APRIL 19 2016 BUILDING APPS'',,&.,
APPLICANT'
DEVELOPER:
PRO]ECT ADDRESS:
OhNER,S ADDRESS:
CONTRACTOR:
ADDRESS:
EIIAIL ADDRESS:
D IMER:
nd local
S ubFcllo
TOTAL AREA SQ FT
ZONE:
Comment
N
PERMIT FEE: $
NEW
ct *st
NOVER COUNTY BUILDING PERMIT
APPLIiATIaN TYPE: COI4MERCIAL
PL E ANSUIER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project ResPonsibility"
.-J R.\.1 GJ....1.-
20tL4tta
APPLICATION
Number
(office u5e)
,orr,'t I t1 lKS T,IAfiE :
OCCUPANT/BUSINESS T,IA E:
PROPERTY OWNER,S IIAIiIE :
{C
CITY:rJ ( ztpz Z oS
,I
\
\\-*
rre nt
PHONE S:
PHONE S:
LICENSE *:ISg}S
c rrv: \,t,.\; -1'1f"J
ACCOUNT #:
sr, r.rc ziPi13?oScl-to.>S-i:Tnu
C\-^5r.=:P*\,1
PROJECT CONTACT PERSON:s
EXrST CONSTRUCTTON: E ALTE I ON EI,RE
- r-:. t. c.*
Che Alt Th v
NOV AT I ON tr G E tr RE LOCATI ON
R E n CS NoNKLED
NC REG f:
S ite?Yes tr N o
R E PAI RS
IS B LDG S P R
N E RAL
lf Relocdion, is there a Natural Gas on the Cu
If UPFIT - The Shell Permit
*'i*** Is
IF Yes, what was the Previous O
NEW CONSTRUCTTON: n ERECT N srRUcruRE fl rasr rnlcx I sutr-r- ! unrrr F- aoo ro Exrsr srRUcruRE
ACCESSORY STRUCTURE:
Is Elect Pol,er on this Building E[- Yes E nO
rs A cHANGE oF occupaNcy usrr fives E[* *****
upancy Type?what is the I'lew Occupancy Type?
ARCH DESIGN PROFESSIOTAL:
ENGR DESIGN PROFESSIOT,IAL:
e,\\-. 6qro.'.Jre pn,
*?o9'q'it'Jl)*c
nre *, 5D.t o9L-
oS"l 1G."- 6$*n-g i,t ct:s-(sI -1--
DESCRIPTIoN OF tioRK:<,t s
ls food or bwerages Pr€Pared or in thls srrucure? [ Yes
hereby certfy
nd ordinances
lhat allinform
nd latio The
TOTAL PROJECT COST:-13
TOTAL SQ FT UNDER ROOF:
ACRES DISTURBED:
NEW IMPERVIOUS AREA:
6"*
BUILDING HEIGHT, jS'q " -
soFr PERFLR:qq6)' (i
3 lrg'5
# OF STRUCTURES:
-
PH:
COMMUN tw SYSTEM
lc- re
in conlractor
Fines Up To
or conuactor
$500.00*'... cL-)\r5<SIGNATUREOWNEFVCONTRACTOR:
(ousl(164
Note: Demollton nodfica{ons & asbeslos
(Pdri Netr'6)
pemh oppllcelio t ar6 io be sublnl[od uslno fl€ appllcaiion brm
contsln Asbesto! or not You 616 rBqui€d to cell NatonalEmlsslon Standards br Hszardo$ Alr Pollurants (NESHAP) et (91
dornolltlon of 6ny facllily or bulldlng See web Sll€: htts:/ /ww.epi.state.nc.us/eprasbestos/ahmp htnl
ls The Propsty Located ln The Floodplain? [ Yes d*"
lding Code and all other applicable State
n the aDoroved Dlans and sDectficalrons
v'olati6i ol rheNC Stare Bldg Code and
lh€ fscillly orbulldlng was bund lo
at lean 10 days pdor b lhe
v
# OF UNITS:
#OFSTORIES: 2
# OF FLOORS
Exsr LAND Drsrunatuo eeRutrr flves El uo
SQ FT EXISTING IMPERVIOUS AREA:
OTHER:
SQ FT
pRopERwusE&Frrce fl [urncmrru leouc leer lcoNoo
WATER: QICFPUA E
SEWER: ,FICFPUA LJ tr tr flzoN ING USE CLASSIFICATIONSYSTEMWELL
SEPT tc PRIVATE SEPTIC tr
"'SEPARATE PL'FTECUIRED FOR ELEC'I, MECH, PI"8G, GAS EOU{P. PREFAtsS & INSEF]S "'
PAYMENT METHOD: ICASTI
OFFICER:
Approval:- Ciq[
(eAvABLE To NHcl flatu eccouur EMcA/lsA I olscoven
(FOR OFFTCE USE ONLY)
SETBACKS: F:-LH:- RH:- B:-
FLOOD:- BFE+2ft=-
REVISED DATE /UT'1/'I2
reEK PHONE *:
PIONE S;
CITY:
-ST:-ZIP:-
i
RECEIVEDMARO9?016
YEAR l.rlADE: 2016
PIFASE PRINT CLEARIY & AIISTJER ALL QUFSTTO{S
"ProJect Responsibilitf'(Offlce Use)
DATE: 3 le
PHONE *:910-199-1119
APPL TION
E R c o U N
TYPE ER D E N TTAL
Jatbl)8o
PERMIT
HOME
ll, -'7 3lTYBUILDING
MOBI L E
APPLICATION
NumberIs
APPLICAMI,S l0A E: Jackie will
DEVELOPER: Cla too llomes of wi ton
PROIECT ADDRESS: 7 713 Pontcha rain Road
SUBOIVISION:
PROPERTY o!'INER'S ttlAfiE : .rud Mi
OI'INER'S ADDRESS: 7 713 Pontchar raix Road
CONTRACTOR: tterrin Mobile Hom Movers
ADDRESS: Po Box 124 0
EIitAI L ADDRESS:ack-ie.wi1.IseG a tonhones. com
PROIECT CoNTACT PERSoN: Jackie l,[i 11se
CITY:Wi Iminqton
LICENSE f: 0 0 2196
CfTY: Leland
(CHECK ALL THAT APPLY)
r-arrlIves@ruo
LOT #: 4R
sT : !!_ zIP: ?!!ll_
PHONE S:910-r99-11i9
PHoNE *:910-?99-1119
ztP | 233f2_
ILE HOME
DESCRfPTION OF WORK: Place l{ on lot with deck and orch
fr,,,,o,-. ,,,
DllclAllEi: I hd€by c.rtt rMl dr l,f*m.non h |nb dprlk.lion
Deolopm.nl s*le &nLr udl bo nodi.d ol dry cn.h!€ ln !E
wlr b.l^ vrda{.n olrt Nc sr.i. cdt cod.rid suhj.€b FiE
,4q
IS THE PROPERW LOCATED IN A F
PROPERTY USE/OCCUPANCY: Ii.I REs
HY,tc.4,+506r-
HUD LABEL: HWC445OS3
I nerocarror oF usED MoBTLE HoME
cffiiad.lleir nlllcomcy $lh rh. sr.E Bllldlngcod6.nd.ll odEr.Fplc.bl. sl.te ad l@1|ff, ordln.rcd ahd 6a!l.uon! Th. NHc
pl.B lnd spG.in@ud3 d ch.n!3 ln @r,Ecro. o. @.rt6cro, lnrofurlm. "1,loTE: a.y wolll Perlonn d wo t's Ap9ofi1ald Pomlts
OtllNER/CONTRACTOR:SIGNATURE :
*,** *,. * *,t *+,i + +,t * **++,i +,t+ + **i)**,r *,r,t+++,i,r+ **+ +,i *,r N,* *,r +* ++ + *r+++
(Print ri.he)
+ 'l * ** r.***,r*rri)* *,* rt )t )* *,1
180
TOTAL PROIECT COST (r-ess r-o0 ! $251
ox ford
LENGTH : s 6
ToTAL ACRES DISTURBED: >1
EXIST LAND DISTURBING PERI,IIT:
SERIAL #:
COLOR:
onc oas 3Er N C AB
Gray
E ves I NO SF
YES r NO
HURRICANE ZOr'r:: f]
DECK:Ives!ro
2fl3 SlloKE DETECToR: E veS E r'ro
F PoRcH: EJ ves E No 64
GARAGE:
SF
DENCE / OTH ER?
