HomeMy WebLinkAbout07110039 Application
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City of Carmel/Clay Township Permit #: zl?
coDLviERCL4-L/INSTTTUTTONAL/MiJLTI-FAti4II.Y IMPROITME NT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
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BUILDER NAME: PHONE: 3 1 G 3 Co l 1 a FAX: 3 1} 2(y - .25
OF 15uLkm Mi-r CON l.T2u GTrs>N Co. '"C.
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
Ilo? i3A2t?S tCw I?/D14 /M Po is f / /Co.lo
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CDNTACT:
T>OVF 2 G IC S? t1 e?•T Gea./ST. Lo M c -,--4, A-
PROPERTY NAME: PHO.IE: 31Q 58 3 - }51 Co FAX: 3 r } 582
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OWNER: -..
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STREET ADDRESS: CITY: G-/MM£L STATE: i,J ZIP: E4 & to 312.
r'3Givo wi. ^'t?i2tarq...J Sr.
LOCATION ADDRESS OF CONSTRUCTION: SUITE 0: (U Applicable)
& PROJECT (-3'5- o N . c q ST . C / /r"t?a- a{ fva31 v-E
INFO: Address of Shell Bulking: (If different than Address of Construction) Lot s and Subdrdslon: (If Appliable)
BUILDING, PROJECT, OR TENANT NAME: Co A•G, w A-- g.Ai La,e+b ZONING: - TAX MAP PARCEL 0:
d +"' -f- j r'" F L,ooit- RE.• Ct>c __ -13 - Co 1 -}o nZ S o0 00 0 0 (o 0 1
STATE COMMERCIAL SCOPE(S) OF G PON ? SIR Ef ARCH J9r MECH i rPLUM SQUARE
DESIGN RELEASE*: y 33 RELEASE: XCELEC ? SPKLR OTHER(S): FOOTAGE: 'f (p W30
WATER UTILITY SEWERUTILITY ESTIMATED COST OFCONSTAUC fDN:
PROVIDER: Ca}./(„otG L PROVIDE?.: G}IJr,,.q Wit- (EXCLUDING LAND VALUE) ` Spo
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PLAN COMMISSION ) BZA I BPw DOCKET NUMBERS) AND/OR
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COUNTY WELL ANDJOR SEPTIC PERMIT #'S (If Applicable): f
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f of Floors: off- 'ckvator or Lilt: 11 YES ,LCNO BLDG. CONSTRUCTION TYPE: l- SPK OCCUPANCY CLASSIFICATION: i _ rz,-aAal
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TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
,lam COMMERCIAL ? NEW STRUCTURE Early Release Manufactured
(Privately ovmed hosp laa and cred cal ? ADDITION Permit: _Y jC N Trusses: _Y X N
olfxesicenters are commercial) O Room(s)
? INSTITUTIONAL ?ry ?Perch? Lot Split: _Y ?N Sump Pump: _Y >e N
Lam' CrtLJ1°i °nine or Deck
t R -ED WP?bP,;ONST !
-REh FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY:
u ompliance with a! FINISH
Number of9 Mate and LOCal COMSACCESSORY BUILDING
n UT n ?? ()NIN ??4tRRAA PLUMBING CONTRACTOR:
FOUND'
AT•IB?N TYPP: (CKei4pallhicf{ ,CbL9?(New) G
apply rj0f ,n cins&4ORare'a),iLAY a GS+M rtA?ff-A.J•G At
E f • ? CELL TOWER CO-LOCATE
SLAB -..L? Cq, OOSA? ? DEMOLITION Plumber's Indiana State License
-BEAM -PIER 01' BASEMENT (WALKOUT:_Y_N) c? 8 i eo G y 3'x-0
? POST
Class Im cam, Permitsare subject to the General Administrative Rules ofthe Stara of Indiana(4e 615 WC 12) regprdlogexpirs ion time farnes farbeginningand
completing conscmcdon.
1, the undersigned, agree drat any mnsvucdon.reansmxdan, enlatgemem, rdocadon, cr alrendonof a srructmt or any change in the use of land or structures requesrrd by
rho apphcadon willmmply an-l and conform to,.111Lpplitable laws of me Statt of lndiara,and the"onmg Odfinz a ofCzrnel Indian-1993'(2-285) and amendments,
adootd uo<a authen[y of LC.36-7 tt seq, Generxl Asembly of the State of Indiana, and all Aces amendatory aere[e. I futthv cerrv tlu: oily W[cheri, bath, and floor dmm are
cornetd m the sanitarysewer. I further etrufy drat the ronstruction'ill not be used or occupied until a Cerd6ra:e or Gsupanrynr5ubsandal Cnmpledon has beaa
?issued bythe Djeoartmevt of Cmnrrp ry ;rvices,C el•Indiana.
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S19.Weof Ownerer AUtheHaed Ayent Print Da I
OFFICE USE ONLY:
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INSPECTIONS REQUIRED:
? Upper Footing ? Lower Footing
? Under-Slab Q Rough-In
Meter Base Final Building
- Final Forestry Final Fire Dept
'NOTE: Above ceiling/grid Ins action naquirements will be
indicated on yourpematt placard.
??1arc?ItAA Nov, 2%07
Filing Fees:
Base Inspections:
Cert. of Occupancy:
TOTAL i°'<, i
Reviewkd/Approved: Dept. of Community Services (Date) Fee Received
S?Pe,. Wlnrms/LLP CCMMEPOAL 4, 2007
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# Charged Re-
Reviews
6
i Additional Fees
Date