HomeMy WebLinkAbout07110053 ApplicationCity of Carmel/Clay Township Permit #: 7 C)5-3
COMMERCIAL/INSTITUTIONAL/MULTI-FAbfILY EvTROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER E: I PHONE:
5 FAX;
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A- 543 4-
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RECORD: STREET ADDRESS
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STA IP:
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BUILDER'S EMAIL ADDRESS:
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? BEST METHOD OF CONTACT:
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PROPERTY NAME: ? PHONE:
G g 7 S FAX:
Z3*0 (? 57?- 2331
OWNER
:
STREET ADDRESS: CITY:
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J STATE' - (SIP'
T
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104m tj k-w
virAt
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D
rAAtvE,& il-
LOCATION ADDRESS OF CONSTRUCTION:
l
d
' SURE #: (If Apelicable)
D
& PROJECT ch
(Q D
I ` ti l?l
INFO: Address of Shell Building: (If different than Address of Ccnstrucdm) Lot # and Sulacimsion: (If Applicable)
OR TENANT N
BUILDING, P ZONING:
? TAX MAP PARCEL #:
-'60 -6l
r& j i
- - 06
STATE COMMERCIAL
r /r FDN O STR ARCH
SCOPE(S) OF C7 MECH Wf'PLUM SQUARE
GE
DESIGN RELEASE #: _
RELEASE: K ELEC C SALR OTHER(S): FOOTA
: 10000
%
WATER UTILITY
PROVIDER: SEWER UTILITY
PROVIDER:
( ESTIMATED COST OF CONSTR ON:
EXCLUDING LAND VALUE) ZZ4
( .6Q
Ca mel r
N
/ BZA / BPW DOCKET NUMBERS; AND/OR
PLAN COMMISSIO
COUNTY WELL AND/OR SEPTIC PERMIT #S (If Applicable): ?L
# of Floors: Y Elevator or Lift: YES BLDG. CONSTRUCTON TYPE: ?.d( trl OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION:
COMMERCIAL
(Privately owneVrs.r
oTfices/ceMn?ee(?5?arc con
O INsrfA_5 ,,tvCV
O
DATI 4'`(PE: (Check all which
for the new construction area)
)tal `,
66611 Q
§l SLAB O CRAWL SPACE
?U? ? Memnine or Deck
NEW TENANT FINISH
ACCESSORY BUILDING
? DETACHED GARAGE
? ATTACHED GARAGE
? CELL TOWER (New)
? CELL TOWER CO-LOCATE
O DEMOLITION
O POST & -BEAM -PIER O BASEMENT (WALKOUT: Y_N)
PROJELI INFO KMA 1 t V N:
Early Release / Manufactured ?
Permit: Y_N Trusses: Y-ry
Lot Split: _Y V N Sump Pump: Y N
FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY:
Plumber's Indiana State License #:
1?L gl() j44 0(0
-ml
Class] structure permits ate subject to the General Administrative Rules of the State of Indima(See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
L the undersigned, agree that any comtrucdoo, rexnsmjction, enlargement, relocation, or akerarion of a strut.are, or any change it the useof land or smcmres requested by
t.'ris application will comply with, and conform m, all applicable laws of the State of Indiana, and the'Zoning Ordinance c; Carmel Indiana -1993' (: •239) and amendments,
adapted under authunry of I.C. 36-7 et seq, General Assembly of the State of Iriima, and all Acts amendatory thereto. 1 further certify that only ki:then, bath and Bocr drains are
connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Cerrifksce o(OceupaneporSubsraorial Completion has been
r of Community Senices, Carmel, Indiana
issued by thZen
ti- 12 -6-7
Sipnatu of Owner or Authorized Agent Print Date
OFFICE USE ONLY: ***************************s::*fix:?:==:a a:s -------------------
INSPECTIONS REQUIRED: Filing Fees: a?a 9!Z
Uppe 'ng Lower Footi Slab Base Inspections: a O8
Cert. of Occupancy: / -
Rough I Meter Base Final ASite+ / 1
U No V 44tO? TOTA : n d 6l ? b a 7 _ZW Reviewed/App ved: Dept, of Community Services (Date) ?-:-A - 1 Il°- 2
5:Pemrits/Farns/ILP CAMMER^ L Fee R d bv: Date