HomeMy WebLinkAbout07110163 ApplicationPermit #:_ l l o l 6 j
=" City of Carmel/Clay Township
COMI1'IERCIAL/INSTITUTIONAL/MULTI-FA vULY IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
\1NOIANP?
BUILDER
OF N E.
A2trlPrl 4!1 S4ilec/Gfp /.i c f PHONE: FAX:
L97 bGfo L17W 775 /3T7
RECORD: STREET ADDRESS:
165 S. f7 CITY: STATE:
0 Id Y??G
BUILDER'S EMAIL 1A"DDRESS: BEST METHOD OF CONTACT:
J??iilATar7t @alzt ssnr? L' ) . Eoa.-I ,,.?-L- `fo`7 -apps
PROPERTY
OWNER: NAME. PHONE: FAX:
12? L ?Qr.46fZ1C 317 /s 5 gaQ 3' 15 593
STREET ADDRESS:
' Z (v
P g
i6
? l CITY: STATE: ZIP:
4-4C-L S^1 5?6 3 2
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LOCATION
& PROJECT ADDRESS OF CONSTRUCTION:
ill oi14E1/^? ZD SUITE (If A? Itca le)
INFO' Address of Shell Bullring: (if different than Address of Construction) Lot # and Subdivision: (If Applicable)
t
BUILDING, PROJECT, OR TENANT NAME:
gAArQ l C.o ZONING: 2 TAX MAP PARCEL
STATE COMMERCIAL
DESIGN RELEASE #: •i
A a SCOPE(S) OF G FDN O SIR
RELEASE: c ELEC O SPKLR co ARCH O MECH PLUM
OTHER(S): SQUARE ?O
FOOTAGE:
WATER UTILITY/ /??
PROVIDER: C? ??
/ti"'/t4&- SEWER U1ILITY
PROVIDER: ??aa.?L- ESTIMATED COST OF CONSTRUCTION: _
(EXCLUDING LAND VALUE) &01 ow
PLAN COMMISSION / BZA j BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: Elevator w Lift: O YES NO BLDG. CONSTRUCTION TYPE: OCCUPANCY CLASSIFICATION:
ok
TYPE OF CONSTRUCTION: TYYPPE? OF IMPROVEMENT: PROJECT INFORMAT TUN:
COMMERCIAL .?\(O NEW STRUCTURE Early Release Manufactured /
(Privately awned hospitals and-rpeditCU,\SADDI'fION Permit: Y _N Trusses: _Y N
? INSTITUTIONAL re commer,@g1f,N`oCwsa CO Porrch s) Lot Split _Y ? Sump Pump: Y
? Municbllc a`Od6`'' IN i- Merzanineor Deck
? d " rGe a?G F // DEL FLOOD ZONE AREA DESIGNATION(SI FOR THIS PROPERTY:
r y Q\2 J\-°a-("(5 yr?, NEW TENANT FINISH
Q? BPSi>'yag n v `` ?`I -'Nj0 ACCESSORY BUILDING
f, 'SSE?rr?f,Futiry??l C,.v O DETACHED GARAGE
F G G P CD ATTACHED GARAGE PLUMBING CONTRACTOR: Al
OU ATIO N.JW E4A: alLw[jie?t ? CELL TOWER (New) l
apply rtTeistructioea) ? CELL TOWER 00-LOCATE
IJ SL io D CRAWL SPAC BAS C) DEMOLITION Plumber's Indiana State License
0) POST &-BEAM -PIER EMENT (WALKOUT:_Y ? N)
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for bevnning and
completing construction.
1, the undersigned, agree that any constracion, reconstIDttior, enlargement, relocation, or alte_etior. c' a srruemre, or any change to the use e; land or structures requested by
rbis aFFlieatior will comply wits, and corform to, all apphcable Urvs of the State of fndim and the `Zoning Ordinance of Carmel !ndiana - IS93- (Z-289) and amendments,
adopted under authority of I.C. 36-7 et seq, Ge .Assembly of the Stale o'I ndians, and all Acts amendatory the:eto_ I further certify that ouly Idwhen, barb, and floor drains ae
connected to thetanitary sewer. Ifutt ertify at the construction will notbe used woccupied undla Certifia[e ofthevpancy or Subsranna/Comp/erni been
issued by the Department of Co pity Setyi , Carmel, Indiana.
?£ /? r.4LG s ? ?EiJ?Erf /l D
Signatu er or Authorized Agent Print Date
OFFICE USE ONLY: ***s*********s*************************************s*sa:atza;a:a;:a:a;?a<fi='===•
INSPECTIONS REQUIRED:
Upper 'ng Lower Footing der Slab
Roug I Meter Base Final Site
Reviewed/App OVed: Dept. of Community Services (Date)
S:PermlWFo,.V1 [OMMI.,
Filing Fees:
Base Inspections:
Cert. of Occupancy
TOTAL
Fee
77f r? c?
?8. a0
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