HomeMy WebLinkAbout08010008 ApplicationPermit #: t
City of Carmel/Clay Township
COMNMRCiAL/INSTITUTIONAL/MULTI-FAMILY I!4PROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER "A j
` PHONE:
3 ffF°'xf?:
6-" l. e 4? : / 2 J 78' /5 f
OF 4?
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1 rJ rA ?,
RECORD: STREET ADDRESS:
f C? CM,
- 51 TE: ZIP:
? l elge C-p
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
PROPERTY ?
NAME: ? PHONE: FAX:
0l
45 7
OWNER: j?
14 L - 3 i
ADDRESS:
/g ? Irk CITY: STATE: ZIP:
? Zz.
LOCATION ADDRESS Of CON5TRUCTIGN:
4
06-
f L StfITE #: (if Applicable)
?G
& PROJECT A
-4
INFO: Address of Shell Building: (If different than Address of Construction)
n Lot # and Subdivision: CIf Applicable)
B,PILDING, PROJECT, OR TENANT NAME ZONING: I `FAX MAP PARCEL #:
STATE COMMERCIAL
IGN RELEASE #:
DE SCOPE(5) OF D FDN
RELEASE: ELEC ?) STR ARCH
o SP" OTHER(S): =i MECH a PLUM SQUARE
FOOTAGE'.
W
. ?
S _
€
WATER OILITY SEWER UTILIT7 ESTIMATED COST OF CONSfRUCT70
PROVIDEBR:
? -
/ PROVIDER: /" ,ti fJ
v fvr?r , j
-'+v_ ( EXCLUDING LAND VALUE)
I BPWW DOCKET NUMBERS; ANDjOR
PLAN COMMISSI
ONN I OZA Z
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: Elevator or Lift: >] YES VINO BLDG. CONSTRUCTION TYPE ,r OCCUPANCY CLl15SMCATiON:
(0' SLAB ? CRAWL SPACE
Room(s)
Porch
Mezzanine or Deck
ACCESSORY 13UILDING
DETACHED GARAGE
ATTACHED GARAGE
CELL TOWER (New)
CELL TOWEL; CO-LOCATE
DEMOLITION
Q POST & BEAM -PIER C]. BASEMENT (WALKOtfr:Y_N)
Early Release
Permit: _Y _N
Lot Split: _Y
Manufactured
Trusses:
Sump Pump;
_Y L N
_Y
ri_!u)
0
rV
Plumbers Indiana State License #:
(?E r
Class I structure permits are suNect to the General Adreinistra&m Rules of the State of Indiana (See 675 LAC 12) regarding expimion time frames
completing construction.
1, the undersigned, agree that any construction, reuonstrucdon, enlargement, reloeanon, or alteration of a structure, or any change in the use of land or s [ cetures requested by
t is app'.ication will comply with, and coP<_71-1' cahie laws of :he State of Indiana, and the 'Zoning Ordinance of Cane ncl Iri&ana - 1993'(L-299) anri arnendm- nts,
adopted under authority o£ I.C. 36-7 e eeraAsse ly of the State of Indiana, and all Acts ammdacory thereto. I further eerd Ey :hat only LtcF ni, bath, and floor drains are
connected to the sanitary sewer. i rther certify, that construction will not be used or xcupied until a Cerrificate of 0ecupaaey or 5ubsranr al Cnmpletioo has n
issued by the Department to muttitySetvices, el, Indiana,
e%.., .,.,.. M suthrvi? d Onmt Print Date
******>r<***?x**********************************************************
OFFICE USE ONLY'
INSPECTIONS REQUIRED: Filing Fees:
O Upper Footing L7 Lower Footing
O Under-Slab Rough-In
O Meter Base Final Building
O Final Forestry Final Fire Dept.
*NOTE: Above ceiling/grid ins on requirements will be
indicated n your permit placard
Review Approved: Dept, of Community Services (Date)
S:PVMi si'ForrnVILP COMMERCM Au9.2007
Base Inspections: a d`. # Chargecl Re
Revews
Cert. of Occupancy: ///, 0 L)