I,4ANUFACTURER:
:28IIJI D
1
WATER:CFPUA
5EWER: ! CFPUA
COIYMUNITY
CENTRAL SE
PRIVATE WELL
PRIVATE SEPTI
1
YSTEM CE NTRAL WELL
COl,l\lUNITY 5Y5TEMc
{.,|.|. SEPARATE PERiIITS IRED FOR ELECT, IIECH, PL8G, GAs EQUIP, PREFABS & IIISERTS *'I'
PAYr{EiIT r,tErHOD: ECOSX tr EcK (payaBLE To NHc) [ uenrcm exeness E r"c/rrsa ! orscovrn
zoNE: _ oFFICER:
Appnoval: _ City:
REWSED 4/12112
(FON OFFICE UsE OlltY)
SETBACKS : F :- LH :- RH:- B:-
DATE: FLOOD:BFE+2ft=
Comnent:
N
PERIIIT FEE:00
NEW
t71a
I
BLOCK *:
PHoNE f: 910-s15-120s
CITY: wilainqron ST: J9_ ZIP::,19j!!1_
E
I
APPLICANT 'S NAfiE: charter Bu I GI
DEVELOPER:
PROIECT ADDRESS: 82 29 sa le
SUEDIVISION:Eorest Creek
PROPERTY OT.'NER, S MI4E:Krls t
OI.INER, S ADDRESS:
CONTRACTOR : Char:ter Bulldl
ADDRESS: 108 clLes Avenue S te 104
f] sunnoom
-
sF
f] cRerruxousr
-
sr
Is Any ELECTRICALT PLU}{BIi'I6 or
If the project is a Relocat
ANOVER COUNTY BUILDING PERMIT
APPLTCAfiON TYPE: RESIDENTIAL
ANSI,IER ALL QUESTIONS APPLICAELE TO YOJR PRO]ECT
"ProJect nesponslbllltf'
Drive CITY;wilninqton
APPLICATION
Number
(offlce U5e)
PHONE *: 91.0'7 692440
ZIP: 28 41.1
BLocK #: LOT #: 11
PHONE f:H nHi smith
LICENSE s: 6,161e
cITY: ?'ilmingtoo ST: _ ZIP: ?g:!:_
EI'IAIL ADDRESS: ton a€charcer il-di PHONE #: 910't 692440
PRO]ECT CONTACT PE RSOit: sean Lewis PHON E *i 9101692440
EXISTING CONSTRUCTION: ! AL rnerron f] RENovATToN I eerennl neearns I RELocATToN
NEl,1l CONSTRUCTION;r'ERECT REsTDENcE o" f] roorrrolr ro Exrsrrnc REsTDENcE
*TPLEASE CHECK AND ANSHER SELON ALL THAT APPLY TO YOUR PRO]ECT:
t/ATT GARAGE 610 SF ! oer eraner sr f] eoncH :g- sF
I roor-
-
sr n sronaee sHED
-
sF
I orcr SF OTHE R:SF
TOTAL HEATED SQ FTr 2863 TOTAT Sq FT UNoER RoOF ! 3828 TOTAL AREA SQ FTi 3820
T0TAI PROIECT COST o-ess lo0 i $ 3o 1o?2
CHANICAL work Being Done to the Accessory Structure? f] V"t fl ruo
, ls there a Natural Gas Llne on the current slte? fives fl ruo
Is there Electrical Po!,er on thls BuildinE?ves @Ho
PROPERTY UsE / OCCUPANCY:rN6LE FAMTLY I OUnlrX I rowNttouse
DESCRIPTIoN oF l.loRK : Ne!, Si.e fanil deel1l wlth attached ar
DISCLAIMER: lh€rsby certt hal all lnbrma&n s sppLcaion k coflect 6nd a! work wlll comply wi,l h6 Stale Bululng code 6nd allohsr appncsbl€ Stab srd loc€lla!!,8
6nd odinsne6sand regulaUons. Ths NHC ! Se lcls Cenbr wli b€ nodfied of .ny changos In ft6 appro\€d plan8 and speclficalo
contacl lnlormaion. "'NOTE:Aryl,/oIk d WO fidApproprlate Pemlls t/lllbe ln Vlobfon of Uo NCSlgb and
OtlNER/C0NTRACTOR: csarter ildi Grou SI6NATURE :
***'i * **,1* **,*+ +* *+* + *:filrtl.* a**L* ** *,1*t ***+,i+** +x{r**+* **** + 'l*:}+ +** *++* l.* + r. r. +,1+ **
IS THE PROPERTY LOCATED IN F LOODPLAII,I? N YES I NO
ToTAL ACRES DISTURBED: l1l3_
ExIsT LAND DTSTuRBING PERIiIT-: ff YEs m No
$500.00"'
EXISTING IMPERVIOUS AREA:
NEW IIIPERVIOUS AREA i
SQ FT
SQ FT418
IIATER:
SEWER:
CFPUA
CF PUA
I cor'uun sysTEH n PRrvArE WELL f] cerurnaL well
I cerrnnl Eprrc n PRTVATE SEPTTC I COtlNUruirv svsrrn
PAY E T I4ETHOD: D Clsn
REOTIIREO FOR ELECT, MECH. PLBG, 6A5 EQUIP, PREFABS & INSERTS '*.
arra* cror*t, ro tra) E *t^rcal{ ExPREss I nclvrso tr
r'
+** SEPARATE
DlSC0VER
*+,t+*il+,1*t*,i***,tr*,i*'l+++i!,*r,t***t***+:l,t,i**+++:1.+,t,|*t***+,i++:*:l,t*rt,t+t:i**+i"! 'i la +* 'i't:i **'r t+'***
(fOR oFfI(€ USt O,ILY)SEVTSED DAt€ 94l11/12
SETBACKS: F:- LH: RH:- B:-ZONE:
-
0F FICER:
Appnoval:- clty:
Coonent:
DATE:- FLOOD:
-
A
- -
BFE+
vll
PERI{IT FEE:
2ft=
NEt^l
)oW-3tpz
@
# 0F SToRIES: 2
0ATE: 3 /1.6/ t6
crTY: _ sT: _ zIP: _
NE!
ffi"
ZONE;
Comment\flU
it. -r,itL (Dni
urrv'n$!€Cl0n ie,qriiieO, ii tr2*-.i
&olb-3138
'tr /C') 3
NE
ExISI COI{STRUCTIoN: E ALT
11 Roloadoai, is there a Nalural Gas
NEI coNsTnu(rIoN I f] EnEcT
ACCESSORY SIRUCTUR€:
HANOVER COUNTY BUILDING PERilTT
APPLI.AiIoH rvPr; COl,tl,lE RC IAL
EA5, Ar!!:; ALI Qt:rr:0^5 rpptIC^a!a To ti,fi pr:'ricT
"Project R€sponslbility,,
APPLICATIOII
iJuDber
APPLICAIIT'S t{Alla: .:!:.lirr s 4 . . :i . : , - -- : : : : : : " ,.
0EVEt0PER: . r-. r.,,
PROIECT ADOR€5S: . r'i0 parr . Fj:r:::j.,. S r':: l{U
OCCUPANT/BUSII.IESS NAflE: :c
PROPERTY OI{XER, S IiIAfiE: lr1]
otJr,/tR, s aDoREss: 4??s r Jrivc Sr€;C(j CITY: Ciarl.:re
CO TRACToR: c1r..v 4 .l'evi L IC ENSE lr ;'ri''
AoORESS: :2 '. shi.'.,;.-i ar:CJTY i i::-rj::i:.:1
EIIIL ADORESS: .5:
PROIECT COI,IIACT PERSON: c
r.ri:t ^ll
1rr rrrl, )
oATE: .jt " )rl
PHONE g: r, -i i: . :, .
CITY: ,:: inr::::. :r:IIP:.rr.i_5
5T: rc ZIP;2Et:J
ST: lrc ZIPi :Ail,
PI()NE S: ":: -.i.j-1,....
PHoNE t: 9::-:91 :.;t;r '
RATI OII RENOVIT:ON tr 6E'iTRAL R€PAIRS R€ LOCAT i O'I
oo lhe C,rr.enl Slle?tr D No lS SLDG SPRINKLEP:1?@v". fNo
NEr{ STRUCTURE ! rrsr rnacx I sxtr-r- [ ypplr I mo ro ExIsr sTRUcTURE
It ll.ect Porer on thls Building Yes DroIf UPTIT - The Shell Perii
IF Ye5, xhit rar the Prcvlous
THrs A cHAx6E oF orrupAxcy us:r f]v;s a
l4hat ir the ltcr occupan.y Iypel
(t
ASCI DESI6Ii PROF€55IOMI :
EIIGR DE5I6N PROFESSIOML:^5ro.rn,:r5
:,rc _ ki-lnr.-r.^: i_:a-S9a:
-1 1.'-,i: : I
in 1116 apdici.iri rsiorGrl and 6tt won stl co.,dr sth tlo Srslo I
NC RtG !: -<0,r:7
NC REG ': I?55:
ls ,oad or bevqags p.ops.!d u h tic *nrrurl fl ve" [] No b Tfiu e,op*1, Loc6t6d ln Th6 Ftoodplrrnf I v"" p ru"^ \\
D€SCNl P-TION OF HORK:
oISCLAIMER:l hcrcby corlt oar
r^d !x.l lr.. o d ordi.r..er..d o a orr oorel +prioorc Slrro tYrj5'y*'or dlanoe ir.urvkrd tr, L 5^rsdSuqoilo t,nu. UD To l5t\:.0C"'
r.. i _. -r.. -r. r..1,
Itn: o..to0ldr ,!.aihdl'r t ..b..!r e.4.-{.16At!..E r Er Y.u .r Drdg b l'. lLd@, EhE lcl SE n.'6 b. tb:.ddr
^t
psn r-r r\:Sd^pi r: 9i 9,
Fni .r9&dc! !r! b D. q&r,!d dho ul. .oC;cdo hm {E lHS.37 .".ii ,rl. r.";!g - h,n"{ .o. b,,a o
7c; -5950 .i r...1 10 ortr Es o irdri.!rb! o,.ry t nry d6-'Bna S- lr
TOTA!PROJECTCOST. SI?5
OWNER/CONTRACTOR: :r:
TOTAI AREA SO F-T
NEW IM2ERVIOUS AREA: r, a
WATEH: ZCFPUASEmR: B CFPUA
OFFICER
Clly
SIGNATURE
r{ba sr9 HV^*.oi .tr. r 4,.GV-!. ts,.tF. tufl
BUILoING HEIGHT - i
SQ iT PER FLR: ,,\i ..ri!
couM S YSTEM LJ =L L LI NING LASSIFICATION:
SEPTIC D PR TE EPT tc COMM rry SYSTE MUN
.i a. iri :r 1 i tLi
TOTAL SO FT UNOER ROOF: ].a t OF STRUCTURES: :,.t OF STORIES: r
, OF FLOoRsr 1
ACRES DISTUREE'Exsr LAND orsruRBNc eenurr I ves
SO FI EXISTING ItIPERVIOUS ARE-A: n./a
PROP€RIY UsE: l,,brrrCe I ESTAURANT !.luenCeulue Ieluc ]] p1 [CoruOO O+ree
t tio
r.<*1,
*
c>.
::-
=r,a<
,tr
$
_ga
SO FT
PAYMEh'T ME]NOO: ECASH cHEcK (pAyABtE To Nxcy !ruenrceN exepess I uwrse E orscown
(FOa oFnc E USE
SE]BACKS
FLOOD:
oNL!;
t'trIi=s,iVA
8FE+?t3
lt
PERMIT FEE: g._=__--
LH H
I
Pl+01{E l: ?oi-ii.i-ra:,i
a
t OF UNITST
aotu-31#16-1053NEW
PLE
OWNEFYCONTRA
(Ou€ltfer)
Note: Demoliton notif calions
contain Asbestos or not. You
demolition ol any facilrty or building. Se€ Asbestos
TOTAL PROJECT COST: s1:!, !''.
