HomeMy WebLinkAbout08010018 Application?SY?ca"f . Permit #:1),?0160 d
City of Carmel/Clay Township
COMMERCIAL/INSTITUTIONAL/MLTLTI-FAMILY PaROVEMENT LOCATION PER?vIIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER NAME: PHONE : FAX:
OF
RECORD: STREET ADDRESS: CITY. STATE: ZIP:
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BUILD EMAIL ADDRESS:
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PROPERTY E? PHONE.- ?? ? ? FAX:
OWNER
:
STREET AD S:
CL s'z Al
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2; ? STATE: II : 1
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LOCATION -
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ADDRESS OF CONSTRUCTION: 5 t
SU *: (If App)I
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& PROJECT 6/Se ter,- o RLS
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INFO'
• Address of Shell Building: (If different than Address o Construction)
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' Lot and Subdivision: (If Applicable)
ZONING: TAX MAP PARCEL #: Pr?F ,?} S ?sc a 6
BUILDI PROJECT , OR TENANT N
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` U 1 /7 0 O ^7 GAO / 0O
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STATE C ERCIAL
DESIGN RELEASE 2
3d QO 3 SCOPE(S) OF O FDN STR ae" ARCH O MECH ti>??PLUM
RELEASE: rP'ELEC L) SPKLR OTHER(S): SQUARE
FOOTAGE: win F
WATER UTILITY
PROVIDER SEWER UTILITY I
PROVIDER: C
A(-me 1 ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) QnQ
: r. a ,
PLAN COMMISSION
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ND / BZA j BPW DOCKET NUMBERS; AND/OR
licable):
OR SEPTIC PERMIT Its (If A
LL A
COUNTY W
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# of Fbors: Z Elevator or Lift: YES O NO BLDGY CONSTRUCTION TYPE: S?k OCCUPANCY CLASSIFICATION: A-3 REPA
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
COMMERCIAL O NEW STRUCTURE
(Privately owned hospitals and medical O ADDITION
offices/centers are commercial)
? INSfCfUIIONAL
O Municipal/Public Bldg, ?-tACj?Q
O School - - _ I, '.'
:3 Cburcb
;,np????, oG?\C ;
O M -LLTf-FAMILY
Room(s)
or Deck
FOUNDATION TYFL: t,L necx an wnicn O CELL TOWER (New)
apply for tft new construction area) O CELL TOWER CO-LOCATE
SLAB C CRAWL SPACE O DEMOLITION
? POST &BEAM PIER ? BASEMENT (WALKOUT:
PROJEMNIFORMATION: . !
Early Release ? Manuv1factured
Permit: _Y Trusses: Y-14
4
Lot Split: _Y _N Sump Pump: _Y _N
FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY:
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PL IN CTO
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Plumber's Indiana State License
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Class I structure permits arc subject to the General Adminimative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or aheracan of a stt-xturt, or any change in the use of land or strucrares requested by
this application will comply with, and conform to, all applicable laws of the State of Indiana and the -Zoning Ordinance of Carmel Indiana -1993" (Z-289) and amendments,
adopted under authenry of I.C. 36.7 et seq, General Assembly of the State of Ir_dana, and all Acts amens! arory• thereto. I further certily that only kitchen, bath, and floor drains are
connected to the saritary sewer. I further certify that the construction will not be used or occupied until a Certificate ofoccgxwcy or Substantial C-ompledoo has been
issued by the Department Community Services, Carmel, Indiana.
tgk?-?4 Denature Owner Autlraized Agent .ant [fate
OFFICE USE ONLY:*******************************
INSPECTIONS REQUIRED: Filing Fees:
ling Lower Footing nder Slab Base Inspections:
Meter Base Final Site Cert. of Occupancy:
„I v, TOTAL:
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