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HomeMy WebLinkAboutJULY 21 2016 BUILDING APPSL6-L7 34 APPLICATION l{umber (OFflce Use) APPLICANT'S *tr DATE: 06,/0?,/ 16DEVELOpER: PHONE f: 910-791_1196 PROIECT ADDRESS: 2?50 vance srreet Cffy, wil.inoton ZI1:2A412 ?ott"-1o3? Ptot'lE *: -z.qt&-.3.€.9,2_ ST: NC ZIP:.zlllL ST: Nc ZfP: 2840 6 s: LLLf-9.1:ll9!- *: -91!:!!!:!l3l- rs Elect Pouer on this Bulldlng EI Yes E ruo *'r** rs THrs A cHAI{6E oF occuPAt{cy usrr Bves [r€ **.** IF Yes, uhat was the PFevious Occupancy Tlpe? Business tlhat is the t{eu Occupancy Type? A-3 ARO{ DESIGN PROFESSIO{AL: cothran Harris Architecture PH: 910-793-3433 ilc RE6 S: 4290 ENGR DESIG PROFESSIOTI'IL: PH: NC REG *: DESCRIPTIoN OF WOR(: Rennovation includioo nechanical, Dlumbino, efectric and fire Drotection ls food or beve.ages prepared o. serv€d ln tlts *ruaureZ I Ve" fl No ls Th. Property Located ln The FlooOflanZ f] Ves [l ruo DISCLAIMEFI: I hereby certfy lhal all lrformatm ln thls appllcadon is conet and allwork will comply with lhe State Bulldlng Code and etl othEruppllcable State and local laws a^d ordlnanc€s and r€ouladons. The NHC DoveloDment Servlcas Conler wll b6 notlfed of srw chenoos ln lll€ rooroved olans and sDeciflcallons or change in cootraclor or conlraclor informallon. "'NOTE: Arry Woi( Psdormed w/O tha Approprlars Permlh u/ill b]s in Vldaton ot the NC Shle Bld€ Code andSubjecllo Fin€s Up To $500.00* owNER/coMRAcron:@ srcNAruREt Hlt? U24,,?r4-tH- cd rln AEHor or rlot Yo{ ErE l6qdtEd lo c![ rhs Nldqul Emllslon g8ndrdE lor Hazrdous Ar fulr,irrrE OESiMP) si (Sl0)rc7.5050 .t lc65r 10 dar! Ftor to tlc ddnotrilon of lrry rEdlly or hrlldlng. 666 Ab€aloc V,/6b Silr: l 9rlsw.6C.stris.nc.ud$U6bG.todshF.ttnt TOTAL PROJECT COST: $30, 000 BU|LD|NG HEtcHT: l!__ # OF UNITS: N/A TOTAL AREA SO FT: _1!32_ SQFTPERFLR:4133 # OF STORIES:;_ TOTALSQFTUNDERROOF: 4?33 # OF STRUCTURES: I # OF FLOORS:.!_ ACRES DISTURBED: o NEW IMPERVIOUS AREA N/A ExsT LAND olsruReNc penr,,rttt f-l vss [l ro SQ FT EXISTING IMPERVIOUS AREA N/A SO FT pRopERry usE: noFFtcE lnesraunmrr luencerurLe [eouc I aer lcoruoo oTHERgsg!]J_ res- ".SEPARATE PERMITS REOUIRED FOR ELECT, MECH, PLAG. GAS EOUIP, PREFABS S INSERTS '' PAYMENT MEfioD: flcesx f]cxecx leevealE To NHc) fieuenrcan exeness fr lamltsa E orscoven WATER: EGFPUA n COMMUNITY SYSTEM T-IWELL IIZONING USE GLASSIFICATION: sEwER: EicFpua frcerurml srnrtc fle-nvare seerrc 5-coruuuNtrysysrEM (FOR OFFICE USE ONLY) ZONE:OFFICER:SETBACKS: F:_LH:RH:_ B:Approval:_ Clty:_ DATE: FLOOD: Commentl BFE+2fl= NEW HANOVER COUNTY BUILDING PERI,{IT APPLICATIoN rrPE j CoITITIERCIAL PLEASE AllSl.rER ALL QUESIIONS APPLICABLE TO youR pRolEcr "project Responsibilit)/, l{A}lE i Ei.st Eruit Miqistries 2750 vance Street CITY:WiLrninqton OCCUPANT/BUSINESS M EI PROPERW OUINER'S OWNER'S ADDRESS: COI{TRACTOR: sancq Buitders Corp ADDRESS: po Box 3167 EIIAI L ADDRESS: terrv8s ancohomeq . com LICE SE f: 34520 CITY: wilminoron PROIECT CONTACT PERSOI,I: AelAr Kennon PHOI{E PIONE Exrsr coNsrRucrroN: E ALrERArron g *.