MARCH 2 2018 BUILD APP!
:,
NEW HANOVER COUNTY BUITDING PERMlT
APPLICAT ION ryPE.. RESIOENTIAT
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT
"Proiect Responsibilit/'
actS -a't 8tr
tg=so)
Application
Number
(office use)
APPLICANT'S NAM e, 'l ,U, L ,, "*t ii L Dale L -
PROJECT ADDRESS:.tZa R
LOT T:suBDlvrsroN:
PROPERW OWNER'S NAME:at+1 ,t t2-PHONE #3\o.2e3.5?77
CrfY: td'.\ rrr',n..{ot! zrP EWOWNER,S ADDRESS , LrZO 'Tour\r s
rtCo'aSt
Po.lg --_-\,
BLDG uCEt{SE S:CONTRACTOR 5 o4<
ADDRESS:tJi.lnior\^
cnoncY 9/o .
sr: N(
49s.
zptZel+63t/r6"CITY
rt I
PRO.|ECT CONTACT PERSON ll Px lto
EXISTING CONSTRUCTION: D Alteration n Renovation E General Repairs
NEW CONSTRUCTION: ! Erect New Residence dlddition to Existing Residence E Relocation
**.PLEASE CHECK AND ANSWER ALT THAT APPLY TO YOUR PRolECTr * r
E Det Garage (SF)tr Porch (SF)D Att Garage (5F)-
E Sunroom (SF)
-
! Greenhouse (SF)-
dPool (sF)
n Deck (sF)
! Storage Shed (5F)-
! other (5F)
6s-tr.C,6t6o.I=5cr<De.eeg
cEo
ls the proposed work changing the existing footprint? fl yes E/tlo
TOTAT 5q FT UNDER ROOF Vot proposed work\ lleatedl Unheated:
rorALpRoJEcrcosrltesstotl:5 z laan LIK
ls the proposed work changing the number of bedrooms? E yes dllo /
lsanyElectrical,PlumbingorMechanicalworkbeingdonetotheAccessoryStructureMYesENo
lf the project is a Relocation, istherea NaturalGas Line on the cu rrent site? E Yes Eh(o
ls there Electrical Power on this Bu ilding? dves E ttto
?OFEB IS 1 Pti
Property Use/ Occupancy:
Description of Work:
dsi Family EA/ew t '7or/Du hou
DISCIA|MER: thereby certrfy that allthe information in this applicalion is corect and allwork willcomply with the State Buildint Code end allother
la\,! and ordinances and regulations. The NHC Development Services Center will be notified oI anychanges in the approved plans and specifications
information. ...NOTI: Any work performed without the appropriate permil5 will be in violation of the NC State BldB Code and 5ubj€ct to fines uP to
ike (uitl"
appli.able State and local
or chante in contractor
Owner/Contractor:
"Licensed Quolilie/'
Signature
ls the property located in a floodplain? O t"X
Existing lmpervious Area:
-
Sq Ft
New lmpervious Areai Sq Ft Existing Land Disturbing Permit; E Yes E No
WATER: ts CFPUA El community system E) Private well E central well E lqua
SEWE irFPUA E System E Private septic E central septic [1 equa
Zone:officer:r )f tr*t 1nx1 )\ 1s1 r}l
Approval:city\tN--Date:)..Flood: (A)(v)(N) Xare
rL s,-r L\
Print Nom
N