TOTAL AREA SQ
NOVER COUNTY BUILDING PERMIT
APPLICATION rYPE: COMI|IERCIAL
E ANS|IER ALL QUESTIONS APPLICABLE TO YoUR PROIECT
"Project Responsibility"
APPLICATION
Numbe r
(office Use)
AP P L I CANT 5 NAME s Construction Co
nCinc
PROfECT ADDRESS; 6rla rilrker .rrn llri-,e Suilc 100
lf Relocation, is there a Natural Gas Lin on the Current Site?n Yes ilNo
NEW CONSTRUCTION:ERECT N STRUCTURE FAST TRACK
ACCESSORY STRUCTURE:
If UPFIT - The Shell Permit : n/a
'}** *,: Is
IF Yes, what was the Previous oc
PHONE f: lt4-11:l-i6aa
ST::r:ZIP::84a3
RELOCATION
IS BLDG SPRINKLERED?flv". [ro
SHELL UP FIT ADD TO EXIST STRUCTURE
Is Elect Power on this Building T Yes nruo
State Buildang Code and
nthea
of the
th6 fecillv or builcling wes found to
-5950 al least 10 days prior to the
CITY: wrlmlnqton
DATE: Cl C6 15
PHONE *: .rit r-rl 5js9
ZIP: :r!4ts
OCCUPANT/ BUS IN E SS NAME: :.:r,:::Inc
PROPERTY ol.rlNER'S NAME: ll - -r:,-ton Investors LL'
OWNER'S ADDRESS: .1125 I re.lnL!Row Drive Ste 800 CITY: cl,ar Lcr,te
CONTRACTOR:6 The s Co st ruction Co LICENSE #:
ADDRESS: )25r t.1)-uiLe one CITY: {,l l Lminqton
E}IAIL ADDRESS: ,:::r ove rman G cl the
PROIECT CONTACT PERSON: ,:hr
(check Ar1 rhat App]y)
ALTE ION RENOVATION GENERAL REPAIRS
rs A cHANGE oF occuPAl,/cY user fivrs I NO *****
upancy Type?what is the New Occupancy Type?
ARCH DESIGN PROFESSIONAL: : P ssociates Ltd. - Wi Imin ton PH: 1!rL'r 99!1 NC REG #: 5lll
ENGR 0ESIGN PROFESSIOTIAL: -r..e:.'PHi 452- 4270 NC REG #: lla55
DESCRIPTION 0F W0RK: I,.e n.,1.' ar-n to office s
ls food or b€verages prepared or in this structure? EYes T No ls The Property Located ln The Floodplain? [ ves [l u:
DISCLAIMER: I hereby cerlify that all informali
and local laws and ordrnances and reoulations.
or chanoe rn conrractor or contractor rnlormatio
Subjecl io Frnes Up To $500.00"'
th s applicalion rs correcl and all work willcomdy with the
NHC Develooment Services Cenrer w ll be notrfied of anv
NOTE: Any Work Performeo W/O lhe Appropriate Permils
chanoes i
will bie rn
CTOR: :r-SIGNATURE:
& asbGstos romoval it opplications ars to be submitt€d using the apdlcation iorm (DHHS
are requlred to call Naltonal Emission Standads for Haz6rdous Alr Polldents (NESHAP) at{91
Site: htFr rww.epi.state.nc.us/epi/asbeetos/ahmp.htnl
FT:r
BUILOING HEIGHT: n,':
SQ FT PER FLR: avq 7080
# OF STRUCTURES: r a
coM M UN ITY S YST E M
COMMUN S YSTEM tr WELL
CENTRAL P R E rcVATEPT
TOTAL SO FT UNDER ROOF: ]I
ACRES DISTURBED EXST LAND DISTURBING PERMIT? r] YES NO
SQ FT EXISTING IMPERVIOUS AREA: , ,, :,
E zo N ING U SE CLAS F tcA I o N
NEW IMPERVIOUS AREA: I)
WATER: ECFPUA
SEWER: [7| CFPUA
SQ FT
PROPERW USE: EOprrce E RANr EMERoANTLE DEDUC lner lconoo orHER:
*.SEPARATE PER[.IITS EOUIRED FOR ELECT, II,IECH, PL8G. GAS EQUIP. PREFAAS & INSERTS *'
PAYMENT METHOD: trCASH I ECK (PAYABLE TO NHC) ilAMERTCAN EXPRESS I t"rCnrtSe E OtSCOven
ZONE:_OFFICER:
(FOR OFFICE USE ONLY)
SETBACKS: F:-LH:- RH:- B:
Approval:_ City:-:- FLOOD:
-- -
BFE+2ft=
REVISED DATE IVl1112
T
Comment
N
PERMIT FEE: $
DEVELOPER:
ST: Na ZIP:.r82ra
PHONE #: q10-392-5220
PHONE #: 9tl 392 522a
EXIST CONSTRUCTION: !Z u
Jtk\,
# OF UNITS:
# OF STORIES: I
# OF FLOORS: I
frF
NEt^l H
contacbr inlbrmaton. '*NOTE: Any Work Perfo
OWNER/CONTRACTOR :
***,*,* )* x,r*i( )* x )t )t* **** *
IS THE PROPERTY LOCATED IN A F
EXISTING IMPERVIOI'S AREA :.28.04
l.ro ft'o
OVER COUNTY BUILDING PERMIT
APPLICATIOTJ TYPE; RESIDENTIAL
ANSI,{ER ALL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibilitld'
3o lb-3'1'l o
iL-t021
APPLICATION
Number
(office use)
NtYc-
PL
APPLICANT' S l,lAltE: J.E.EVANS coN TRUCT]ON, INC
DEVELOPER: NA
PROJECT ADDRESS: 5 O O 4NICKOLAS
SUBDIVISIO{: I.IASONBORO FOREST
DATE :3/24/t6
PHONE #: NA
CITY: WI LMINGTON ZIP i 284a9
BLOCK #:LOT S: _
*a 632 3414PROPERTY &'INER,S I,IA},IE: DR. DZUR K
OHNER,S ADDRESS: SAME CITY: _ST:_ZIP:_
CO{TRACToR: J. E . EVANS coNsr LICENSE #: 386r2
ADDRESS: 311 JUDGES RD. UNIT 8 CITY: WILMINGTON sT: g zIP: 2B4os
EIi!AIL ADDRESS:evans s !2 G i1 om PHONE f:19a 924-l
PRO]ECT CONTACT PERSON: MIKE NS PHo|'IE *: 410 t919
EXrSTritG CONSTRUCTTON: ! nlre TION RENOVATION ! crrueRal necnrns ! RELocArroN
NEW CONSTRUCTION: LI ERECT NEI,i
**PLEASE CHECK AND AI{SWER BELOW AL
ESIDENCE OT
THAT APPLY TO YOT,R PRO]ECT:
ADDITION TO EXISTING RESIDENCE
! noncu
-sF
f] sronaee sHED _ sF
DEC K SF
TOTAL HEATED SQ FT:TOTAL SQ FT UNDER ROOF: _ TOTAL AREA sQ FT: 16e
oooo.oo S 0F STORIES: 2TOTAL PROJECT COST tr"ss r-oo : $
Is Any ELECTRICAL, PLTJMBII{G on CAL l./onk Being Done to the Accessony Structure? E Yes tr No
is there a Natural Gas Line on the Cunrent Site?tr Yes EIruo
HON EP
tr
ATT GARAGE
-
SF
suNRooM t64 se
GREENHOUSE SF
DET GARAGE
-
SF
POOL SF
If the project is a Relocation,
Is there Electrical Power on th s Building? lEl ves [ ruo
PROPERTY USE / OCCUPANCY:SI LE FArtlr rY ! ouelex ! rouiruxouse
DESCRIPTION OF ltlORK: CONVERT EX STING SCREEN PORCH IN TO A SUNROOM. PART OE PROJECT COST IS TO
FO9II-ER HEAT/AC REDOING }IHOLE HO E WITCH THEY HAD A SEPERATE PERMIT. NO STRUCTUA], IIORK
DISCLAIMER: lherebycerlily hat all inbrmalion in tlis lical,on is conectand all work will comply wih he Slate Building Code and alloher applicable Slats and locallaws
and ordinances and regulairons. The NHC rvices Center willbe noiified of any changes in t'le approved plans and specifcalions orchange in contra€bror
E Fbrmitsvrillbe in Vioblion oflfie NC Slats Edg Cod6 and Subject b Fines Up To5500.00"'
srGNAruRE: JE Evr,t'ts €hn17 t"q
(
)i )*,*** **** **i.i. r.,* i( * * i(
'1.
:1.:t,t:l :l:t )t )* )t*)t,t*:i *,*,* ,t * * * )t )* *** *,r* )r **,** *,t,r* *,*
E EHoLAIN?YES
I{ATER:
SEWER:
SQ FT
SQ FT
TOTAL ACRES DISTURBED:
NEW IIIPERVIOUS AREA: +AAO EXIST LAND DISTURBING PERTIIT:Ives [ru0
CF PUA
CF PUA I crrurnlr see
! cou'rururrv
IC
TEM tr PRIVATE WE LL f] cerurnel we ll
*** SEPA'IATE PER}IITS R ED FOR ELECT, MECH, PLBG, GAS EqJIP, PREFABS & IiISERTS *'*
PAYITENT Ii,IETHOD: E CISX E Ecr( (IAvABLE ro rirry [ ru,reucAli ExpREss MClVr5A tr DISCOVER
zoNE: _ oF FrcE R:
Appnoval :- CitY:
(FOR OFFICE USE ONTY) REVISEO DATE O4l11l12
SETBACKS: F:_ LH:_ RH:_ B:_
:a )t )i,r,r** *'l{.,* *)t** **,t+,*,}* **i* x ** * * *,1. {r,t,t rr*** i( )t 1( )t )t,tir l.,t i. i. ,t i. i. * * * * ,t ,t ,t ,t ,}:} il.:lr :} t,l. * ** )t ** rt t * )t*,* )**,1* *i.
