HomeMy WebLinkAbout05020015 Application~l/Clay
BUILDER
Application for
Improvement LOcation Permit Date__
Roll File
r resident/at construction; and for commercial projects, within one (1)
lane Coramemial Desi R~' 2 .ears oftheisenance date. _
NAME
PROPERTY 'C~r.
OWNER
PHONE FAX
CITY STATE
LOT SUBDIVISION
LOCATION 15~ ~ ~'~>~, I" of: o~-.oA-,--t ~ ~
~D~S OF ~NSTRUCTION
A. T~E OF CONS~UCTION Do plans include a porch?
1. D S~gle F~ly ~ Yes ~No
2. ~ Two F~y
3. ~ T
4.~
5.
1. 1~ Public (Name of system_
2. [] Private(Couatypermit#
C. WATER:
1. li~ Public (Name of system ~ _
2. [] Private (County permit #
D. ZONING: ~(~
F. TYPE OF IMPROVEMENT
1. [] New Stmctt~e
2. [] Addition: Porch Room
3. I~ Remodel FI C~rcial ~'~ Space
4. [] Foundation Only
Y, N ) 5. [] Demolition
Accessory Building
Detached__ Attached
YES NO ~<
YES NO ,~
YES NO ~c'
YES NO x-~
Plumbing Contractor_ ~a ~ ,., ¢ a~o 4~p_ o~
E. ESTIMATED COST OF CONSTRUCTION IRC Plumbing Code: [] Plumber's
(Excluding Land Value) Indiana Plum~ing Code: ~ License #:
1, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change ia the use of land or structures
requested by this applicafi0n will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cunnel Indiana - 1993"
(Z-289) and amendments, adopted under authority of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further
enrtifythat onlykitchan, bath, and floor drains areeonnected to the sanitarysewer, l further eertifythattheconstrucflonwillnotbeusedoroecupiedunflla
Certificate of Occupancy has been issued by, the ]~epartment of Comgl~l~ Servieea, Carmel, Indiana,
INSPECTIONS NEEDED:
SignOre of Owner or Authorized Agent . l~ </ Upper Footing Lower Footing Bonding/Grounding_.__(#)
-"~' Meter Base ~ Site
(Phone Number)
ElMafl: 'l>o*/~gge.~ ~ ~t ~,n~n ,n"ezo~Sn-, ~o_ _. _ ~ . ..
Plan Commission/BZA/BPW Dockei #'s; TAC Date(s)
Filing Fees: ~
Base Inspections: ~ , /~eviews
Cert. of Occupancy: it O O ~, ~ ~/'
Additional Fees
P.R.I.F.:
CITY OF CARMEL / CLAY TOWNSHIP Permit#: 05020015
IMPROVEMENT LOCATION PERMIT APPLICATION Date: 02/15/2005
For: Remodels O' Tenant Finishes: Comrnercial. Industrial. or Institutional
PARCEL ID #: 1709250000001002
LOT & SUBDIVISION:
3500 MERIDIAN ST N CARMEL. IN 46032
Zoning: B6 FloodZone: N
PROPERTY OWNER INFORMATION:
Name: ST. VINCENT CARMEL HOSPITAL
Ph,#: 3'175827516 Fax#: 3175827829
Street Address: 13500 N MERIDIAN ST. CARMEL. iN 46032
:
Name:
Address: 13500 MERIDIAN ST N CARMEL, IN 46032
CONTRACTOR INFORMATION:
N
Ph # (317)634-6112 Fax#: 3172642529 Emall:
Street Address: 1107 BURDSAL PARKWAY INDIANAPOLIS, IN 46208
Plumber'"s Name: SULLIVAN & POORE Codes for Project:
Special Notes/Conditions:
ST. VINCENT CARMEL HOSP TAL OPERATION ROOM/SURGERY
AREA REMODEL. CONST,TYpE: EXST. SPK OCCUP.CLASS:
EXST REM, STATE REL.#: 307011. ARCH. ELEC. MECH.
PLUM. THREE STANDARD COND TONS.
* NO NOTES *
Lot Split: N
PERMIT TYPE_:
COMREMODEL; COMMERCIAL REMODEL
Water Service by: INDPLS
County Well Permit #:
Sewer Service by: CARMEL
County Septic Permit #:
Fou ype: SLAB
Manufactured Trusses: N
SumpPump: N
Usage Class: INS
Construction Type:
State Design Release #: 307011
Square Footage: 1400
$275000
This permit is valid only ii construction commences within one (1) yea~ of the date of issuance of the State Contmerclal Design Release. mi construction
must be completed (C/O issued) within two (2) years of the issuance date.
1, the undersigned, agree that any construction, reconstruction, enlargexnent, relocation, or alteratio] of a structure, or ~my chapge in th.e use of land. or structu~s
requested by this application will comply with, and conform to, all applicable hws of the State of Indmna, and the 'Zomng Ordmarxce of Carmel Indiana - 1993
(Z-289) and amendments, adopted under authority of I.C. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify
that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further eer tify that the.construction vail not be used or occupied until a
Certiticate o£Occupm~cybes been issued by the Department of Conununity Services, Carmel, lndiana~
FEES:
COM. IND. INST, CIO I00.00
C.LL REMODEL/TENANT 517.00
CII FINAL
CII ROUGH-IN