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HomeMy WebLinkAbout07110028 ApplicationF • y CAy t City of Carmel/Clay Township Permit #: © / 111 R-Q COMMERCIAL or INSTITUTIONAL Ev1PROVEMENT LOCATION PERMIT APPLICATION For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings BUILDER of NAME PHONE ? FAX G RECORD: ?' ' ` CCU STREET ADDRESS CITY S `? Gt ? r Q STATE / 'hL6 /P 3v P (? ra _y • i f G C BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT: PROPER TM ? PHONE NAME 6V-r- 6 q, ! Ci I FAX OWN R / I i y STREETADDRIESS 2?- D c1?L (= ?. Avo Q6C3v11l Al 1 /?TIP ( G LOCATION ADDRESS OF CONSTRUCTION SUITE * (If Applicable) IS-4 & PROJECT INFO: Address of Shell Building (If different than Address of Constructlon) Lot # and Subdivision (If Applicable) BUILDING, PROIECT, OR TENANT NAME: ZONING: TAX MAP PARCEL #: RT otrw c-- Ns?a-rJ?E-c:c= -s STATE COMMERCIAL DESIGN RELEASE #: 3 SCOPE(S) OF 'J O FDN O SIR ARCH RELEASE: K ELEC G SPKIR OTHER(S): MECH O PLUM SQUARE FOOTAGE: / Z WATER UTILITY )k ' fjLrF SEWER unLrrY C /2`t C-L LL-? fZ4 ESTIMATED COST OF CONSTRUCTION: PROVIDER: PROVIDER: ( EXCLUDING LAND VALUE) C nJ--() PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable): # of Floors: ' Elevator or Lift: El YES A, NO BLDG. CONSTRUCTION TYPE: OCCUPANCY CLASSIFICATION: TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: L" COMMERCIAL NEW STRUCTURE (Privately owned hospitals n G1\09 ADDITION and medical officerfrICJ2"e?Ulattons O Room(s) are commerd b?k C' O IN ,Nith U O Form ?l des. O DEeaanine or Deck -E TENA FINISH S, $ b1 t r?rA;.@,.ear' Q VN`?? ( % O Vdn ACWCESSORYTBUILDING FOUNDATION T13%: W4 all r a?? ?iFh O DETACHED GARAGE aPP f( eWfm? P!.c?tioih _`ih W?A O ATTACHED GARAGE ?LV{ OF l? O IWJLrS`P_ACE O CELL TOWER (New) O } }& BEAM --t BASEMENT O CELL TOWER CO-LOCAT (or POST & PEER) WALKOUT:_Y.?S N O DEMOLITION ^ r? Class I structure permits are subject to the 1, the undersigned, agree that any construction, n requested by this application will comply with, an 289) and amendments, adopted under authority of lcitchcn, bath, and floor drains are connected to th Occupancy or Substantim)fampka" has been of Owner or Authorized Agent PROJECT INFO&ATION: Early Release Manufactured Trusses: Permit: _Y ?/ry _YVN Lot Split _Y ?N Sump Pump: Y Does any part of the property lie within a special Flood designation area: _Y ? N < q PLUMBING CONTRACTOR: n I r!l ?Lft- 1 0, w fU TANK s P IQFr C (? r Plumber's Indiana State License #: 9406033 Indiana (See 675 IAC 12) regarding expiration time frames for atgement, relocan n. alteration of a s=cture, or any change in the use of land or structures app)icabl 41Ws of ate of Indiana, and the "Zoning Ordinaice of Carmel Indiana -1993" (Z- Setieral Assembly of the rate of Indiana, and all Acts amendatory thereto, I further certify that only I further certify that construction will not be used or occupied until a Cettilicarc of ;partm ry Services, Carmel, Indian I) 4(-75-H Z a - zS d Pntn Date OFFICE USE ONLY:*********************************************************************** INSPECTIONS REQUIRED: Upper Lower Footing Under Slab Roug Meter Base Final Site Filing Fees: Base Inspections: Cert. of Occupancy: 2;3 `4 o 0 aok: a o 4zl ro D # Charged Re- Reviews Additional Fees