DATE:_FL00D: - -r- N BFE+2ft=flts
SF OTHER:
! enrvlre seeruc ! coMMUNrry sysrEtl
N
I
sg
T+
o
3
4.E
dI
t_
NEW NOVER COUNTY BUILDING PERMIT
APP carloN TYPE: RESIDENTIAL MOBILE HOI4E
PLEASE PRINT CLEARLY & ANSIdER ALL QUESTIONS
"Pnoject Responsibility"
, olb
(office use)
DArE.3- 3t_lb
PHONE *:
1on ZIP :o
PHONE S:tq5-g?Yo
APPLICANT'S tlAIi'lE :
DEVELOPER:
PRO]ECT ADDRESS:
SUBDIVISION:
CONTRACTOR:
ADDRESS:
CITY:
PROPERTY OWNER,S T,IAI4E:
OI.JNER'S ADDRESS:
BLOCK #:
I
EI4AIL ADDRESS:
PRO]ECT CONTACT PERSON:/<on
CITY:5T:ztP:
LICENSE *:75A ACCOUNT #:
ST:ZIP i dEl {
PHONE f:/0 '.ub/)
o <E PI0NE *: (gLdlqs--?2firrouz.{z Catd,h4 --satTHATLY)
ELOCATION OF USED I,IOBILE HOI4E
C ;b
Lc4r /,Dh,
(CHECK AL
I rnsrall rew MOBILE HOME
JonDESIPTIONF hIORK:
OISCI Ii/EB: I h€.eby cenjt lhal all inrom aion Ln t'rh iscor..radatrslt*lconCywrhtl.Sr.BuildingCo(,.8ndalloth.r6rplic6bl€Slj'r€andr*arta*s,odinan..saMr.Ouklio.6.ft.NHC
approv.d ph.! and specilicaions d change ln conlracio. or .onlr.clor inlomlion. -NOTE Any Wo PerLmed WO lne AppopnaE Pemir
OWNER/CONTRACTOR:
,* )t:t:1,* * x* **)t,*,*,t*,t,**** ****
IS THE PROPERry LOCATED IN A
PROPERTY USE/OCCUPANCY :E
o€velopmenl Setuices c€nlerwilbe
^oril'ed
oaany changes in
willb€ in violarion ol t\e Nc sla|e Bldo code and subjecl lo Fin
HUD LABE L:
YEAR I.4ADE:
(P.1nt Name)
IDENCE / OTHER?
MANUFACTURER:a7
SIGNATURE:
,t ,t ,t ,* ,* ,t:l ,. * ,* ,*:* + +)t,t*)t )i:*,*:ytx * )*,* )***,* )t,t,l )i )i )t * *,t:tr *,t ,t * * ,* )*,r )i * ,* *,* t,t +ri + !* )t,*
LooDPLATN? [ v"r ffruo
HURRICANE ZONE:
DECK: E YEs NO
TOTAL PR0JECT COST (less ro0:
WATER: N CFPUA
SEWER: E CFPUA
,k,r* SEPARATE PERrillTS
PAYi'1ENT mETHOD: I cAsn
zoNE: _ 0F FICER:
Approval :- CitY:
1v<a sriroKE DETECTOR: @fi5 | nO
sF PoRcH: E vrs EKno
tq (N*
Re./rrtao.tEncri-__4_SERIAL #:
COLOR:
GARAGE: I vrs@6
SF
TOTAL ACRES DISTURBED:
SETBACKS: F :_ LH:_ RH:_ B:_
t^rr
SF
Exrsr LAND orsruRerirc-EEn ;;;F'l ves pt-ft6-
COT'IMUNI
CENTRAL
SYSTEM
PTIC
TE WELL
TE SEPT
NTRAL WELL
COMMUNITY SYSTEM
CE
PRIVA IC
EqUIRED FOR ELECT, I{ECH, PLBG, 6A5 EQUIP, PREFABS & INSERIS '+'
cHEcK (pAyaBLE ro ir{c) ff eru rccoum ! rclvrsa I orscoven
*++ REVT5ED 4/12l12
(FOR OFFICE USE OI{LY)
DATE: FLOOD: BF E+2ft=
.re$liELnNraIlatlrm t
Comment:,J*rr, ,rr, $ ]00
CITY:
APPLICATION
Number
LOT *: _
'40a700 7 AB
I'FT
.tr l$'
I
$g
*o
)+
o
45
4,E
.Q\-tI
t_
&tlln3'tlt
w.q\t
.. ...,::..
,.&",
NEW ANOVER COUNTY BUILDING PERI'IIT
APP IcArIoN rYPE: RESIDENTIAL I4OBILE HOfiE
CITY:
CITY:
€as ib ltome LICEI,ISE S:75a ACCd'NT *:C
APPLICATION
I'lumber
oorr.3- ]l-lb
PHOTE S:
ZIP i
PHONE T:..1q5-g?.fo
APPLICANI'S I,IA'IE:
DEVELOPER:
PROIECT ADDRESS T
SUBDTVI9ION:
CONTRACTOR:
ADDRESS:
PROPERTY O}'TER'S tlA'IE :
oI,JNER'S ADDRESS:
?
*LOT
ST:ZIP:
CITY:5T
EitAIL ADDRESS :PHONE S:
PRO]ECT CONTACT PERSOiI:x U n L {E PHO E S:
mouea @afi!57,11(CHECK AL THAT A LY)
I rrsrall re IOEI LE HOI4E ELOCATION OF USED I4OBILE HOI4E
D IPTION F hto8(:Jon
Dlscl, llER: I i..by .atl, 0Dr tll hL. im o rrri.I.dGt 'd dr 6r l{l comd, *iti uE sr& &i$?l! c6.rr &d.n o$s.rrr..ti. st l. e4r6b{. o.atMn.d.,n cld.riMl. T& l*lc
.pp.d.nd.N..dt!.dnoMrrchsrc.o.o.ni)rq*..45.h.rh{.Brir.-ilo1glAnywonP.rtomdwNOtl.lrropi.r.P@,l.o.vlkrrmd! sds.r c..q rn b. nolntrd ol t.v ci.n$s in
Car' LL-*1
b tq t !-
O.INER/CONTRACTOR:v
* * *l* *,f *,* +,1* *i| *l ta *,r *{r *It,. r *it *** * * r * * * 1,* *ri
IDENCE / OTHERI
*i! b.
'^
v'd.&.
"r
.. ,{c s.k 6'.c cZ),|+r )q.)R
I5 THE PROPERTY LOCATED IN A r-ooorurut I ves
HI,RRICA'{E ZONE: f]
DECK: I ves @-no
,@6a
SIGNATURE:
SERIAL S:
COLOR:
/40n 9A7
TOTAL ACRES DISTURBED:
EXIST LAND DTSTURBING pERXIT: I VeS ffi
n, ELfs E Ho ama6E: I ves pffi- sr
EKo
-
sr
PROPERTY
,fJ1S,,
USEG lo
t
YEAR I4ADE:WI
I"IANUFACTURER:a?
3 SI$(E DETECTO
sF PoRcH: E YEs
(NeTOTAL PROIECT COST (Loss Loi):tq
HATER: EI CFPUA
sEr.lER: ! CFPUA
Cotll,,lt NI
CENTRAL
--,..sYsrEM lel PRTyATE WELL I lcE
EPrrc @fnwarr serrrc fl
NTRAL I..,E LL
Co,,$ui,l ITY SYSTEM
"i SEPARAT€ PERMITS REqUIREO FOR ELECT, ,.ECH, PLBG, 6^5 EQUIP, PRETAES & INS€RTS "'
PAYttEuI itEn(D: E *"CHECX ( PAYASLE r0 M{C)I aru rccourr flrcuvrsa I orscovrn
rE!I5rO 4/12/12
( ror orrtct ust oarY)
ZotlE : _ 0tFICER:
Approval :_ City:BFE+2ft
ll
rtift
Ir
Co0nent:
DATT:
PERI4IT FEE: $7w
PL€AsE PRIIIT CLEARLY & AI,ISIIER ALL QUESTIOiIS
"Project Responslbllity"
BLOCT *:
(Offic. Urr)
t
Rc.tmrr-n",
LENGTH: 'r')
SETBACKS: F:_ LH:_ RH:_ g:_
F LOOO:
fls
N \lc
ffr
NEW HANOVER COUNTY BUILDING PERM
APPLICATION TYPE; RESIDENTIAL
LEASE ANSI/I/ER ALL QUESTIONS APPLICAELE TO YOUR PRO]ECI
"Project Respons ibil ity"
orz# tb-loY8
i', ;'olb-3qVa
.li c
APPLICATION
Number
(office Use)--/-a-/e.-sssrfufAPPLICANTJS NA]'!E:
DEVELOPER:P
PRO]ECT ADDRESS:
SUBDIVISION:
PROPERTY OWNER' S
OI^'NER,5 ADDRESS:
(.,"-
CITY:
0r\c
CITY:
LICENSE $:
CITY: LT
sr: l!.1(zrP :2
*,Wzw;@c, le
SF
SF
)f3l-
.,C€
(11
-< r^?€
14-Ot-
PHONE #:
ZIP i 2
E
CONTRACTOR:s-l <^
ADDRESS:
EMAIL ADDRESS:
PROIECT CONTACT PERSON I
EXISTING CONSTRUCTION:
7fi9 L/ACCOUNT S:
o
STORAGE SHED
e
** * + + * * * * *,r * * * * *,k **,k *
o
DET GARAGE SF
PO0L _ SF
DECK
PHONE f:l)/I
)
NEI-.,I CONSTRUCTION:ERECT W RESIDENCE or ADDITION TO EXISTING RESIDENCE
lL*LJ L
A ERATION R ENOVATION GENERAL REPAIRS RELOCAT]ON
ALL THAT APPLY TO YOUR PRO]ECT:
PHONE S:
PHONE S:5:s-.3 2
6*, Z\ce ,,r-^*-1P,'.:.L
--2-?- $ r'-F
(
C.(
r*predE csecx AND aNst,lER BE
t*, oo*o, 1( / t
TOTAL HEATED SQ FT:2 TOTAL 5Q FT UNDER ROOF: 3( J,-
'O'O'
AREA SQ FT:
$230 do c)ToTAL PROI ECT COST 1ie.s ro1 :
I5 Any ELECTRICAL, PLUI,IEING oT
If the project is a ReLocati
Is thene Electnical Power on
PROPERTY USE ,/ OCCUPANCY:
DESCRIPTION OF ORK:
Ot.llNER/CONTRACTOR:
EXISTING IMPERVIOUS ARE
NEI IMPERVIOUS AREA:
suNRoof4 _sF
GREENHOUSE SF
l(.Kowurur
PAYIIENT METHoD: E aott
ZoNE: _ OFFICER:
Approval:_ City
Comment:
r-ce)'-6."1^
c'<cf aJ
E 5
SF OTHER:
SIGNA
n
# OF STORIES: ,/
HANICAL Work Being Done to the Accessory Structure? [ V"s f] lo
is there a Natural Gas Line on the Cunnent Site?