*liIi'll'*''E^1111*'- a:prrRs fl REL(rArroN tf Rolocaiion, is there a Natural cas Line on the Einent Site? [ vF[ r.ro ts gt-DG spRtN-rLEReoz I ves I r.ro NEr{ coNsrRucrroN: f} erecr NE}, srRucrunE I rasr rnecx ! sxer-r- [ unrrr ! mo ro Exrsr srRucruRE ACCESSORY STRUCTURE: If UPFIT - The Shell Permit *: REV|SED DATE #1 1/12 N PERMIT FEE: $_ APPLICANT'S I NEI^J HAN0VER coUNTY BUILDING PERMIT dU applrcArroil rpF: SIGNS / BILLBoARDS Ugi pLE^sE pRr{T cL€ARLy & Alrsr.,ER ALL ouEsrroNs RECE'YED JUL 0120fi 24tt! - aot? ie-lqvs- APPL ICATIOT.I ltumber iu+r". u".1 'i"ii.i"i,'-'=, lqttf5. I bt SX.pf - _,_-- ci.,,fltt5urq1.rfr' oCCUPANT/EUSINESS NAIIE: J 2Mo) APPLICAI{T'5 NAI4E: DEVELOPER: CONTRACTOR: ADDRESS: PRO]ECT CONTACT PERSON; ZIP i pRopERry owruen,s nar,r_rt f$ffi1 or,lNER's ADDRESS: 14[6 S itr:s#o" +#iffiX,n..Th'n "o*' iy!r, rgb^ .:IT^'f ,.1:?#b- Sp- Fs qtu?3,.-441?- r[rJgzrr,lxltC I crw:[\tn4fgfui pHorE rr'NLrro?-&4lLo,ql}-31u4t4 o,Qto-3sZ-4fUbEl+D PHoNE (CHECK ALL THAT APPLY) llren I DESCRIPTION OF HORK: llltL'r rrl Stgi rs srcN(s) oN 0R oFF $ oH f'l orr DISCLAIMER: lbsrobr cdly lhal a[ hrormalim in lhb €rplicalion l! co(recl rnd.ltwork w toornrty wth t|e Stato Buitdn! 6nd ordlnenc.! lrd..rul.rioB. TtE NHC D.v.l.pmdr 6.ivlc Cdr.rwtt ho nodfi.d ot.ny ch.n€€. In th..ppr@.d conkacror lnlomation. "'NOTE: Any work P6tmlE will b. ln Violltion ol lh! NC Stare ot,NER/CONTRACTOR:SIGNATURE: *** 'i,t 'l * * **. *,i* r( * + * *,i* r * * * t,l * * a t*,i * 't,t* *,i* *:r ** t+* * i + *'r, r r,r, +* t t,r/+**,r * +** * + * *,* *,r. * * rr, **[,* ], * TYpE OF SrGN (s ) fj+nrrstoorle loounal E r,ranquer l-l cno:rcrror L lrmr A41ilsnrrere Y" ..,.,1lrr:r , :io*r^ #:i.Total Number of signs on this rroJect: 4 S5f', f/5sr6N l Helght: 1' sign Dlnenslons: 4' * at-- Totat se.FT. "+ sirn, [?K4 1-,,/l.itlsrcr: I"lul:' stsn Dtmenslons . 4L_ x 12,3', rot"t sq.FT. ,r tti", -41 ( SI6N 3 Height: Sign Dimensions: X Total SQ.FT. of Sign: 5I6N 4 Height: -_-_ Sign Dlmensions I ._-- - X __ Total SQ. FT. of Stgn: rorAl pRolEcr cosr: $q+)uDJ;) rs rHE pRopERTy LocArED rN n rLooorurt? fi ves E ,lo *+i SEPARATE PERI'IITS REQUIRED FOR ELECT, I,IECH, PLB6, 6A5 EqJIPJ PREFABS & II{SERTS '** paYr,rEr'rr rETHd)r lll casn fiJalecr leavmlr ro nrc; ll_l arenrcar exrnrss fl rc/vrsl fl orscoven ***r**!