HomeMy WebLinkAbout07090140 Application`,SiC .qA V p
Permit : 6 7 / 0M O
City of Carmel/Clay Township
COMMERCIAL/INSTITUTIONAL/MULTI-FAmiLy IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
O
l PHONE: FAX:
NAME: ??
C
OF I \
Cit
.Ot C M,
RECORD: STREET ADDRESS: CITY: STATE:
11o C_CL rn,e,1 ---A=U ZIP:
Loo'
BUILDER'S EMAIL ADDRESS:
t BEST METHOD OF CONTA
PROPERTY
OWNER NAME: - PHONE: FAX:
?-e (ra ce --70,-t"fS V G
: -
r CITY:
STREET ADDRESS: 1401
ZIP:
LOCATION D oFCOST UCTIO? _ ? s?rrE : ?IrApplicabie)
& PROJECT / (J
INFO: Addeg of Shell Building: ( different than Address of Construction)
? Lot # apd Subdivision: (If Applicable)
l
f
`•tI
BUILDING, PROJECT, O NTT NAME:
NA
R
TE
tl
-) ZONING: TAX MAP PARCEL
ana
(Dr, Jer2
STATE COMMERCIAL ro&t A #3IrAt3 SCOPE(S) OF 0 FON r STR LARCH C-?MECH 'Z?PLUM
RELEASE: 3 ELEC n SPKLR OTHER(S): SQUARE
FOOTAGE: n
DESIGN RELEASE
WATER UTILITY SEWER UTILITY
PROVIDER: ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
W,UUC?
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
'
COUNTY WELL AND,IOR S (If Applicable):
SEPTIC PERMIT #
of Floors: 1 Elevato(or Uft: Q YES A NO BLDG. CONSTRUCTION TYPE: OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION:
COMMERCIAL
(PmateN owned hospitals and medical
offices/centers are commerdaJ),.ntl?
O
TYPE OF IMPROVEMENT:
O NEW
t 2U- ^` :J Porch
EkItUOipal/Put, Btgg^e \vilf' ` C Cam, O M anine or Deck
Ul bl[O GGt1 c i ?VLrr.;BI C, C rREKO€IFD
f}IUrdLi St t' (,rS( hF-}!SIT-EN?NT FINISH
O MULTI-FA MI?Y F C?Ilf?t?' '?I (jAeGESj6RY BUILDING
Num?mPnt(i'?ii t-r r c?L + O DETACHED GARAGE
FOUNDATIOSPWPEi'?Check all y O ATTACHED GARAGE
O CELL TOWER (New)
a I for the new construction area) O CELL TOWER 00-LOCATE
47- SLAB O CRAWL SPACE ? DEMOLITION
& BEAM -PIER O BASEMENT (WALKOUT:_Y_N)
PROJECT INFORMATION:
Early Release
Permit: Y
Lot Split: Y
Manufactured
Trusses:
Sump Pump:
_Y Y N
_Y --IN
FLOOD ZONE AREA DESIGNATIOIN(SI FOR THIS PROPERTY:
V\JL
- ----T l?f\\?;J\C / \4.0-,-VV Plumber's Indiana State icense \ 1a?31l0?
0 T
I L? ?(?a 51 "'T
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 beginuing and
1, the undersigned, ag=ee tha: aoy construction, reccasu-uction, edaegement,onal c i alrtgcr o h use of Land or structures requested by
this application will comply with, and conform in, all applicable laws of the State o Indiana, and a "eomng manta o .nell m a a- 1993 (Z-289'1 and amer.•d=rns.
adopted under authority of I.C- 367 et seq. General Assembly of the State of Indiana, and all Acv amendatory thereto. I fa-ther certify that only kitchen, bath, aid floor trios are
connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Ceraficite of0,cupancy or Subsrstrtia/Compyerioo has been
issued by the epartment of?ty Services, Carmel. Indiana. r -
maGla LaLA-bit r - D-7
Signature ofo nera th Agent Print Date
OFFICE USE ONLY:
*************************:s*xsa?:fia:fiaa=:?{ INSPECTIONS REQUIRED: Fling Fees: !1f? f, ?
? Upper Footing O Lower Footing Base Inspections:
O Under-Slab Rough-In
O Meter Base Final Building Cert. of Occupant
O Final Forestry Final Fire Dept.
'N Above ceiling/grid n
indicate our p ection requirements will be
ermit pI TOTAL:
I ?e ?.7 0
Reviewed roved: Dept. of Community Services (Date) Fee Received by:
Charged Re-
Reviews
Additional Fees
/ Date
s: Parmit•.frnitAs(rLP COMMERCIAL Avc.3107