HomeMy WebLinkAbout07110090 Application/`?i of cyly`.. 1W
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Permit #: 071100
City of Carmel/Clay Township
COMMERCLAL/INSTITUTIONAL/MULTI-FA_MMY IMPROVEMENT LOCATION PERMIT
N01eM,,. ' APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER oNE: FAX: 3/ -
OF F L, $o?- 0000
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
1C) '
f7_? nc3
e
BUILDER'S EMAIL ADDRESS: BES ETHOO OF CONTACT: _
PROPERTY E: Pio E: 314- FAX: 3 (? -
OWNER L-- e; ?? Ca 4
:
STREET ADDRESS: / f CRY:
&9 C)O 1 ! Cv f? S ?a ?T SATE:
r 7:F 4 ZIP:
LOCATION ADDRESS OF CONSTRUCTION: C
o o f
C
?''
?- S SUITE --: (If Applicable)
S o
?2
& PROJECT D
.
l
INFO: Address of Shell Building: (If different than Address of ConsWctl ) Lot C and Subdivision: (If Appli ble)
BUILDING, PROJECT, OR TENANT NAME: ZONING: TAX MAP PARCEL F :
STATE COMMERCIAL n SCOPE(S) OF O FDN O SIR $I ARCH MECH O PLUM
SPKLR OTHER(S):
ELEC SQUARE
FOOTAGE:
S
DESIGN RELEASE O
RELEASE:
WATER UTILITY ?j.T"?'Yl GC
- SEWER UTILITY
PROVIDER: ESTIMATED COS OF CONSTRUCTION:
(EXCLUDING LAND VALUE) _
S
PROVIDER: O O
PLAN COMMISSION / BZA i BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT :'S (If Applicable):
R of Floors: Elevator or UPI: YES Q NO BLDG. CONSTRUCTION TYPE: OCCUPANCY CLASSIFICATION:
o9
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
l14 COMMERCIAL ? NEW STRUCTURE Early Release V Manufactured
v \ (Privately owned hospitals and medical ? ADDITION Permit: _Y /\N Trusses: _Y zN
offices/centers are commercial) ? Room(s)
O INSTITUTIONAL O Porch Lot Split., _Y 5-N Sump Pump: _Yr,__N
C) Munidpal/Public Bldg O Meaanine or Deck
O School ? REMODEL FLOOD ZONE AREA DESIGNATI S5AR6
O Church ? NEW TENANT FINISH
O MULTI-FAMILY G ACCESSO Y BUILDING -
Number of units:
? GARPAGE AGE PLUMBING CONTRACTOR: I (•II•?=l•
`• 9:
FOUNDATION TYPE: (Check all mirrill ?vl%52' - E R (New) NC
apply f r the new rn?Fn?sspp0A ??JJUu>?#?t( nct Q CELLnE TOW LOCATE
SLAB tO(21AtVP5?A3CFCOCr^.i Q./")TV Plumber's Indiana State Licen
POST & SU6nI Spl?g _ r7, (?Ery ?({tr?t r ,P Y N) 4 X74-
..rF. .ter a t
i Zre [b a pdmimstrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration rime frames for beginning and
Class I structur p jl
U r'? completing construction.
1, the undersigns re chest any construction, reconstruction, enlargement, reloc don, or alteration of a suu:rnre, or any change in the use of land or structures requested by
this application will cortpivwith, od confatm:o, all applicable laws of the State of irdiana, and the`Zcning Ordinance of Carte! Indiana-1993"( 289) and amendments,
adopted under _uthorky of IC. 36-7 et seq, Caneml Assembly of the State of Indiana, and all Acts omendztory thereto. I hurther certify that only kitchen; bath, and door drains are
connected to the sac itaty sewer. I further certify that the construction will not be used or occupied until a C1trvh"re of0ccupancy or Suhsoesda/COmpkdon has been
issued by the Department of Cc unitysen-ices, Carmel, Indiana. I
Sy rent OwnaO Authormed Ag Print Date
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OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: S4 ?• Xl]
Upper Footing Lower Footing Under Slab Base Inspections:
Cert. of Occupan
Rough In Meter Base Final Site
TO AL: X13• So
O 2 "1
1, IS
Reviewed/Al) ved: Dept. of Community Services (Date)
S:PenMts/FormVRP OMMEAOAL Fee ReCeh'ed cry: Date