****t** * *'r* *****il* l* *il*+*,t**+* ** *-* *,t * r,:*'!'i**F'r**r*,rai*.* a+* r**** +, ***** +r*r*r**+r* zoNE,orr-t.oFFrcER: t+n, l'#,"j:ltf':l'df',.ifr1;'1,1'il1m" ""'' approvar: Df- cttyd.$rLt1\ oare,tr Fc,llu FLooD: -- - &*x_ irr]2r.= co.."nt,ffi0lrd nnll 5r4tn-ruI h rXgd a07, 8l {r, ul,li 4.ir' FEE: g-_ O lrlal \nLxtnld,;r atf:c'*xd.Si..rn 0.ruo0 8. .:SO1 kttslandL"n4 S,ry (tll-rr ncl Jo nxciid "3f n r lc} oml-rrl,rhr,re , (orv'\ City lnpeclion Requrreo, 9l&254-gr33 'o1- ?ttt b-7osB L6-L572 APPTI{ATIOfi ilumber (Offlce use) DATE: 5-?s-16 ZfP: ze*o: " PIGI{E PTCINE #: ITEhd HAIiIOVER COUfiTY BUILDING PERIIIIIT &ppt_Ic$Trs't rypE; CO!{IIIERCXAL prEeSE Ar{sliEft ALL qUEsTIOil5 AppLrcAELE IO yorjft pRolEcT ',project Rerponsibilitts, APPLXCAT{T'S ilAilE: iasper Ne'*man DEVELOPER: PROIECT ffiOEESS: 1114 R+ndqll parkroay surre +CITY: r,rilminsron 0{CUPtr{T/BUSIirIESS lUllrlE : oasis ssLooi PROPERTY frd{ER}S OhtrTER'S ATFRESS: lrlAllE: xorman Bra-Llgf ord CITY: witminqr,on f,: ?6t-5111 ST: Nc ZIP: 28493 ST;lS* ZIP: zB{03,, *: szo-arze f: 520-8129 3205 RandalL Pkwv CONTRACTOR I 5e'*r;a: B:cs ADO*ESS: :.02 old easr,wood Rd Unir Ba EilAfL AD$RESS : j nervmanai nemanlros . -qqm LICEIEE S: ?tela CITY: I,;i"lminqron PROIECT COi{TACT PERSOil: Jasper *ewman PI,IONE PIrcNE (Check tll That Apply) EXr$T COTiTSTRUC?IOX: E ALTERA?r€H{ [ ner$VarrOx f]_CeXenA- tf Falodon. is rhere a Natural Gas Line on the Current Srtee il Yes fi xo REPATRS f] nelOCrr:Ou ls BLrc SPRINKLERED? f] ves fflno r{Er{ cosrsrtucrrot{: f} rn;cr NEkr srnucruRE f}FAsr rRAc( [ sxrlr- f] unrrr f] m ro Exrsr srRrrcruRr SCCE5SCIfiY STfiUCTUEE: If UPFIT - The 5hel1 PErmit #: IF Yes, uiat ARCH DESIGSI *ii*t rs THrs A cltAt{GE oF oCCUpAgCy USE? flyE5 f]rp rr*** uasthePrev1ou30ccupancyTypel-tfiatisthel{eu0c€up3ncyTyp€} Pf,OFESSIOIIAL;.poogrieir Arehir.ecLure PH:3{3-1065 f'lc fiEG STRUCTURE$: # OF $TORIES: #OF FLOOR$: rs Elect Pouer on this Buitding f,l ves fJ uO h food r bcvragec prepryBd or e6n ad h tris sucilrer flves fJ ruo b The Proprty Located ln The Flmdilain? fi ves ff no DlSClllllER: I hereby certify that all rnforrnation in this apdicat,on is con€(x and all work,.yill comdy wilh the Stale Butlrling Code 8nd all otfier applicable Stfite and lacsl l€ws and ordinances and reoulations. Th€ Nl'lC DeveloofiEnt Services C€nter will be notified of any cfianoes in tre aooroved dans and sDecificatims S"#iffi Hfg1iffH SffiSr.gor iifornralion "'NorE. Any work Performed wno the Aepropriate eermns wFrlYdasor c{ tteHlate Blds code ar}d ENGft O€516I PROFESSIOIIAL :HC REG *: 7434 *: DESCRIPTIOI{ OF LIORK: r.wo new openinss in exiscinq wal1 io expand lnto exislins unil, no ocher wcrk OWNEH/CONTRACTOR: "'..per l.reu.