Comment:
IrQrr ill -r ,n\n'- ftito.h I
i$
NL J 7"rf'qDermit Fee:s
15,a
o
zlp, 28lto9
EMAIL ADDRESS:
pnonz, 9lo . ?!o1, l-T8l
tr
Total Acres Disturbedr
-
M 1.:
APPLICANT'
DEVELOPER:
S l,lAilE : McKintey auttcling Corporal ion
PRO]ECI A ;6?52 Rock s Roa
OCCUPAI'JT/EUSINESS NAIIE : chenrcex
PR0PERTY OliNER'S NAITiE I Mayfaire 111, LLC
O}.INER, S ADDRESS:328 Ol.de Point Loop CITY: H3mpsss36
CONTRACTOR: McNinley Building Corporat ion - LICET'ISE f::oege
ADDRESS: 3go? peachtree Ave., suire 2oo ITY: wilmingron . ST: Ng ZIP: 26a63
PHONE S:9to_J95_6035
. DATE:2-14-18
PHONE T:
ZIP:2B4os
- PHONE fi: sro-264-4144
5T: Nq ZIPl2saa3
.c
EIIIAI L : bl i skomck inl eybui lding, com
PRO]ECT C0 TACT PERSON: Brandon Lisk . PH0tlE t: eto-395-8036
EXIST CONSTRUCTION:
lf Relocation, is th6re a NaturalGas Lln€ on lhe
No
NEUI CONSTRUCTION:
GENERAL REPAIRS TI RELOCATION
Ii. No rs BLDG spFlftKLEREDf_ yosli_
lxo0
AT TE RtrT ION
(Che(t( All
RENOVATION
rrenr site? r-
Ih.t apPty)
esu
ERECT NEl., STRUCTURE fl FAST TRACK n sHELt UPFrT n ADD TO EXrST STRUCTURE
ACCESSORY STRUCTURE:
++.t* r5 THJS A CHAr,r6E 0F oCCUPANCY USE'r yES F. O '....IF Yes, what i{as the P.evlous O(cupancy Typet - t{hat ls the ileH Occupancy
Tvoe?ARCTI DESI6TI PROFESSIOIIAL :
If UPFIT - The Shell Permit : 13-523s
€NGR DESIGII PRoFE5sIoNAL :-
0ESCRIPTION 0F trORK: uiii!-lIr...rion ro exrslrrng oftice s
Is Elect Powen on thls Euilding ff. Yes f No
PH
PH
NC REG S;
NC REG r:-
p."" ,40, rJ,t ( {}. (2) (t(\.:,,. s.t 1;i;. I /it: I
ls food or bovsrages ploparsd or served ln this structure?l-. Yeslf . No ls Ths Propsrty Locar€d ln The Ftoodptainf _ ye{i_
N8CLAIMERi lhereby cenify matall inlormation h allother spplicablo Staro t,and localla$s and ordi
tY,'
,c \,..;.t\
Suchanbjecl9e in contraclorFinos up To
nancei and regulations The
0{ conlraatot ihlomatim. "'$m 00'.,
rhis appllcatlon is correct and altwort will comDly with lho Srate Burldino Code and
il3?r?fl"J",effi";ff#lf::9,98i1$#iS:'S'r.J,""11,"*"r,"9."';i.liilf#ii,,ig plans and aoeoftcauonsNC Srate Bldg Codo and
OWNER/CONTRACTORi srandon r,i sk SIGNATURE:
CENTRAL SEPTIC
PA'iAII] PERMITS IIFOIJIRED FOR ELECI, MECH. PTAG, (nAS EQUIP. PRIfABS & II.ISEII IS
Z-
(Ou.ldis4
aonl'n AsbGslos or nol You rro .oqurod to c5ll tha Narion.l Emi*iion srrnd.ds ror Hazardo{rs Ar Po{urant. (NESHAP) ar (919)70r-5950 6t le.3t 10 days p.ior to u10
domoli on olsny lacil;ly or building. Soo A5b!aO! Wob S.Li hxp //vJ*w.6pi.srii\e. nc.u geprasbesros/ahmp-hrrnl