s Building? f] v.t l--'l ruo
[v.t ! ruo
SINGLE FAMI LY DUP L EX TOi^] N HO L JS E
t
DISCLAIMER: I hereby cedi, rhar all inlomalion i isapplicalion iscotrectand allworkwillcomplywih he State Auilding Codeand a[ oher
and ordinances and regulations The NHC ent Setuices CenEr willbe noUfied ol any changes in he apprcved ptans and spec
conlractor intormatlon "'NOTE Any Work Per d W/O rhe Appropriate Permils wittbe in Viotatlon ofthe NC Slale aEg Code
*(
TURE:
** ** * ** * * *,* * *,t + + t* + ++r( * *
I5 THE PROPERTY LOCATED IN A L ooD P LAI N )
*
To TA L AC R ES DISTURBED:
.ffi;
'r )as F T ,/q
SYSTE|1 PRIVATE lilE L L CENTRAL l^lE L L
PTIC PRIVATE SEPTIC COI'1I1UNITY SYSTEIl
+** 5EPARATE PER]'4IT
SQ FT EXrST LAND DTSTURBTNG nrnmrr: I vrs l--.l No
REQUIRED FOR €LECT, ]VIECH, PLBGJ GAS EQUlP' PREFABS & INSERTS 1*i
cHEcK (payABLE ro ruxc; I BrLL AccouNT [,lc,rvrso Iorscovrn
(FOR OFFICE USE OI,ILY) REVISED DAIE O4l11/12
SETBACKS: F:_ LH:_ RH:_ B:_
L
DATE:_ FLOOD: _
A
*** + * +*,i* * * * * +* )** * * + +* )* *,t,t**,**++,F*,k**,t*+*,li+*+,t**)*****++,t)t******++****,***++***++*)i,r)i***
B F E+2ft i
I
IJ 5 -7 0
To $500.00"'
PERI4IT FEE | $
I,.IATER: fI CE"UA
=,,.SEWER : I.,!4 CF PUA
BLOCK f: LOT s: _
! cerlrnal
OVER COUNTY BUILDING PERMIT
APPLICATION IYPE; RESIDENTIAL
ANSI4IER ALt QUE5TIoN5 APPLICABLT TO YoUR PSOIECT
Project Res pons ibility"
\a*!;\ffi'ns
APPLICATION
Number
(office Use)ffi
PROPERTY OI./NER, S
OI^INER'5 ADDRESS:
EXISTING CONSTRUC
NEW CONSTRUCTION:
i.'PLEASE CHECK ANO ANSI,IER BEL
{*l oo*u, 'lq } t,
PLEAS
APPLICANT'S NAflE:l€ur--r
DEVELOPER:
PRO]ECT ADDRESS:
SUEDIVISION:
NEW HA
//--6.-b
at zrp:2Y/D
.ot -t ZAq-T
E
CONTRACTOR:e I t^
ADDRESS:
EIqAIL ADDRESS:
DATE:
CITY: - Cc.Sfl'e
BLOCK f: -
PHONE *:ii l- 351
CITY: t-r t^- ),^ a *-c,r..sT: g.zrP :
L
Y
,I
)_
(
OH ALL T APPLY TO YOUR PRO]ECT:
sr:@(zrr: fue
PHONE S:
PHONE f::-2o-:s*3 \
LICENSE #:
CITY: L- r
| 75-to ?
{ r.-'. ^,./a^0r*J
STORAGE SHED
PRolEcT CONTACT PERSoN: J o.^L-)€6^kL
TION:ALTERA ION R ENOVATION GENERAL RE PAIRS RE LOCATION
ERECT NEW SfDENCE or ADDITION TO EXISTING RESIDENCE
F.,-:1_R,^,Lqtjc;do r, /4? ,,
SUNROOM 5F
GRE ENHOUS E
TOTAL HEATED 5Q rrr 2})ct TOTAL 5Q FT UNDER RooF: @r l /ToTAL AREA sq rr: 2'rc, /
# oF sToRIEs: HZ
Done to the Accessory structure? [ Vut I no
OET GARAGE
-
SF
POOL _ SF
DECK SF
SF
SF
T0TAL PROIECT C05T lress rorl : $
OTHE R :
DUP L EX TOWNHOUSE
Is Any ELECTRICAL, PLUIIEING or I'4ECH
If the project is a Relocation,
Is there Electrical Power on thi
PROPERTY UsE / OCCUPANCY' I Srn E FAMILY
ICAL l,Jork Being
s there a Natunat Gas Line on the Cunnent Site? ! vut I llo
Buildins? l-l v"t l-l uo
oo
1.^t*
Ooc)
€)<(I
SIGNATURE : ,-
]"Qr^ Acr.',DESCRIPTION OF WORK:
DISCI.AiMER: lhercby certit flat allinbrmalion in his ap licaton is co.recl and all work will comply wih he Stale Building Code and all oher applicabte Sta|€ and locat taws
and ordinances and.egulaions. Th€ NHC oevalopmenl Center willbe noljlied ol anychanges in h€ approved p ans and
conlraclor inbmalion. "'NOTE: Any W he Approprisrl. Pemirswillbe in Violation ofthe NC Slats Bldg Cod€ and Su 00"'
c__
,,^ <
o.- bOWNE R/CONTRACTOR :
EXISTING IMPERVIOUS AREA: (
** *,t*,t+,t,i**,** * * * ** * ** * ** t,f +,*
I5 THE PROPERTY LOCATED IN A FL
l"J** *************** *
YES
)t* * + +,t* * * *,t *,** +,* + )i *,f * * * *,i *
N
NO
TOTAL ACRES DISTURBED: , / a'.
EXIST LAND DISTURBING PERIiIIT:f-l Yes l-l r'ro
N
LAIN?
L
<.
L
SQ FI
SQ FTN
WATER:
SEWER:
El.l IMP OUS AREA:
PAYl,lEtlT l'4ETHoD;
)t* *,t + * + * )k* * )t*,t * + + * * )*,t,i )t* )i * r( *
COIT,'V1UNI ry SY Etl PRIVATE WELL CENTRAL WELL
COMMUNIry SYSTEM
(FOR oFFICE UsE ONLY) REVISED oATE 04111/12
SETBACKS: F:- LH:- RH:- B:-
creul ! CENTRAL SEPT PRIVATE SEPTIC
**i SEPARATE PERiIITS RE IRED FOR ELECT, I]ECII, PLBG, 6A5 EQUIP, PREFAES & INsERIS +*'
tr CASH CHE (nAvABLE ro wc; flmenrcrN ExpREss E rrclvrso E orr.our*
)l( )t *,f *,t i(,t,firt* * * )t )t *)t )i )t:* * * )t,t )*+ )t* * )k* )t * )k t *)t * * * )*,**,f + +,* * )t * )* * * * * * *,i
ZONE: _ 0F FICE R:
Appnoval:- Citv:-
Comment:
TE:_ FL00D BFE+2ft
rl ,-P4s
PERMIT FEE: $e10
/={c
PHONE S:
tr
E
NEW
Aott _f!l{st
ovER coUNTY BUILDING PERMIT J
appLrcarroN rypE: RESIDENTIAL ap-pttcetrott
..& PL
APPLICANT'S NAI1E: !,..i.H a,'r\', E
E ANSIi/ER ALL QUESTIoNS APPLICABLE TO YOUR PROIECT
"Project Responsibility''
Number
(office Use)
DATE: ,i,1,/lt)
PROIEcT ADDRESS: lirr: !Hr:rER COUF T CITY: r\,r LMTNGToN ZIP i 2ti4t2
SUBDIVISION: l{ullrrrlcraN FCPEs SEC 5 BLOCK #:LOT fi: i.i
PROPERTY OWNERj S NAI'IE: R:rtnI HT PHONE #: ! l :r -i !r2 5 14l
OI,INER, S ADDRESS: lOI: CHII,DER COURT CITY: ar LI,lrNaircN ST: NC ZIP:28412
CONTRACTOR: P(,'ricH coNVERs rcN LICENSE #: N/A
ADDRESS: 6821 MARKET STREET CfTY: I,JTLMTNGTiIN sT: ll!_ zIP: :j_1!i
orchconversio maiL. com PHONE #:914-'7'7',7-3363
PROJ ECT CONTACT PERSON : i',r. ,.-:BR]TT PHONE *: q--!-r-rr-lJDl
EXISTING CONSTRUCTION:ALT RATION R ENOVATION GENERAL REPAI RS RE LOCAT ION
NEW CONSTRUCIION:ERECT NE
LL THAT APPLY TO YOUR PRO]ECT:
DEVELOPER: :, ,
TOTAL HEATED SQ
ATT GARAGE
-
SF
SUNRoOM r arr SF
GREENHOUSE SF
POO L
DE CK
fl oer cnnnce sr ! eoncrr
-
sF
SF STORAGE SH ED
SF OTHER:
SF
SF
FT: tgr TOTAL SQ FT UNDER ROOF: 19I
# OF STORIES: 1
Yes il No
is there a Natunal Gas Line on the cunrent Site? [ v"t fl
TOTAL PROIECT COST (ress ro0 i 29,r.14
Is Any ELECTRICAL, PLUMBING on ME HAI'IICAL Work Being Done to the Accessory Structure?!