*a..SIGNATURE: {et.[{rr} {Prklfirn.} r*d6: B€fidlEon nd*cstofie & €sbe6io6 rmwal pffinti appllcdon8 tr6 b be EUOmlt d uafu fI6 appffcadoo ,unr efltgln fubod6 fr n€il. you as,rasdrFd to dl Slc l{ational Emie$lm Stindards h l{a:ar}ous .tr Pdlut6nls {HESHAP) EB (S19}707-5S0 st l€6st 10 dayi frld io th€ d€mofition ol an,? ,aGlily or building. S€e Asbesros Web Site: r . . # TOTAL PROJECT COST: ,3r o.?o TOTALAREASA FT: - TOTAL SO FT UNDER ROOF: ACRES DISTURBED: #OF UNTTS: NEW IMPERVIOU$ AREA:SQ FT IXISTING IMPERVIOUSAREA $CI FT pnopERTyuse: fJorrEE ffREsrAunnr,n f]uencar.rnue fiJeouc f]err f]coNm orHER. EXST ljND D|STURBTNG pERMr?ilVeS [lNo WATEFL mCFPUA fICOMMUNTTYSYSTEM IWELL nZONTNGUSECT-ASiSTFTCATON; $EWER: mCFPUA flCenrnru-SEmc LIPRTVATESEPT|C IfCOMMUH|TYSySTEM FAvirErrrrMErfrotr: flcnsn f]cneo<(pAyA8r-ET0NHc) flnuenrcnND(PRE$$ flucnns* Dplscaven {FOR OFF}CE USEOilLn REYISED DATE {,/11I12 ZONE:-OFFICER:SETBACKS: F:_LH:_ RH:_ B:_ Appro,val:_ City:-DATE- FLO@:- BFE+2i= AVN Commsnt PHRMIT FEE; $ ffi ,Nyffi APPLICANT'S NAT'IE: DEVELOPER: NEW HANOVER COUNTY BUTLDING PERMIT APPLICAIION TyPE: RESIDENTIAL PLtASt At{Sr./ER ALt QUESTIO S ApptICABtt TO yot R pRolEcT "project Responsibility', ?o16-?onq iVW APPTICATION Number (office Use) PRO]ECT ADDRESS: SUBDIVISION: CONTRACTOR I ADDRESS i PROPERTY OWNER' S OI{NE R, S ADDRESS: LICENS E CITY i TOTAL AREA SQ FT: 2 structu.e? [ ver ffi rrro current site? [ves [l no ZONE : - OFFICER: Appnoval ;_ City: Comment: )**,i* rt,t** * ****,** ** )r * 5Q FT TOTAL ACRES DISTURBED: 5Q FT EXIST LAND DISTURBIiIG penurrr l-l vrs l--i Ho B F E+2ft= N PERMIT FEE: $ srtL!L-znt&k,*'98:231:466S NE}.' CONSTRUCTION: 1'PLEASE CHECX AI{D I arr camcr PHONE pRorEcr coNrAcr prnsoru, J-r,<-/ 6zD pHoNE f: ?/o-a9-#83 EXrSTriG CO STRUCTTON: f] rrrraarrot [t n$ovarrol Ieerrul neearRs I RELOCATTON E rnecr NEt"t REsTDENCE o" I aoorrton ro ExrsrrNc REsTDENcE ANs!{ER EELON AI,L THAT APPLY TO YOUR PRO]ECT: SF fl oer ennace sr f] concr _ sFI mor- - sr ! sronree srro SF 5F orHER: /8-O sF TOTAL SQ FT UNDER ROOF: ! surnoor.r - sF I enrrrHousr _ sF I orcx TOTAL HEATED SQ FT: # OF sTORIES: Is Any ELECTRICAL, PLUIIBING or lttCHrflICAL Hork Belng Done to the Ac(esso.y If the project is a Relocation, is there a Natural Gas Line on the rs there Electrical power on this Building? lFl ves l*l uo PROPERTY USE / OCCUPANCY;SINGLE FAI'4ILY DUP LEX TOWNHOU5E OF WOR(: ,r*)r* *****,i*** ++****r** **** *(Ii'Jl,lt1"J, * * *** ****,ir r * * )r:r +:r** ii rs rHE pRopERTy LocArED rN a rloooeurrl I ves l--l no w^rER: WFpuA E comr,tuNrry sysrEM E pRrvATE r^JELL ! crrurnar wrli sEwERt Z cFpuA I crurur srerrc f] pRrvATE sEprrc I communrrv svsrrm ,'I SEPAJIATE P€RMITS REQUIRTD FOR ELECT, I.1ECH, PLBG, GAS EQUIP, PREFABS 8INsTR'lS.1, pay}lENr r'rETHoD: !.os, I cr..t( (pAyaBLE ,o ,r.y [ *r^r.o,, .