HomeMy WebLinkAbout07100097 Application/: V``YPCCy F! 1.1
City of Carmel/Clay Township Permit :
COMMERCIAL/INSTITUTIONAL/MULTI-FAMILY IMPROVEMENT LOCATION PERMIT
N01Pe,,., APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF NAME: PHONE: FAX:
1 e?O m8n to 2q7- 3D60 297-7142
RECORD: STREET ADDRESS: CITY:
201 6 rkllYl-e l?oa? STATE: ZIP'
14 ?:- IN 462-I--
BUILDER'S EMAIL ADDRES : BEST METHOD OF CONTACT:
r
6vice _ horma nil (?waf'd i of?c+ ts.
4 any e?G?1
PROPERTY
OWNER: NAME: PHONE: FAX:
wole-ay 't6o'j-B
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION
SUITE #: (If Applicable)
ADDRESS OF CONSTRUCTION: /,*l1
faly
? wive
M
& PROJECT
?tne
X
INFO: Address of Shell Building: (If different than Address of Construct on) Lot # and Subdivision: (If Applianle)
BUILDING, PROJECT, OR TENANT NAME: r
X
111-A
dl/ b-es ZONING:
OM-Mr TAX MAP PARCEL
001
16-17q-76-190-00-Oy
e ?,?_
44 &
e .
STATE COMMERCIAL
DESIGN RELEASE
V /I SCOPE(S) OF C FDN C 5TR 0 ARCH 0 MECH 0 PLUM
RELEASE: 0 ELEC 0 SPKLR OTHER(S): SQUARE a
FOOTAGE: / 1
WATER OVIDER: UTILITY
PR
/ V A
PRO DER: 1,4 A-
(EXCLUDING LAND VALUE) tlo?
PLAN COMMISSION/ BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT w 'S (If Applicable):
# of Floors: Elevator or Lift: Q YES rJ-_ NO BLDG. CONSTRUCTION TYPE: OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE AIMPROVEMENT: PROJECT INFORMATION:
r
COMMERCIAL Lf(EW SIRUCIU Early Release Manufactured
(Privatey rnvned hospRlls ?•m e?call? ?[j' ADDITION Permit: _Y i ! Trusses: -Y ?ZN
offices/centers 713• al),SC " 05. ROan(S) \
O INSTTTUIZf>Ntj- `? rr c 1 GC?v ' Lot Split: _Y N Sump Pump: Y N
Jitmuc
? Glpal(Pu"fl
F,`t7 g?Chao1`t a?? a?' eaanine or Deck
'Cp? FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY:
REMODEL $t?1 Chtpch'" tv^r P? O NEW TENANT FINISH ` f _
? MULTI-F? C? ,?L G O ACCESSORY BUILDING {?l
NLgxa?? units 0 DETACHED GARAGE
VV `"' F V\ O PLUMBING NT CT R:
FOUNDA (Check all which O ATTACHED GARAGE
CELL TOWER (New)
apply foconstruction area)
CELL TOWER CO-LOCATE
SLAB O CRAWL SPACE DEMOLITIONS rPlumbet's India a State License tt:
qko- POST &_BEAM -PIER ?::] BASEMENT (WALKOUT:_Y??ll.
Class I structure permits are subject to the General Admin' 'EWOMe''tA"f lbdirc i ee 675 LAC 12) regatding expiration time frames for beginning and
nompletingcow rucu
I, the undersigned, agree Lhat any construction, reconstruction, a ment, re lxadon,, gr?a4 no. [ s:rxcurt,oranycharge ie the use ciland or strucmu. srequescedby
this application wdll comply wich, and conform co, all applicable la thepp"TIfftte?of?nc ,lj'tSd the - gordirance of Carmel Indiana-1993-(Z"289) and amendments,
adopmdunderauthorityofl.C.36-7erseq,Geeer3l Assemh'.yolth o"th am and all Acts anendat rv thereto. Ift Cher ready that onfi kitchen, back, and floor drains are
connected to the sanitary sewer. I further certify that the constru on%vill not be used or occupied ila Certificate of Occupancy orSvbstaotia/ Completion has been
issued e D tmentof C mmunity Services, Carmel, Ind' a
Signature of Owner or Audlm rnzed Agent Print Date
**********************************************s*
OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees:
Upper Footing Lower Footing Under Slab Base Inspections:
Cert. of Occupant
' Rough In Meter Base Final Site
IOTA .:
07
Reviewed/App ed: Dept. of Community Services (Date)
5:Penars/Form J1 COMMERCIAL Fee Received by: J
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