PROPERTY USE / OCCUPANCY:S NGLE FAMILY DUP L EX TOWNHOUSE
DESCRIPTION OF WORK: ] ]].] ],:72'-4" X 16 FT SUNROOM ADDIT]ON ON NEI] BRICK ,' BI,OCK / E1EVATED SLAB
If the pnoject 1s a Relocatio
Is there Electrlcal Power on
NEW IMPERVIOUS AREA: 19I
ZONE : _ OF F ICE R:
Approval :_ city
}1Y I,LAP.T ] I.]
* * * * + * * * * * * * * * * * * r( tr( tr( ,( ,( ,( + *tr<
No
TOTAL ACRES DISTURBED: C, CC45
EXIST LAND DISTURBING PERMIT:
++++,t+,t+,t,*+*,***)**r*:**r******+*+*,F++tr<+++******)r*****)*r(r(*
NO
is Building ?T ves I-l rlo
applicaton is conecl and all work will comply wih trre Slate Building Code and all oher applicable SraE and local laws
i S€rvices C€nbr willbe notli6d ofanychanges in he approved plans and specifcations orchange n conlrac!cr or
DISCLAIMER: I hereby ce ity hat all inbrmatlon in t)
and ordinances and rcgulations The NHC Develop
contacto. rnformaijon '''NOTE: Any Work Performe /O he Appropnale Pem ls w be nViolaiionoflheNCSlaieBdgCodeandSubjecrbFinesUpTo950000^"
OWNER/CONTRACTOR: .',-:rr';: .rr SIGNATURE:
)
IS THE PROPERTY LOCATED IN A
EXISTING IMPERVIOUS AREA: 213
PLAIN? E YES
WATER:
SEWER:
CF PUA
CF PUA
COMMUNITY
CENTRAL 5E
SQ FT
SQ FT
YSTEM PRIVATE INELL CENTRAL h]EL L
COMMUNITY SYSTEM
(FOR OFFTCE USE o{Ly) REVISEO oATE 04111112
SETBACKS: F: LH: RH: B:
TIC PRIVATE SEPTIC
*** SEPARATE PERMITS EQUIRED FOR ELECT, I'IECH, PLB6, GAs EQUIP, PREFABS & INSERTS *,**
PAYMENT HETHOO:ECK (PAYABLE TO NHC )AMERICAN EXPRESS U T1C /VI5A tr DISCOVER
* * x * * * i. 1.1. 1. + +t r. * * * )i* *** * ******,k**i.1.1.*+***++***,*)*,*,***************)i+++++++++**************
I
DATE FLOOD: _ _ BFE+2ft=o i_ N s65_
TOTAL AREA SQ FT:
-
PHONE #: rla- i / r-rra:
EIiIAIL ADDRESS:
tr
RESIDENCE o" I aOOrrrOt TO EXTSTTNG RESTDENCE
**PLEASE CHECK AND ANSWER BELOW
I casx
l*l vrs [f] r'ro
Xl
r7-r()
rr'l
.I
1J
_o
o
6
te
ao
!
(J
KJq
fl
lr Trin:
-5El,lEE:
7"A t:
coxfient
City Inspeclion Requueo, q1S254'ti.'l
Stolb-i.'tl b
ld I'IANOVER COUNTY BUILDING PERMIT
APPI.I ITION ITP'',' N ESIDENTIAI
,r-ErsE A,tst,,ri Al"L orjEsTloxi lPprrcA0L! To YoIe pllorE(T
"ProJect n'esponslbtttty"
PIIONE ,,
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I'IIONE. l];
srr l!-c:ro: z8tl0 [
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pnone ut 782.Ziob
nIl.ocAlrofl
5r alort
lln-trXt
APPLICATIO}I
Numbet
(offl.. Ur6)
oorr, Q/a/ta,1xfffie _--.
It-tgt* $
APPLICiINT'5 il ilE r *
D[VII.OPER:I LLC.
Pn0lEcr ADDft!5S c*cI ry:
SUIJDIV15IONI fl-oct( ,l:
PfiOPE'iIY OI.NTRJS NA}I[:
oliNf[rS ADon[ss r I CITY;
CONIBACTON:t 9,,t_Ic[ sE ll:rl
AODNESS:CITY;
Fl't4lt ADDtfsS; $
Pnol[cT coflIACI PefiSoN:M qel K"tl <r
EXISTlN6 CONsTNUCTION:ALTENATION RI:NOVATI0N 6EiIENAI RTPAIIISL]
-,/B,i CoNsTRUCrroN: M IRE
Al.t TIIAT TIPPLY T0 VoIJR Pno:,tcr:EnsE afl!r.-(B
ArT 6AllA6[
suN8mt{.- _sF
6RE$ltl0usE s
TOTAI.
'|EATED
5Q FT:f, roml s QFT
Tot'Al- Pno:tECT C0ST&.$l-d), t 4l0.ooo
llEcllltllcAi. $,brk setngIs Any ElECTnlan!, PttlllBr|16
ff the proJect ls a Reloca
Is there Electrlcal Pot'rer
oh, is there a
i5 InlldlnS?
NNOPERry UsE / OCCUPANCY;SIII6LE TAIIITY
D':--s CRIPII0N 0r l'Anl( :
EI., ITPENVIOU-S ARIA:111
8-l-f oo,,r.rn,
lpproval:_-..- City
-5 I on elmee
-_
sF 6oo^3*SF
I rool
-
sr I sronnct strrD
-'sF
fl orcr
-
sn OTHIN:
[0 i sl'lElr
+$5
UNDER nooF: 21127 TorAL AREA sQ FT:
,l OF STonIEs: l'5
Done to the Accersory stru.tnrel ffv*, fl lo
titryfi e as Llne on the current sttel flver ' fl to
Sfv"' ffro _/
fJ ounrrx d***u*
I'
DlsctllM[n: lhs6by ctllll/ l]lal3, hb;nalbn , ' 6rrrcauor l! .!ftcl lnd !fl G, t wll.onrply vlli ]l. sl.l. t]ullrho codo ud tt o0l.r oppbtbl6 sl.l, !4d b.6l lavs
soC or.llnaue, ard ,.0!l!!o,li, Iha NHC s.flks! Csnlsr $rll b. m,&d ol my ch.ms! h $s lpf&vad pLn! sod !0tcllcrlbat ot ch.no o b .oa lrach r or
LlItv6cbr h brm6tor. ,',IOfIr Any lvork l{}o r,rs ./\ptyop,ldlo Pr@ll, v,,Il !e h vhl.lbn ol uo Nc SlaL trpTol500.00,.
OIiNETI/CONTBACTOR:t-D4(-SI6NAIURE r
**i+:r{++i+tt+t***ti!*'}*+
I.' IIIE P'IOPEIITY LOCATED IN
lPrlnt I.!.t ,,/r***t++,1+*++++;l+*++1+**+++r,.f+t++++*****1**+*,|++tt,l*{$}**,}**?Nt*'}---(FrooDPr.ArN? l-J vEs LII No
vf("fXISTING I4PEBVI0US
^SEAi
.{Q FT ToTAL ACn[s DISIURBEDi h,b?4
sq FI EXrST tlND DTSTUSBTMi prRt{rTr E yES
c PUA L] crxuurr SYsT[t]! rnrvare wrLr. !CFNTIIAL I,.,[tL
col1l4uliIry SYsTEtlPUAIrE,\]TNAL rrtc f] eRruare sretlc [-j
r+* s[PAflilE rFP.]'tJ ifQUInsD roR ELECT, l.lfcl,, Pt!6, 6As EryIP, PREFTIBS & I}|SERT.S +1r'
PAYfiENT ,.rETHoDr I cnsl rcl( (r,AYA0Lr. ro rrlr; lJarrrRrreu rxrnrss Irl I'tc./wsA Illnrscovrn
:! *+ *,I,1.*.i *:l* I * +i 'l't* f ***+,rr*t+*.|++1.+++++rj+++*,r++a,l,r,+++*+++rr+*+*+*+:l+***+++*+++,t:'*B+
(tor off]aa uJf oIrY)
^rusc0
DITE 6allr/12
sETBAcKsi r, * r.u, * nrr: .* o:*
orrr;.-l'?-l0rrLooo; _.- -- -*,X. grs+zft.
tl
PENIIIT FET;a'+
LOY ,,I: I
NEt,l nEsrtlEttcE or ! noortrol T0 ExrsTrNc RE.srsEircE
<(A,ali;O
*As-faoes 7Au Nq1
ANovER couNry BUTLDTNG pERMrr ?8"{G - l0 36
&
APPLICA|ION TYPE; RESIDENTIAL
EASE ANSWER ALL QUESTIONS APPLICABLE TO VOUR PRO]ECT
APPLICATION
Number
(Offic€ Use)
NEW
ro )e c t R e 5 p o n S b 1 1
/u,
,r/'
'/o tt'
z*:21@
APPLICANT'S NAJV]E:
DEVELOPER:
PRO]ECT ADDRESS:
SUBDIVISION:
PROPERTY OWNER, S
OI,JNER, S ADDRESS:
,o*r, R'15 oFFrcER:
app"ourt, DY- city
HONE *:
CITY://
elocr *Y
Itn--
PHoNE *: 23)'yy'//sr:lL ztpl.2(y'o3
ACCOUNT *:
SI i iUC- ZIP I.l
RE LOCATlON
E
ADDRESS:
EMAIL ADDRESS:
PRO]ECT CONTACT PTRSON:c
AL R ION fi-ae rovarron ! crrenar nrnarns
NEW coNsTRUcTIol: fl rnrcr r't h, RESfOENCE or ADDITION TO EXISTING RESIDENCE
LL THAT APPLY TO YOUR PRO]ECT:
! eoncu
-
sF
CONTRACTOR;,lv,
DESCR IPTI OF I{ORK t,l,
Ot^,NER/CONTRACTOR :
TOTAL HEATED 5Q FT:TOTAL 5Q FT UNDER ROOF:
TOTAL PROIECT COST (tess t o0 :
Is Any ELECTRICAL, PLUMBING or
If the project is a Relocatio
Is there Electrical Powen on
PROPERW USE / OCCUP x GLE FAMILY DUP LEXI
DET GARAGE
-
SF
POOL _ 5F
DECK SF
STORAGE SHED SF
SF /3FsOTHE R
# OF STORIES:
TOTAL AREA SQ FT:
aco\1
/zz,c
J_
/,a 2ua {/,rt
'r"t-t**t*
HAl,lIcAL work Being Done to the Accessory Stnucture? [ Ves p[ f,fo
T
,rJ O&
, is thene a Natural Gas Line on the Curnent Sitel I ves firuo
his Buildins? lF v"r I-'l r'ro
DISCLAIMER ereby cedliy lhal all informarion in applicaton is corect and all work willcomply wih tre State rng and allotler applicable SiaC and local laws
regulalions The NHC Develo t Servaces C€nbr willbe nolitud olany changes in fre ap d specifEations orchange in contactoror
conlraclor inbmadon "1lOTE: AnyWork lhe Appropriac Permitswillbe in Violatio^ ofthe NC Sta e and Subjec
TOhINHOUSE
00"'
( /^/0 SIGNATURE :
r t * * * *,*+ * I * ; i(*'*. + t + + t !* ** + f * rr * * * * * t+ t *,r * *,** * **,* *,6* rk t,t** )i *!t*,r **)t**rt !** !* x !t+ rt !t,t !* *!*)t* !*,* * * )*,i
IS TI{E PROPERW LOCATED IN A ELOODPLAIN ?YES Ero
AEXISTING IIiIPERVIOUS AREA I
NEW IT1PERVIOUS AREA:k SQ FT
SQ FT
TOTAL ACRES D
EXIST LAND DI
l
IsTuREED; n/f\ ----r---_
SIURBING PER IT: I I YESV
!a€
=-e,I
-.o
=D(Dl)C,
-E9?I\)(,I
!)