*..., tr ,.rrii^ [orscovrn (FoR OFfTCE USE d{rY) SETBACKS: F: LH: RH: B: REVISE0 DATE 04l11/ 1? TOTAL PROIECT COST rr.ess Lort : $ H, C.tXt,<rC, EXISTING IIIPERVIOUS AREA: NEI,J IiIPERVIoUS AREA: DATE:F LOOD: DATE : PHONE S: pnmt e*L'fl3;L @_ sr: ,lzzrP ta*1c? lotb- 7o9/ NEhr HAN,,ER couNry BUTLDTNG ,r*rrle? u" lkqg APPLICAII I rYPE.. SIGI{S / BrLLBOARDS PLTASE -PRINT CLEARLY & AI{5I{ER ALL QUESTIOI{S"Project Responsibility- APPLICATIOI{ I{umber tEI"r*l- APPLICANT'S AfiE: OEVELOPER: PROJECT ADDRESS: OCCUPAIIT/BU5II{ESS NAJiJE: O}[{ER'S. ADDRESS: ADDRESS: 56 EIIIAIL ADDRESS: PRO]ECT CONTACT PERSON: oarc, bP+ltt, ztP: ffi::ll]^:H::.s t{anE: TES l+otd,^t ( LL( pK) E s:crw: l^ lll"t-, -laa st:AlLztP: ?q d:.d7 LICE SE *: l'l . .':) l^:-lFtr= sr vtN.*: #42\ Pl{o E *z nto.H|-i2dl (FOR OFFTCE U5€ ot{LY) SETBACKS: F: REVISED DAIE 3/]O/T2LH: RH: B: BF E+2ft= Ct."s-,k- LJttsc,--.-.--.-_Ptro E *: qn-?67.61?L (CHECK ALL THAT APPLY)ffintcr l-.1 nlrrn ! arnarn ! eur-anir I cnarce our DESCRIPTIOT{ OF l{)Rf : p-r<_c_ I tt\ .l:,--" - r--_ -t - -^1_-_ .- -,) trtl rs srcr(s) oN oR oFF pRErrrrsEs? (* D o+ ::::fs: ::jY::P^-"xt "l']gi:lT ,1 ,1," apprijarion is coned a'd all work wi[ comdy wiur rhe srae Euirdins code and a orher appricaue srare and rocar raws ::::j:::l"fflL:*i*:1";.i:.i,l11Tl1T5i:,::N.icescen*.'I,irrbenouri"d;il"#;il;;;;;;;;;;;#;:iffiffi:'"i5ffi"'f:';HT:lco.tactor intdma$on. ",NOTE: Any Wo.k perbrmed *,O rhe Appropiat. perm* *ilt ;l;iioiil; ;; ,r;!;;il; or{rrrER/co rRAcron, C_\<rL \-^)r\s.-.^_ srcirAruRE: (P.int tiar€) * *:f:i:a l. *:t:t * *,t t,a * *:*,* * *,*:* + ** *+ ** * +,1*,**a+,* )*:. *,1,t,*:* *,t * *:* *,.* r** + *:*:* a rt,t,i:a +,t,a *:t +*, *:t,t+,* )r +:t.t,*,t:f,t,. * wPE OF SrG[(s) ffie sranorlc (Ground )LI SHINGL E MARQIJE E hALL signs on PRO]ECTION ctitoPY Project: n noor E orxrn Total Number of this srGN 1 tleight: 5 ('( sign Dimensions, 72" x 56 q Tota1 sQ.FT. of sign: l?-d SIGN 2 Height: Sign Dimensions: X_ Total SQ.FT. of Sign: srGN 3 Height: sign Dimensions, - x _ Totar SQ.FT. of sign:SIGN 4 Height: Sign Dimensions: _ X_ Total SQ.FT. of Sign: TOTAL PROIECT COST: $ 55oo ' oo rs rHE pRopERTy LocATED rN A FrooopLArlt I ves KIruo *{. SEPARATE PERI'IITS REQUIREO FOR ELECT, EO{, PLBG, GAS EelJIp, PREFABS & I{SERTS ,r** PAYI,IENT IETHCD: It*****+.*'lt )a,t****r.