HomeMy WebLinkAbout07120074 Application0 7f (C77
r"`"`"~• City of CarmellClay T ommship Permit
COMIVIERCLAL/INSTITUTIONALIiM?[]I TI-FAMILY R"ROVEMENT LOCATION PERMIT
`' ?kiS,anR. APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER NAIVE: PH E: FAX.
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OF i wl"y ¢? r 7
31Call- U 3-t?130c>
RECORD: STREET ADDRESS: CITY; STATE: ZIP:
53 oC> rQj?15`!t?., ? &!?
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
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-ikOm P LAJC? Y41.403
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C. 'Cis
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65
PROPERTY NAME. PHONE: FAX:
OWNER: FA- X21 3 )619-OMS r - 4 7 2- (13,>2-
STREET ADDRESS: f. CITY: STATE: ZIP:
Sep 5 T,? .-jd r xA 4,c2- o
LOCATION ADDRESS OFCON5TRUMON: #_ Applicable)
& PROJECT IDS • ( 64 c- .46G3
INFO: Address of Shell Building: (If different than Address of Construction) Lot # a lk?5ubdt?isio Applicable)
BUILDING, PROJECT, OR TENANT NAME: ZONING: TAX MAP PARCEL
? r-Jrs 2 r 71 -ci s 0 -?? oL - -
STATE COMMERCIAL SCOPE(S) OF [J FDN
S
EL R?r STR ARCH -IT MECH ?_ PLUM
PKLR OTHER
S
: SQUARE
FOOTAGE=
DESIGN RELEASE #: - EC p
RELEA
E: K (
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S
WATER UTILITY SEWER UTILITY ESTIMATED CC15T OF CONSTRUCTION:
PROVIDER: j ,?,,
N/ ,, ? ?? PROVIDER: = (EXCLUDING LAND VALUE) AZ
/ BZA j BPW DOCKET NUMBERS; AND/OR
PLAN COMMISSION
COUNTY WELL ANDIOR SEPTIC PERMIT #'S (If Applicable):
# of Floors: Elevator or Uft: C YES NO BLDG. CONSTRUCTION TYPE[ S? OCCUPANCY CLASSIFICATION: - -
TYPE OF CONSTRUCTION: TYPE WL XMPROVEMF ENT:
lj? COMMERCIAL ? .. NElly STRUCTURE
(Privately owne# fta" IS and med{Cj+l ._ y ADDITION
otTaces/k +ters are commerce Eg, ] Roam(s)
IPI IMUTIONAL porch
4 Munlcipal,'PUblll Bldg Q3 L"Trlezzanine or Deck
C school REMODEL
ti• Q... Church NEW TENANT FINISH
?% PoLtl-FAMi4V 1L ? ACCESSORY BUILDING
Awrber of uftt 5: ? DETACHED GARAGE
i _' 11 CD
FOUNDATION TYPE: (Check all which ATTACHED GARAGE
apply for the new construction area) 0 CELL TOWER (New)
? CELL TOWER CO-LOCATE
SLAB ? CRAWL SPACE ? DEMOLITION
? POST&-BEAM PIER 0 BASEMENT (WALKOUT:_1f N)
Eady Release
Permit:
PROJECT INFORM&TTI,QN:
Manufactured
Trusses:.
0
Plumber's Indiana State License #:
e10 B1:>0135
Class I structure permits are subject m the General Administrative Rules of the State Of Indiana (See 675 LkC: 12) regarding expiration time frames for beginning and
complering construction.
1, the undersigned, agree that any construction, reconstructive, enlargement, re-ocaticn, or alteration of a suvcturr, or any change in the use of land or structures requested by
this application will comply with, and conform to, all applicable laws of the State of Indiana, and the 'mooning Ordnance of Carmel Indiana -1993° (L-299) and amendments,
adopted under authority of I.C. 36-7 et 9eq, General Assembly of the State of Indiana, and all Acts amendatory thereto, I further certify that only ki:chen, bath, and floor drains are
connected :o tht sanitary- sewer. I further certify that the construction will not be used or occupied until a Cerefficate ofCkxupatrcy orSubGs=dal07wplerlaa has been
issu a rof unitySetvices,Carmel, Indiana.
S .J [4- c_-e>';P
5ignstu of Owner arAuf#wized Agent kri?K Z' 1'7 - '7 .{ 2.- 9 de <.<t 7-
-7 7?- 7-7 .te
OFFICE USE ONLY' **?K?K?k?k#?k?k,k?k3k?K?k#?k#*?K*?kjk*?c?K*?K*?K?K*?K K*?K?K K?Kfi#?casa<a ?a rc?a fa tfi F wt? TTTTT
Filing Fees: 30 G` ° a
INSPECTIONS REQUIRED:
Upper Fooling Lower Footing Under Slab Base Inspeckions: r.
Cert. of Occupancy:
Rough In Meter Base Final Site
TOTA 7
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Reviewed/Appr ved: Dept, of Community Services (Date)
Rpeimlts/FormsjlLp MERCLAL Fee ke ed by:
3
a-s-. 6
Date
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PLUMBING CONTRACTO