IOTAL PROJECT COST: 25, ooo BUILDING HEIGHT f OF UNITS:
TOTAL AREA SQ FT : 2 , ?51 SO FT PER FLR
TOTAL SQ FT UNDER ROOF:f OF STRUCTURES
ACRES DISTURBED: NA EXST LAND OTSTUBBTNG pERMtr? r yES Jr NO
NEW IMPERVIOUS AREArra SQ FT EXISTING IMPERVIOUS AREA: N^SO FT
PROPERTY USE OFFICE RESTAURANT MERCANTILE EDU APT CONOO OTHEI
COMMUNITY SYSTEM ICATIONWATER:
SEWER:
SYSTEM
CFPUA
CFPUA
''' sF
T.1 WELL
Itrlvere seprtc
T''] ZONING USE CLASSIF
?ouurururrv
PAYMENT METHOD: r CASH fi. CneCX leevneLE TO NHC) r_ AMERTCAN EXPRESS r_ MCA/|SA r_ DISCOVER
(FOR OFFICE USE ON
zoNE:lAX oF
Approval: ft-
FICER '!;/A Ln rrlA RH-N/Lv B.dA-
BFE+2ft,
SETBACKS: F
N
ru PERi'IT FEE: :Comment
city: lqn DATE FLOOD
Oil inmeciion Reourreo, 9lS25,i-0m)
2otSv Zlcl1
NEW HANoVER couNTy BUTLDTNG qERMTTWZ {S q35
APPLICATION ryPE I COIIIII1ERCIAL
pr.EAsE Axslr€R ALL Qu.sTro*s applrcAalE ro yo,R pRoJ€cT aF-p'LTffirIo-N
..pro1ect ResponslbultF ,#i::::.,
$i IminqtonSul te
f OF STORIES:
r OF FLOORS:
\k\
Ydt;
---lar\l1.
/^\//c/W+W35
to r$-.)19!
APFTIEIT--Io{
Number
(Office Use)
- DATE :
!;i
NEW HANOVER COUNTY BUILDING PERMIT
APP LICA| ION TYPE: COII4IYIERCIAL
PLEASE ANSWER ALT QUESTIONS APPTICABLE TO YOUR PRO]ECT
"Pro ject Responsibility"
APPLICANT',S MltE i rqcxrntey Building CorporaLion
DEVELOPER:
PRO]ECT AD
OCCUPANT/B USINESS NAiIE: Chemrex
PROPERTY Ot,lNER'S t{A}tE: Mayfai1e 111, LLc
OWNER'S ADDRESS:328 olde point Loop - CITY: H6npssga4
CONTRACTOR: McKinley Buildj.ng corporar ion _ LICENSE #: :oese
ADDRESS: 380? peachrree Ave., Suite 2OO CITY: pil6ipgsen
EI'IAIL ADDRESS: bt i sk@mckinl eybur lding. com
lI t tto
ALT E &rro,
l.
2-14-18
PHONE *:
: 5?52 Rock spring Roa Suite 130 ; Wilmington ZlPi2a4as
- PHOIIE #: sta -284- 4344
ST:Ns ZIP:2sa63
-PHONE *:910-39s 5035
- PHONE S: 910-3e5-5035
(Check All rhat Apply)
EXIST CONSTRUCTION:RENOVATION
lf Relocation, is there a Natural Gas Line on the ,rrent Site?r es
GENERAL REPAIRS
li_ tto rs BLDG s
No
NEId CONSTRUCTION:ERECT NEW STRUCTURE FAST TRACK
trPRIN
RELOCATION
KLEREDf _ Yesli_
SHELL UPFIT ADD TO EXIST STRUCTURE
ACCESSORY STRUCTURE:
If UPFIT - The SheII Penmit #: rl-6218 Is E1ect Pouer on this Building li. Yes f N0
***r.+ Is THIS A CHANGE OF OCCUpAl,lCy USE? r yES li. I,lO *****
IF Yes, what was the Previous Occupancy Type? _ what is the New Occupancy
IX8fi 'rrtrun PRoFEssr.NAL :. PH:NC REG #:
NC REG #:EN6R OESIGN PROFESSIONAL:-PH:
DESCRIPTION OF WORK: M,;;;-;l;;; ion ro exisiEins otfice space ,{\a o t,Jrtt b..l.tb" ?wls food or beverages prepared or served in this structure?f . vesli- No ls The Property Located ln The Floodplainf - Yefr_*oaV4q*(
lag4
..|\NoDISCLAIMER: I hereby ceruly lhar allrnformation
and locallaws and ordinances and Iegulalions. T
or chanoe in contraclor or contractor iiformalion.SubFctlo Fines Up To $500.00"'
WATER
SEWER
SYSTEM
CFPUA
CFPUA
in this application is correct and all work will comply with the State Building Code and all other applicable State
he NHC Develooment Servrces
TE: Any Work Perlormed w/O the Appropriate
of anv chanoes in lhe aooroved olans and
Permrls will6'e rn Violatroi ot rheNC Stare
soecillcations
Bldg Code and
Center will be notified.,No
OWNER/CONTRACTOR: eranaon risr SIGNATURE
(Oualiriel)
contain Asbestos or nor. You are required to call the Nalional Emission Standards lor Hazardous Ajr Pollutants (NESHAP) at (919)707-5950 al least 10 days prior to the
demolition oI any facility or building. See Asbeslos Web Site: hltp://w],tw.epi.$rle.nc.us/epi/asbestodahmp.himl
TOTAL PROJECT COST: 25, OOO # OF UNITS
TOTAL AREA SQ FT : 2 ,76I
TOTAL SQ FT UNDER ROOF
ACRES DISTURBED: NA
NEW IIVIPERVlOUS AREA: NA
BUILDING HEIGHT:
SQ FT PER FLR:
# OF STRUCTURES
EXST LAND DISTURBING PERMIT? T YES J,- NO
SQ FT EXISTING IMPERVIOUS AREA: NA
CONDO OTHET
# OF STORIES
# OF FLOORS]
SO FT
PAYIiIENT IVIETHOD f cASH li. cnecx lenvnBlE To NHc) f-AMERIcAN EXPRESS t-- r',tcnrrse l-- olscovER
ZONE OFFICER
iFOR OFFICE USE ONLY)
SETBACKS: F:B
Approval:- City:- DATE- FLOOD BFE+2ft
.'SEPARATE PERMITS REQUIRED FOR ELECT, MECH, PIBG. GAS EOUIP, PREFABS & INSERTS
Comment
OZ lcf,.e po ff{tl^
LH RH
N
PERMIT FEE: I
PROIECT CONTACT PERSON: Brandon Lisk
sr:ffi-2TFTlilll-
pRopERry usE: EoFFrcE ! nesraunenr flrr,rencrrrtlel-J EDUoTI APr[
E
@
TI COMMUNITY SYSTEM T] WELL flrZONING USE CLASSIFICATION
fl cer.rrRnr seerc f] rHvArE sEPrtc E-coMtvtuNlw
Prf
lpt@
g-ze7
N ?'xiqJ uf
v
N
NEW HANOVER COI,,NTY BUILDING PERMIT
APPLICA|IAJ n/pf : COiIIIERCIAL
ptEAst arisllllR Alt gjEsrtoits apptlcaSLt .ro ycuR proJtc_r,.proj€ct R€sponslbility,,
",,
(
aFFIi-eATmr{
l{uDber
(Offi(c Ur.)
rc: )-/1 r/2.19
flo S 2063 t5-zrt:@t
s2 t9rP,2go/,
zrp, Z3?/i
q lu.< z<xB t t
APPLICAI{T'S IIAI,IE:
DEVELOPER: 6E
PRO] ECT
occuPA r/8[6IitEsS ilAttE :
PROPERTY Ohi{ER'5 tIA'tE :/Ar,, knT Lt<
Pt{xE t
AJ AtC7I
O {ER's ADDRESS I 2 OL'
Pllo E *
s
CO TRACTOR:
AIDRESS:
'7-D r",{,'o
/./ /L /Pe?,\)
. LICETISE *:nCITY;
ION GENERAL RE LOCATI
ADD TO
Is Elect Pod€r on this BuildinS
ZEilArt aDDE
PRO]ECI COTJIAC TP
EXIST CONS ALTERATION
lf Relocation.