*+*****,t**+**)t:t***++:t,*,t:i,t*,t****,*)*)*+*:l,t,i:t ):,t,***)*+**)a****** jt+***)i:i:*:i)*At*** I casx I criecr (payaBLE ro r{rc) [ lrrearcar exenrss E nclvrsa I orscovrn ZONE: Approval: Comment: OFFICER: _ City:_ DATE: FLOOD: oJ*nr, ,.r' $ k)0. dD CONTRACTOR: APPLICATION TYPE: SIG]IIS ,/ BILLBOARDS PLEASE PRIIIT CLEARLY & ANS}JER ALL QUESTIOT,E 'Project Responsibility" APPLICANT'S DEVELOPER: PRO]ECT ADDRESS: OCCUPANT/BUSINESS PROPERTY O[{NER'S OttlNER'S ADDRESS: ao,Y^rta- ?-<-r.r-'-'. CIw: ( .f, N L,!.^ *1 ll3. zIP: NAIttE: NAitE : CITY: (--^^LICE SE *: ADDRES5: <("t+ n Carof i,-*- 6a"-ct ful I crw: Llt\e-.- -^., {-.-,.-. sT'/./LztP:. -<-f 4l? EIiiAIL ADORESS:PtorE *: qlo-7qU-kZQ3 Ptpt{E s: ?tc:'367 -A1l(, (CHECK ALL THAT APPLY) ALTER E REPAIR E ENLARGE E CHANGE OUT PRO]ECT CONTACT DESCRIPTION OF }.IORK: SIGN 2 Height: SIGN 3 Height: SIGN 4 Height: ,ffne rsraHorlc (Ground )-E sHruer-r I,TARQUE E l.lALL E noorI orxrn Approval: coflment: t{ PERI.tIT 74tb- 1D97 APPLICATIOI{ Numb€r (offi.. U*) D^r* 6lL7ll6 Pro E *: ato-]9Q'EZQJ PIONE *: X bot't Ranct- D c ?4tb- -/D?7 NEW HANovER couNry BUTLDTNG pERmrr Pgttb-1811 {r*r. IS SICN(S) ON OR OFF PRE}IISES? and ordinances and regulations. The NHC Developdent SeNices Cenierwill be noiified ofany changes in lhe approved plans and specifications orchange in contaclor or o{NER/cor{TRAcToR: /?\.}s-L L-J$s..,'-'-' 5rG[ATURE: (Prrnt [a,le) )t l.t rt +:* r.,* ** + ** X. * *,i +,t + +* r. r. t )*,* + +,1++,* * * )t,t * +rt *,*,1.,t * +* l. * r. *,i + *+*****rt'|****+++'l )i * ']* +:4,. * '* *:*:l * *,. 't * t:. TYPE OF SIGN(S) Total Numben of Signs on this PRO] ECTION CANOPY Project: srGN 1 Height: 6at' si'n Dimensions, 6o* x 5q * Totar se.FT. of sign: ll- E( !il sisn Dimensions: x Total SQ.FT. of sign: sign Dimensions: - x- Total SQ.FT. of sign: sign Dimensions:x _ Total SQ.FT. of siSn: T9TAL pROJECT COS1: $ \L(?O (2'ofS rHt PROPERTY LOCATED IN A FL@DPLAIH? [ Ves fi-ruo SEPARATE PER',IITS REQUIRED FOR ELECT, I{ECH, PLBG, GAS EQUIP, PREFABS & IflSERTS *** pAy Erfi I1ErHoo: E crcx I orecr (pAyaBLE ro flHc) [ otenrctr rxnness E nclrrsr f] orscoven +,t + )t )t * * +,t *:*,*,* N,** )t,*:*)t,l*l*,i***,**,*,i,t* + rt {.:t,* )*,8,} ,},t + * )* * * )8,} ++)**:*'*'* )t{'***'} *+*++*)*)*)*'* ** * + * * '} 't* '* rt * rt:* ZONE:OFFICER: (FoR ofFrcE usE oNtY) SETBACKS: F:- LH:- iEVISED OATE 3/30/12 RH :_ B:_ - City:- DATE:- FLOOD:BFE+2ft= ,rrrr-@ sr:AJC zrP:<,63oJ f \ a-^s-\r-L--) r\g-^- Vrt'i:r ffi ri,l W, 1.,\i it \ol t'r 5 u n,ts NEW HANOVER COUNTY APPLICATION TYPE: BUILDING PERMIT DEMOLITION tottoi{o t APPLICATION Nunber rirrr." u*l ztP t2s!{ta SI :AzL z]P: )8<1"3 LICENSE #: K.IN,I ACCOUNT fIrrv, ly'it.