!.IATER:FPUA COMMUNT TY YSTEM PRIVATE I,JE LL
SEI^lER:CFPUA I celrrRar s TIC PRIVATE SEPTIC f] comuuurw svsrem
*** SEPARATE PERI{ITS
PAYMENT iIETHOD: U CASTT E HECK (pAyaBLE ro rurc1 flarll ncco-mr tr
EQUIRED FOR ELECT, MECH, PLBG, GAs EQU]P, PREFABS & INSERTS '***
MC,/VISA DISCOVER
*x,k* *** *x*)* * ,*,*,r *,r)r * ** i< !t,t *,t ****,rrr)*)*)*,***,*)t**,*x,**,t*,**t*****,*,t,t )*,r****
(FOR 0FFICE USE o!LY)
r,t.l/A LH, t{./a nH
E,vo
**)t*!t )t )k * * )*,* )* x*!t)k )k )* *)k )*+
REVISED DATE 04l11/12
:l.Va s:Nt/A
7 rrlr'l BFE+2ft=
-
I,l
PERMIT FEE: $
5 ETBACKS
oarr,t*/(n/rlz
Comment:
e b
!41
ns?urr\ 3.rqt
CL
,orr,46'2,
LOT #:
-
tr
fl arr canncr _ sF
! surnoom _ sF
I cnrrrnousr
EXISTING CONSTRUCTION; f]
**PLEASE CHECX AND ANSI{ER BELOU
PHONE #:
PHo E s: ^a?->f3f
tr
D CENTRAL h]EL L
CITY:
L]CEN5 E
C ITY:
F LOOD:
[rEI
oc,
e!
tl
CJt4,G
tat€
€oeo-
olrt
lr,(.,!.,G
*+PL
I,'ATER:
sElrER r'
ZoE;fr
Approval
confte t:
f tafv)
i:ity lnspection Requrreo, El tl-254.$.,1
olrNln'-5 ADDnESS:
EhI HI\NOVER COUNTY BUILDING PERMIT
APPLI CArI oN IYP6: R ESIDENTIA L
PLgrsE AliSt{E8 ALt- ot€sTIO[s Irp!]CA8!E r0 WUS ptolE(I
"ProJe(t lesponsibiut/'
Qrtto-311?
/b_ /09/
APPI.ICATTON
lilumber
APpl-tcANI.,S
DivELoPEtt i IL
.r:91 .r'lJ.-r 6
(0fftc. t,s6
tL
PHoNE #t
pnolEcT A00n[55:
SUBNIVI5IONI
PNOPERTY OUN[flJs .!AH[:-$l'5 ,Jru'o l-L{-
CITY:
Il.oc( $:
zrpt z.tttz
LICENSE I >t
LOT ,,:
P$Nr.'$t -/82"
sr: NLl:t: z el
sr: N!_czrP;?g(11
L
8 Itc ITYr
coflt ITACI0F:f.zrl I
loDn[55:t0 ClTY:
cllf4
lQo
l-"1 eoor-
-.
sr I sroRaee suED .."--.sr
DTCI(sij 0littR:5r
EI4AII- ADDRE5S;PBINE ltta(Z,7e(t6
PNO]ECT CONIACI PIRSON:PHoNt $. 7,f Z-Z-rd (
IflxrsltNo coNsTll,cTroN:ILTENAIION R IiNOVAI'IO 6[i]ERAI. REPAIRS RTLOCATION
NEI.I CONsTIUCTION:uft r N[]J n[srDENcE o" ff loornot r0 ExrsrrNc n[srDfii]cE
nsE c !c[nNI) trJsr,Jrn+5'I0ll Al.L TIiAT APfLY T0 Y0UR PRoIECTT
ATr 6lRr6[DET 6ARA6[ S':PORCH .34----srI
'r'oT^l. HTiATED SQ FT:2 qr ToT L SQ rI Ur,lDER lr0o': i 2927
Tol'Al, P[0]ECT C05TtLass :$000 ,l oF sToftIES: 1.5
rs Any ELECTnrci!-/ PLU Blil6
If the pro]ect Is a Beloc
Is thene Electrlcal Polrer
ol NIn/CoNrRACfoll r
NfI,, II4PENYIOI's AREA:
fl.lA
**+*++*t*+t++l+ta***:li,
rS THI PNOPEITY LOCATED III
EXIS IIM ft{PtflYfOUS AREAr
co|1r4u I
CEI'TRAt
T0TAI A,tE^ sq rtzL* lsq\wt1,000
l{EcllnlllcAl llotk Belng Done to the A(.sisory structurel I Ver lJ lo
oh, is there a NituraL Gas Line on the Curtent Slte? [Ves Ifo
thts Bulldirsr E{ves fl No
l
\j
PNOPEIITY UsL' / OCCUITINCY:5rN6L[ [Il,tIl.Y DUPLEX 5E
Dr-s(:nrPTI0N otr {,J0R(;
ot!cLAlrcti: I i3r€by ceni0 rlal 6ll Ll rvlll ty !./l!i 6taa E!l6li0 C{)nl 5t6L
6/ o'dto!n.'t.nd ,noul )ons Tho lltlc Oo SrrvLd! C.n&a vrll !. no lfl! d o, &ry ciaro0, h !b6 6pflrovdd llrnr rnij 6p.llc6lbns or ahsr0e h d:otar.br.a
.,N o[Ei d lv,lo Ia An[roprhb P nlll! rvli t o l, Vbl.i]on o, lho NC sta To i50000'h
SfCUnrUnn t
cr.r,ur fl
,** 5TPAfiATE l,' I
P^Y ENT IETlroD: lf CeSri
++*+i i.*,li:ljl +,i*+**t+ +*+*t*++i+++++1+f ++++**:i++
-.1 i orrrcrr,
;.- ctty i oatt;!-)-fu
Lt)
FLOODP!ATN?
*++ta++t++a*ll1*r*+++t+ +*,1*t++++t+rl*++l,i+++l$l+a*++fl vrs B1n
sQ Fr ror^L ncnEs DT5TURBED; @_0.C1
5Q FT EXr5T tirNo DT5TUBBTNG plnilllr El yfs
rnrrc I pRrvATE sEl,TIc I col,trutrw svsTrlr
flEQUIiED FOR ELECTT flECU, prn6, 615 EQUIP, plEfAsS & IIISERTS .1{
corc( (pAyABrE. ro rlc; fi arrrRrrm rxpnesl .Erc/vrsl fr orscovrn
(foi offl(a usE q,
SETBACKS: f
-i+++++*t:++:l++r+{.+*t N*+**1t+t+*+*trt4**:r*
tY) , ifvtsa' D^tE olltrtrz
, -* Lu'-{-- nr: t e :-L
FLoOD: .............._ , V BFE+Z{I
l,[RtlIT FEE I $
"i'./ ?
ll surnoor'r .,..-.--sr,
l] ene rmousr ''-_'---.--
d{
svsrefi flJnnmre r,rrLl I cEITrirlL r,rErr
NEt^l ANOVER COUNTY BUILDING PERMIT
APPLICATIO^| ryPf : RESIDENTIAL
EASE ANSWER ALT QUESTIONS APPIICABTE TO YOUR PRO]ECT
"Project Responsibility"
\ 6 -\o'a-t
APPLICATION
Number
(Office Use)
(!
APPLICANT,S NA,i1E
DEVELOPER:
PRO]ECT ADDRESS:
SUBDIVISION:
PROPERTY OWNER'S
OI{NER,5 ADDRESS:
CONTRACTO
ADDRESS :
EIiIAIL ADD
z.CZ
&
CITY:
CITY:
LICENSE *:
oorr, y'4; -,zG
PtroNE #: 7/O-5',Q -azrP;=5V"
P}ENE #:Zo--{/e4//8NAM
R:
ESS:
PRO]ECT CONTACT PERSON:
ATT GARAGE
GRE ENHOUS E
TOTAL HEATED 5Q FT
EXISTING IiIPERVIOUS AREA:
NEW II{PERVIOUS AREA:
I./ATER:reua ! cowurur
creua ! crrurna
* *,I SEPARATE PERI4
ETHoo: ! cos,r
CITY:
J
5F
ALL THAT APPLY TO YOUR PRO]ECT:
LI DET GARAGE
-
SF
5F
sr.zLGtp:ez/J'/
,A4rro&!/5 /
4/o{/aaz/8
. ao?< PHONE #:
PHONE #:
RE LOCATION
PORCH SF
I sronncr SHED _ sF
oTHE R i SF
U5E
BF E+2ft=
AL RATION A T ION GENERAL REPAIRS
NEW CONSTRUCTION:ER ECT RESIDENCE or ADDITION TO EXISTIN6 RESIDENCE
**PLEASE CHECK AND ANSWER BELOH
! surunoom _ sF PooL _ sF
DECK SF
OTAL SQ FT UNDER ^O* ,*{ TOTAL AREA
'q ", //5
&a.'9 # oF sroRrEs:fi, a"o
TOTAL PROIECT C05T rress L oq :
Is Any ELECTRICAL, PLUI4SING oT
If the project is a Relocati
Is there Electnical Power on
PROPERTY USE / OCCUPANCY:NGLE FA!1ILY DUP L
IS THE PROPERTY LOCATED IN A FLooDPLATN? Ll yEs It 1 t&
HANICAL Work Being Done to the Accessory Structure?
, is there a Natunal Gas Line on the Cunnent Site?tr Yes Ero_/.this Building? lzr-Ye s
T
Eto
ex I rowru
RIPTION OF I,/ORK:
R: lhe.ebyce ly hat allinbrmation rs applkaiion is cofiectaod att wl wih fie slare Buitdin! code alloher apprrcabte Siate and
and ordinances and regulalions. The NHC Cbvelop ni Sewices C€ner willbe notfied olanychanges in $re approved ptans and specificaiioos orchange in conlracbror
contactor inbrmaton "'NOTE Any ta lh wil th N C Slale Bldg Cod Subl€ci io supTo$00'
otalNE R/CoNTRACTOR :S I GNA T URE
** ** +,*,* * +,t* *,t *,t ** * * *,t * * )t ,t+ *,*** )****:tri:* +**,t **x* *x+ *** +**,t* *++* +,*x ** x:t * ++ *,*)r** *
SQ FT
5Q FT
svsrrm ! pRrvATE wELL fl cerurnal wrrr
nrrc ! pRrvATE sEprrc ! comuururw svsrem
TOTAL ACRES DISTURBED:
Exrsr LAND DrsruRBrNG rtnmrr: I ves [ ruo
L
ITS
SETBACKS: F:_ LH:_ RH:_ B:_
NTM
REQUIREO FOR ELECT, MECH, PL8G, GAS EQUIP, PREFABS & INSERTS *}*
cHEcK (payABLE ro runc; I nmrnrcAN ExpREss E r,rclvrso ! orscovrn
* )t)i* )* r* )* )**** )***)k x x*+ +** *x*x *+*,i,t* * xx* +****:*+ r**,t x* + r*,* * ,* )* + ,* +,* ,r x rt*
(FOR OFFICE USE ONLY) REvIsEo DATE o4l11l12
* *)k * * * * *)*)k * * * *rk * * )k )k * * * *,**
ZONE: _ 0F FICER:
Appnoval :_ City:
Corment:
DATF :_ FlooD' _
AVN
_ PERIIIT FEE: $
@
BLoCK #: LoT S: _
EXISTING CONSTRUCTION: E tr tr
lIa.lr
r(\
uo\'
ffi
APPLICATT'S M}tE:
\L-qqr
Oo'rL-31(d
DEVELOPER: GQ
PRO]ECT ADDRESS:
PROPERW OIIII,IER, S I,IAI,IE:
O.[{ER'S ADDRESS:
co{TRAcToR: GRA
ADDRESS:
I rrr eauce
-]
st
I surnoor'r _ sF
I enre uouse _ sF
TOTAL HEATED SQ FT:
TOTAL PROIECT COST Gess Ld) :
Is Any ELECTRICAL, PLt tiB$6 or
If the project is a Relocati
Is there Electnical Poh,er on
NEW ANOVER COUNTY BUILDING PERMIT
APPLICATI I rYPE: RESIDET{TIAL
AT{SI{ER ALL QUESTIOTIS APPLICABTE TO YUJR PROJECT
"Project Responsibility"
Ot)^)c.dr,\l nJC,
CITY:
e
PHONE *
LOT #: ?F*eZIP i
,,ro*, of?ro)8go-o€Bl
CITY: [l,J rtaa,ua 4zrt)sT: @zrP:
APP L I CATTOiI
l{rmber
(oFftce Use)
oarc,O3'28-)al (o
tgtd\31"7-.x1t Lb
slr&nprN'/6!
Plnw *:(q idZbT-3.lLlc
Plo E #: CiloYllJleb
?rT'
{R
<L
E #:
oU
tr DET GARAGE PORCH r{8 5F
! emr-- sr
sFn
tr STORAGE SHED
SIGNATURE:
r*rt )* *,* r*,* )t,l + ,* * * * )t *:3 r* )* )*,1 r* rt )* i*++,8**rt)* r* rh* )* ++**)t
SQ FT
SQ FT
c,LICENS
CITY:
EiIAIL ADDRESS:
PRO]ECT CO TACT PERSOITI:
EXISTIiIG CO STRUCTION: E AL narrol ! RENovATToN ! cerenar neenrns I RELocArroN
NEr{ coirsrRucrror, [t rntcr RESIDENCE o" ! mOrrrOt TO EXISTING RESIDET{CE
**PLEASE CHECK AND ANSWER EELOI,I LL THAT APPLY TO YOI,R PRO]ECT:
orcr 7{6 sF orHER:
5F
5F
TOTAL 5Q FT I'NDER Rq)F:)"t TOTAL AREA SQ FT:
aoerooo # OF STORIES:
tJork Being Done to the Accessory structure? [ V". [l Ho
, is there a Natural Gas Line on the Current Site? [Ves IUo
his Building? [ ves lXl to
d t,tr ("^A
clnlaclcr inbrmaton. '-NOTE: Any Work W/O fia AppropriaE Psrmi6will be h Violation of th€ NC
or change in conr&t)ror
Fines Up To $5O0.0e"
PROPERTY I.'SE / OCCUPA CY: E rNGLE FAMTLY I ouelex ! rowmousr
DESCRIPTION OF I{ORK:
DISCLAIiIER lhereby cerrit har alllnbrmation m applicaton b corect 6nd dl
'Nork
will comply witl $e Stare Euilding Code snd attoher apptbabte Stab and tocal tars
and ordinances and reqularions The NHC t Services CeflErwillb€ nodtud of ychanges in tle appro\i€d
)*:*,*,*,*,* * ++,t* * + *,* ++++ ++* **1t
IS THE PROPERry LOCATED IN A looonurrl I vrs
EXISTIT{G I PERWOTIS AREA:
IIEW IIiIPERVIOUS AREA:
EIrro
TOTAL ACRES DISTuRBED: ,O6 n ce.L
EXIST LAM) DISTURBI G PER IT: N vts J-.'I rc
IIATER:CFPUA I counulrw rem E enrvarr uell fl crrurnal welr
ff comm.rrrw svsrrm5EHER: E creun I cetrRlr rc [l enrvnre srerrc
*** SEPARATE PERIIITS
PAYTEI{T iETlrrO: E CASX E
EqJIRED FOR ELECT, I{ECH, PLBG, GAS EQUIP, PREFABS T IT6ERTS "Icx ( PAYABLE ro lxc; I arenrcAr ExpREss E rczvrso fl orscovrn)****,*:***,f !*,t,i*+)t*****)**,*)r)*,r ,r*,f )t** **,**,r* ** *)** ***)* )r** * ,t,t I ,t ,t,* * )*,* * +** *,r ****,r i * )k**,**,t**,*,**,r,**
(FOR OFFICE UsE ONLY)REVISED DAIE O4l11l12
ZoNE: _ OF FICER:
Approval:_ City:
Ccfltrr€nt:
SETBACKS: F:_ LH:_ RH:_ B:_
8F E+2ftoATE:_ FLoOD: _
A il
PERIIIT FEE:
'
SUBDIVISION:
o'r ER/coNTnAcToR:
BLOCN *:
NTU
lTHAIICAI
"t(\-!'' ffi
)r,ilralq"
\b-qqt
APPLICATIOI
urbeP
(offlrc usc)
o[etO3- 28 -fo)l6
, (9Js).3-k7:i! Au
ztptth9z9
*.4
NEW AITOVER COUNTY BUILDING PERI{IT
APPLIATTOTI TYPE.. RESIDENTIAL
IEASE AllsLE8 Att qrESrIOXS AptlrcAarE TO YqrR PlOlECr
'ProJect Rerponslblllty"
APPLICA'IT'S tIA E:R
DEVELOPER:
PRO]ECT ADORESS:
SUSDIVISIOI:e
PROPERTY O{'{ER'5 tIA}'E :
ONIER'S ADORESS:
conrrlcron, GRA c \-)
ADORESS:
EITAIL AODRESS:
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DESCRIPTIoN 0F l,loRx:
PRO]ECT C${TACT PERSOT{:
EXISTIIIG CO{STRUCTIOT{ :
EXISTIT{G I',IPERWOUS AREA :
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IiIPERVIOTE AREA:
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PROPERW IlsE / OCCUPAIGY:E INGLE FAMITY tr DtJP EX tr TOt4tiHOUS E
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DISoLAIMER lh6@by c€,tify itar allrntllrhation rn a3 applicario.6 co.lct.nd all work wil comply wrh t'e SEG Auitsing Code snd ri ohor spptrabro Slsb md toc6ttrws
alrd ordha.cs8 ani ,69ubrbn! Tho l\+lc Oels Sa Ni.€s C.nbr wil b€ noriH ol a.y .hrnges i. he €pp.oved
15 THE PROPERTY LOCATED ItI A looorurrl I ves Eno
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... STPAXAI E PER'lITS REQIJIRTO FOR TLECT, IITC}I, PI86, 6A5 Eq,'IP
PAY ETT ETHOD: E CISTT Ecx (payAsLE ro rrc1 [ orrnrca]l ExpREss
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Zol'lE: _ OFFICER:
Approval:_ Clty:
Conlent;
(FOR O'FI(E UsE OITLY) REVISTD DATE E4l11/12
SEfBAC(S: F:_ LH:_ RH:_ B:_
FLOOO: 8FE+2ft=DATE:
PERfiIT FEE:,i]f,-
SF OTHER:
TOTAL 5Q FT U'IDER Rq'F: