~ (Z~289) and amendments,
adopted under authority of l.c. 36-7 et seq, General Assembly of the State of Indiana, and 31I"Acts amendatory thereto. I further certify that only kitchen, bath, and floor drains are
conn anit sewer. I further certify'that the.construction will'nofbe~us~d or ocd_pied until a Certificate of Occupancy or Substantial Completion has been
iss d by De tmen mmunity $eM.. ces, C~~eJ, Indiana. - -' G J /.
I --~-:--.-- '" '7 2~ '0-'
- ~K.. O::'f';\a,<; '(
Signature of Owner r Authorized Agent Print Datd
Manufactured
Trusses:
~N
-::;;;- N
Sump Pump:
Plumber's Indiana State License #:
DC. 'Pi oDCXJ I 0 \
OFFICE USE ONLY: ********************************************************[)**************
INSPECTIONS REQUIRED: .~ Filing Fees: 11 ::s-~. 0
Upper Footing lower Footing Under Slab ~(' Base Inspections: ~ C) . () 0
~ ~. 7'\,Cert. of Occupancy: ~ / I . tJ 0
M~~~S~ ~ 0
~\ TOTAL If. 0
07
pproved: Dept. of Community Services Date)
S/ILP COMMERCIAL Date