- srr4zL;ag-"o3 PLEAST PRINT CLEARIY & ANSWER ALL QUESIIOI]S"Project Responsibility" PRO]ECT ADDRESS: SUBDIVISION: PROPERTY OI,'INER' 5 OIdNERJ S ADDRESS: CONTRACTOR : ADDRESS: Ei4AIL ADDRESS: PRO]ECT CONTACT PHONE PHONE *: )r1 &jo *: 5Tl,9r9ct B F E+2ft= DESCRIPTION OF hIORK: 'y'l"vr,rtt - (!h.t lyp€ of Building Oo You lant To OemolishT)Norlt 4f .** 6nd ordinancss and regulallons. The NHC Developmeni Services Cenier will be nolified ol any changes in lhe approved plans and specilicanons or change inconraclor o. conrraclor informallon. "'NOTE:Any Work Performed WO lh€ Approprial€ Permits will be in Violalron ofthe NC Slare Eldg Code and Subjecl ro Frnes UpTo $500.00"' Ot\,NER/CONTRACTOR:,!. ilttr <-- SIGNATURE: / + x* * *)** *:t * I **,t *,** * **,*,**,* )* * )* * + j* * * ,t,* )*,t * !r,* *,t )t * )t,*)t *,t * * *,* !i* )t,r )r )* )r * * * *,r r** *,t * *,* * * * *,** * * )i *,* * r* )* * * * * rs THE pRolEcr: E RrsrorNrral /[t corurRcrnr TorAL AcREs DrsruRBED: /1-_.7-__ TOTAL PROIECT CoST lress r.or1i S 6. Sto ExrsrrNc LAND DrsruRBrNc pERMrr? n ves p rc DoEs rHIs srRUcruRE oR BUTLDTNG coNrArN AsBEsrosl Ivrs SHo rs rHERE A NATURAL cAs LrNE coNNEcrED To rHrs BUrLDrNcl I ves fl rc rs rHERE ELEcTRTcAL powER oN THrs BUTLDTNG? pvrs [ rc WATER: IXCFPUA sEl,rER: lFi cFPUA coMMUNrrY svsrer,r I PRTvATE wELL CENTRAL sEprrc f] enrvare srerrc ! coMr4uNrry sysrEr4 Note: The National Emission Slandards for Hazardous Air Pollulants (NESHAP) Regulations Require that you contact thern at (919)707,5950 at leasr 10 days prior to lhe demolition of any facilily or building, whelher lhe facility or building was lound to conlain Asbestos or not Demoliiion notificalions & asbestos removal permil applications are lo be slbmitted using the application form (DHl"lS-3768). This form can be found on lhe web site shown below. Note: Obtaaning a demolition permit from lhe NHC lnspeclions Dept. does NOT salisly or meet the noliiication requirements ol the HHCU (Health Hazards Control Unit). 'Keep in mind that an asbeslos survey is required by a NC accredited asbeslos inspeclor prior to any renovation or demolitjon of a facility. Please see the Asbestos Web Sile hlto:llwww eoislale nc uslep/asbesLos/ahmp html pAyr'rEr,rr i,lErHoD: flcasx I cxrcx (PAYAELE ro Mrc) flaru rccourr I msrencrno I vrsr )t** ri+ri *:t,**** * *)t,t** * *,t* *,t )* )*,* )* )* * *,t ,* :* *,t *,f ,t )*,i *,t*,t * *,* * * * )*:i,l)t )* ** * rt )** )t )i *+ !t* )* )* **)t,**,*)* * )* *+*,t)t* * * )i trtr ZONE :OFFICER: (FoR oFfr(E u5E oNLY) SETBACKS: F :_ LH:_ RH:_B : FLOOD:r I --"'.PERMTTFEE:*l0D- Approval:City:DATE: P<r Drru.r bn\ow*)-X LOT $: *: Comment: