HomeMy WebLinkAbout07110136 Application``({ 6F CFRyF\
' City of Carmel/Clay Township Permit #:, a o /.3
I COMNMRCLAL/INSTITUTIONAL/MULTI-FAD4II-Y IMPROVEMENT LOCATION PERMIT
f APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes & Accessory Buildings)
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BUILDER NAME: PHONE: FAX:
OF -
RECORD: STREET ADDRESS: O?D CrTY: STATE: ZIP:
5-- JJ 6? FiE?o Ah? G7M,16, 4r•? ?? 33
BUILDERS EMAIL ADDRESS: BEST METHOD OF CONTACT:
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PROPERTY
OWNER: NAME: ,,, // PHONE: FAX: 5,11
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lUI%L bill] a') L f c? a-633
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STREET ADDRESS: CITY:
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`cam 0 z_ " C/' Pr ID J-/NG IA / TE: ZI
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LOCATION ADDRESS OFC ONSTRUCTION: SUITES #
:: (If Applicable) G? ?
& PROJECT 1(4572- '_j
INFO: Address of Shell Building: (If different than Address of Construmon) Lot # and Subdivision: (If Appliable)
C'
B DING, PROJECT, OR TENANT NAME:P y ZONING TAX MAP PARCEL #:
STATE COMMERCIAL
DESIGN RELEASE #: Z 9 g 7 SCOPE(S) OF O FDN O STR ARCH O MECH O PLUM
RELEASE: 0 ELEC C) SPKLR OTHER(S): SQUARE ?t
FOOTAGE: s
WATER UTILITY
PROVIDER: (' , ? Al 5,
, SEWER UTILITY
PROVIDER: C?w ESTIMATED COS OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 3?
BZA / BPW DOCKET NUMBERS; AND/OR
PLAN COMMISSION //
COUNTY WELL AND/OR SEPTIC PERMIT "S (If Applicable):
# of Floors: Elevator or Lift: N YES O NO BLDG. CONSTRUCTION TYPE: a-L2, OCCUPANCY CLASSIFICATION:
TY???..PE OF CONSTRUCTION: ? TYPE
qcg COMMERCIAL O
_ (Privately owned hospitals and medical Q
offices/centers are commercial)
O INSTITUTIONAL
O Municipal/Public Bldg
O School O
O Churd
O MULTI-FAMILY 0
Number of Units:
F1(??fit F(n?R?
FOUNDATIO: P(9r_ alhwhLoNNS
AD
a p for th{e$eLY9ioJJASt r'"
SLABt C21 (? S?(i?WL'SPnJ?jrf?G1 alI
CD POST &DE BTFAR, C 1MEELMI r BATM5M}E
NEW STRUCTURE Early Relea Manufactured
XY N Trusses:
i
Y N
ADDITION
Q Room(s) Perm
t ?
Lot Split: Y 4N Sump Pump: _ N
Y
O Porch
O Meaanine or Deck
REMODEL
FLOOD ZONE AREA DESIGNATION(S) FOR THIS
PROPERTY:
NEW TENANT FINISH ?(_ u 5 A D e
ACCESSORY BUILDING
?44 GARAGE
GARAGE
?ED
PLUMBING CONTRACTOR:
geLJIft tlER (NEW)
CELL TOWER CO-LOCATE
n??LCWN Plumbers Indiana State License #:
FSMY4991FP. Y N) P C806 4D 10 Z?L
Class I structure permit' araaubjc'A6;d b6')xal.Administrarive Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that zIN mnstraction, reeonstrucaon, enlargement relocation, or alteration of a structure, or any change in the use of and or stn:cm-es requested by
this application will comply with, and ecnfotm co, all applicable laws et the Scate of Indians, and the "Zoning Ordinance of Carmel Indiana -19933' (Z-239) and amendmtms,
acopred under authority of I.C. 3r-7 et seq. General embly of the State of Indian. and all Actsameadater/thereto . Ifurther certify that only;dtchen, bat',, and floor drains are
connected to saui ta.:y scwc*-. 1 further cer ' the construction will not be used or occupied until a Certificate ofoccupa cct orSubsrantia/Completion has been
issued partment of Co rs armel, Indiana.
c .m n1 r utlwrizM AU Print Da
OFFICE USE ONL ** ****************************************************************
INSPECTIONS REQUIRED: Filing Fees: ?? ?? d(J
Uppe g Lower Footing der Slab
Rough In Meter Base F at Site
a 67
Reviewed/Approved Dept. of ommunity Services (Date)
S:Pe.fts/Form(/ILP CON.1 ERZAL
N
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N
IN
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Base Inspections: SOX. d o
Cert. of Occupancy: / / r d ()