HomeMy WebLinkAbout07100095 Application07 10 ooq s
City of CarizidlGay Township Permit #:
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of NAME ` ' PHONE FAX
T141- looo 571.-5/72
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RECORD: OJSTIwCT10?1 fla ISL.
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STREET ADDRESS CITY STATE ZIP
8863 ?ASTCE?./a?D vxwc TND1.4nlAPOC/$ /rJ y6-250
BUILDER's EMAIL ADDRESS BEST METHOD OF CONTACT:
/45r^tt-!E 4L ST 6LGOWSTRuGT/CAI. rcl. ??400jjg
PROPERTY NAME PHONE FAX 'F'7,1 _ /` g2
5 571-)01fe
LILL
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CARE 5Ec
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OWNER:
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STREET ADDRESS CITY STATE ZIP
$1/01 f}ARCouRT" LFbAD 5UTE 5701. /ryD14 4*0L/S Irj q6.Z60
LOCATION ADDRESS OF CONSTRUCTION SUITE # (If Applicable)
&PR03ECT 1,340 A. MmDYArl STUtE-r 8utt.pt c.3 5UIT1- 101/
INFO' Address of Shell Building (if different than Address of Construction) Lot # and Subdivision (If Applicable)
Ay
BUILDING, PROJECT, OR TENANT NAME: ZONING: TAX MAP PARCEL #:
Awrl l4r+'tA To( oG ?oN)Cot ocr
STATE COMMERCIAL SCOPE(S) OF C FDN U STR CK ARCH ^( MECH (V PLUM SQUARE
DESIGN RELEASE #: RELEASE: X ELEC ? SPKLR OTHER(S) : FOOTAGE: a 36 3
WATER UTILITY SEWER UTILITY ESTIMATED COST OF CONSTRUCTION:
L44 /
e
PROVIDER: PROVIDER: (INCLUDING LAND VALUE) I N
)
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: Elevator or Lift: Q YTS CK NO BLDG. CONSTRUCTION TYPE: Il,g SPK ?? OCCUPANCY CLASSIFICATION: 13
PROJECT INFORMATION:
M
O
COMMERCIAL Lc \ T O -
(Privately owned hospitals G0?`_ t? Qom`
eenF?ea re ?iCr, zcdes.
and medial offit
are Comm L n G T? ?P'a^t5 ??OC2-?{ S ??
IN
CD doll 0' ?O'ON G
INDATION TYRrr Il`Whi?p\r` - O
ly for the neyr, on area ?
SLAB l# O CRAWL SPACE ?
POST & BEAM ? BASEMENT O
(or POST & PIER) WALKOUT:_Y_N ?
Early Release Manufactured
Permit: _Y ;ie_N Trusses: _Y -X --N
Lot Split-. _Y ? N Sump Pump: _Y -)LN
J44emanine or Deck Does any part of
ODEL ?ePs"Phsr-',1
NEW TENANT FINISH `?f designation area:
ACCESSORY BUILDING S?, PLUMBING CONT
DETACHED GARAGE
ATTACHED GARAGE
CELL TOWER (New) Plumber's Indiana State License #:
CELL TOWER CO-LOCATE
DEMOLITION CT 141. goo (. 6
gjdi
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (S eI;'P^) et
beginning and completing construction. D (, V Is
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of 2 st 1c or any change in the
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, -Zonin Ordinance of l as? It 289) and ame ts, adopted under authority of .C,36.7-et seq, General Assembly of the state of Indiana, 1 A a telyd$o ?i
kitchen, ha floor dtayrs are connected to a sanitary sewer. I further certify that the construction of be used or not pie,
orSnbstantOComnledan has&en issued by the Department of Community Services, Carr 1, Indiana
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OFFICE USE ONLY: ********
INSPECTIONS REQUIRED:
Uppe Doti ng Lower Footing der Slab n
Rough In Meter Bane ( final Site
v
duln ?? 0 1% 07
Reviewed/ proved: Dept. of Community Services (Date)
S:Pe mti/Fwms(ILP COMMERCIAL
time fumes for
orstrucmres
ana -199Y (Z-
en certify shot only
rn6"te of 1
*************************/******/*****************
Fling Fees:
Charged Re-
Base Inspections: O Reviews
Cert. of OccuDance ///. 60
O Additional Fees
Fee Received by:
the property lie within a special Flood
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MECHArilr.?l ?orJTRRST1rJ(r SE¢J/CF? /A1?i
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