HomeMy WebLinkAbout07100099 Application?<•""A Permit #: ()1-7100o 7
City of Carmel/Clay Township
COMMERCIAL/INSTITUTIONAL/NULTI-FAMILY RAPROVEMENT LOCATION PERNIIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
of
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NA"E' PHONE: FAX:
?jb6a 29?-714Z
?dwar ?rivelo vy?n? Co GGG 2
RECORD: STREET ADDRESS: CITY, I STATE: r ZIP:
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BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
e- horm?dwardrasa v. co -ev oyl'I
PROPERTY
OWNER NAME: HONE: FAX:
04"e as R ave
: STREETADDRESS: CITY: STATE: ZIP:
LOCATION
JECT ADDRESS OF CONSTRUCTION: SUITE #: (If Applicable)
?`??? Fu/rfu? Mahon Dr?'ve
& PRO
INFO' Address of Shell Building: (if different than Address of Construction) Lot # and Subdivision: (If Applicable)
BUILDING, PROJECT, OR TENANT NAME: ZONING:
am TAX MAP PARCEL #:
16-09-z6-00-190-015.001
STATE COMMERCIAL SCOPE(S) OF / FDN [? ARCH .? MECH V PLUM
RELEASE: D ELEC D SPKLR OTHER(S): SQUARE
FOOTAGE: 177q
DESIGN RELEASE
WATER UTILITY /
PROVIDER
- r?PI SEWER UTILITY
PROVIDER: (? r e/ ESTIMATED COST OF CONSTRUCTION: Q1 ?a DD
(EXCLUDING LAND VALUE) , U
: (?
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; ANWOR
COUN'T' WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: Elevator or Dft: 0 YES V NO BLDG. CONSTRUCTION TYPE: V-4 OCCUPANCY CLASSIFICATION: t-51-1
"TYPE OF CONSTRUCTION: TYP- PROVEMENT: PROJECT INFORMATION:
(d COMMERCIAL 1?-?R1.?W,?TRUCTURE Early Release ? Manufactured ?
(Privately owned hos aaisrm edica?. kSo' D}'MON Permit: _Y _N Trusses: _Y _N
offices/cenSCraar ognmeraaq, 1,h 0'1 O Room(s)
? IN ? ?)?gnGO "I , ?06es' ll(.SPOrch Lot Split: _Y 7N Sump Pump: _Y /N
R Ur((;ipal/PIIbjC&dgx'`? anine or Deck
,^jr)ry}pDEL FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY:
C) Chur?L-(yV??N CJ-`.? ',NEW TENANT FINISH X - vnyhaded
O Mf7q(1I? [f L ACCESSORY BUILDING
Nurt+b€Nr O DETACHED GARAGE PLUMBING CONTRACTOR:
O ATTACHED GARAGE
FOUNDAT TYPE: (check all which O CELL TOWER (New) God b f UWi b nQ
apply for the new construction area) O CELL TOWER CO-LOCATE
SLAB O CRAWL SPACE O DEMOLITION Plumber's Indiana State License #:
O POST & -BEAM -PIER CI B Alec r' N) PC /000(90B 07
Clu I structure ptrmirs are subject to the Gen lministrative Rules of the Hof Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
I, the undersigned, agree that any consnuction, rrtAblvwratioa of.structure, or any change in the use of land or stuctures requestedby
this applAcatioa will comply with, and coafom m, bie laws 0, dhe State of the'Zoning Ordinance o: Camel Indiana -1993' (Z-239) and amendments,
adopted under aethorirv of I.C. 36-7 et seq, Generaof the State of Indiana, and all ca amendatory thereto, I further certify that only'atcheo, bath, and Door drains are
connected to the sanitary sewer. I occupied until a Cefafirare of Occupancy or Substantial Completion has been
issued a Deparme t of Co muniryServic, Indiana.
L r jr? _ eH A4, rw,yhh N/60
signature of Owner or Auth Agent Print
OFFICE USE ONLY: ******************
1pL CTIONS REQUIRED: t
'ootm oting Under Slab
In Oren Bas m Site
Rl _ _ _ _,- _ .[l OA. 151.
Filing Fees:Z
Base Inspections: J -d O "
Cert. of Occupancy: Z l u-
lroved: Dept. of Comrilunity Services (Date)
l?CDMMEBCLIL Fee Recely y: Date