Permit 10020145 VOIDED City of Carmel /Clay Township Permit i
l l
COMMERCIAL/ INSTITUTIONAL /MULTI- FAMILY IMPROVEMENT LOCATION PE' lir
i APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, Accessory Buildin0
'INDIRNp:
BUILDER NAME: I�&PI14 PHONE:, •AX:
OF NAME:, !`1 -ee- 31- SCE I ley .s
RECORD: STREET ADDRESS: ti 21.-1).)03
T: ZIP:
1 G? 'i f s I 1
-I/" i s L N F 6
BUILDER EMAIL ADDRESS: i BEST M OF CONTACT:
11et�tiM CA/ r "ve �JbvltNc. COtrv, t i l 8 i e er tfr,,
PROPERTY NAME: i PHONE: FAX:
O NER: i1_ L -1' ill C �a
STREF D•RE. L. 1
CITY: �j� STA 7
LOCATION ADDRESS OF CONSTRUCTION: SUITE (If Applicable)
PROJECT -Z G ..ZS IV. 1 l St 5 -b�
INFO: Address of Shell Building: (If different than Address of Construction) Lot and Subdivision: (If Applicable)
BUILDING, PROJECTR TENTT NAME: f 1- ZONING: TAX MAP PARCEL
STATE COM SCOPE(S) OF 0 FDN 0 STR 0 ARCH 0 MECH 0 PLUM SQUARE
DESIGN RELEASE RELEASE: 0 ELEC O SPKLR OTHER(S): FOOTAGE:
WATER UTILITY SEWER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE)
PLAN COMMISSION BZA BPW DOCKET NUMBERS; AND /OR
COUNTY WELL AND /OR SEPTIC PERMIT #'S (If Applicable):
of Floors: Elevator or Lift: O YES O NO BLDG. CONSTRUCTION TYPE: OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: t I TYPE OF IMPROVEMENT: PROJECT INFORMATION:
O COMMERCIAL M1 0 NEW STRUCTURE Early Release Manufactured
(Privately owned hospital's and medical O ADDITION Permit: Y N Trusses: Y N
offices /centers are commercial) 0 Room (s)
O INSTITUTIONAL i 0 Porch() Lot Split: Y _N Sump Pump: Y N
O Municipal /Public B dg y l kt `l 0 Mezzanine or Deck
0 School ti- y 1 REMODEL FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY:
O Church
fit," r- O NEW TENANT FINISH 1 O MULTI- FAMILY ,.ii 0 ACCESSORY BUILDING
Number of units: I 0 DETACHED GARAGE S
PLUMBING CONTRACTOR: 1
FOUNDATION TYPE: (Check all which O ATTACHED GARAGE ii
apply for the new construction area) 0 CELL TOWER OWER (Neww) E 'U(i F
r fl V
LI CELL TOWER CO- LOCATE
SLAB 0 CRAWL SPACE 0 DEMOLITION Plumber's Indiana State Licensee:
POST BEAM PIER BASEMENT (WALKOUT: Y N) ,...,,,..z,,,,,_
s
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, 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 "Zoning Ordinance 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 certify that the construction will not be used or occupied until a Certificate of Occupancy or Substantial Completion has been
issued by the Department of Community Services, Carmel, Indiana O A L 1
c a. f -eh C.- l L
Signature of Owner or Alithozized Agent Print i Date
OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: Off
O Upper Footing 0 Lower Footing g j i ion C arg:. wal
0 Unde in--Rough-In N-vi:
O er Base 0 Final Bul ifing Ce o a AM! Final Forestry 0 Final Fire Dept. p
NOTE: Above ceiling /grid inspection requirements will be TAL Add feral F s
indicated on your permit placard. D /J i'
Reviewed /Approved: Dept. of Community Services (Date) Fee Received by: Date
S:Permits /Forms/ILP COMMERCIAL Aug.2007