No
NEI,J COIIS
accEssoR
If UPfIT - Ihe Shclt pe.nit fl:
s
*
a
P
PHOt{E
TRUCIIO : Iis lhere a Nalural Gas Line on lhe
T-'l fiEitovATUCurrenl Site?r trYesl-i Ho rs
PAIRS TI RE
a.oc s#"*,EREDT vesf-;
xISr sTntrnnEl*y:]:::.:_Er.rcr r{Er{ srRucruRE f}FAsr rRAcxY STRUCTUTE:D sHErL f] upFrr E E
DESIG}I PROFESSIO}IAL:
EI{6R DESIGT{ PROFESSIO AL
DESCRIPTION OF I.'OR(:
a€-
rhis strucrure?f vesflf, No ts The p.o
IF Yes, r.hat ras the p
Infi?
..... rs THts l cHArrcE
r.cvious Occupancy T)DG?
OF OCCUPA}ICY USE
l[-u.
vrs ( rc.....ls (hC ta€e Occup.ncy
pa llt 0 k?15?o Nc REPHtqAT n< RE
Yes t7,ln
rsFEE, l8 lErEtEr
o,9zazz-a,-Tia-6
ls ,ood or beverages prepared or s€rved in
N8"*,rra", , l'"..o,
""r,n, lhsr el r druuon m9l!-!9!l l9i! 3!q q6nsnc.s snd r+{ul.tions Thcg,Sff tr il"tsfffi iiffi Ess" titormatron :;
WATER
SEWER
SYSTEM
tns_applcaDofl is corrcct ard 6I i,o.t wit, comoty wi$ the St.|e Buad,ng Code lndil8!.\f,ft ffi itff ffi strEfl ,:"JtEe*h.""J#i.*{*;[*ff.fl flx Bhg Code and
Perty Located ln The ainfL Yefi
all lpdr.Ue Slats
NO
OWNER/CONTRACTOR:
Nolei Demotoon notificatons t lsbesbs re,novrt pe.mit applasLons 6rG to t, submincd usin0 rn€ appticstion ,onn (DHHS376Econt ln AsDe$oa or nol you Ora raquirad lo cal rhe Nalonet Emisiion Stsndsnts lor H.r.(hus Air Potn nl' {N€SX,cp) at (919)707.5950 ar b.<r rdenblitbn ot.ny t dny or Drriliir! S€.Silq: h|g'Jrrr{.*..g.st6L nc.uYepibs!.noy6 hmD hlml
rorAl pRoJEcr cosr, 4l) 50O.BUILDING HEIGHT 13 doFuNtrsTOTAL AREA SO FT *6500 SO FT PER FLR # OF STORIESTOTAL SO FT UNDER ROOF d OF STRUCTU RES * OF FLOORS
ACRES DISTURBED: Z. D
,(/A /?_t\.d,(cr,,-n STGNATURE:
NEW IMPERVTOUS AREA: j 3 362-Exsr LAND DtsruRsrNo peRurrz .,,l- yes
SO FT EXIST|NG TMPERVTOUS AREA: C)
PROPERTY usEr [orrrce I RESTAURANT
NITY SYSTEM
!urncrxrruefl eoucf[
COMMU
SEPARAIE PIRMI]S FTOI]IRED I OE
LASSIFICATION
LH RH B: BFE+2tr:
N
CONDO OTHE .P / n4;-L
DISCOVER
PERMIT F EE: :
APT
BEiEyt E CENTRAL sEplc fI Tl WELL T-l zoNtNG USE CPFIVATE sEplc E-UoMMUNrry
€L ECI. MLCI,I. PLBG GAS EOLNP PBEfABSE INSEF'T
PAYMENT MEIHOD l- cnsn l- cHEcK (PAYABLE To runc1 J- AMER|CAN EXPRESS
ZONE: OFFICER
(FOR OfFTCE USE ONt-Y)
SETBACKS: F;Approval:_ City:_ DATE_ FLOOD
Comment
6nk^
fiu;t ut.f (t t O
Glors * 2 of%
\
Efo-czs
r^€Ptlo.
cA/lsA
R"ht
[]r\c
7ir$-rg
I
SQ FT
t;
ICIN
a L\=Y54'bt
.)
t
a
c
z:
APPLICANT'S M}tE:
DEVELOPER: 6f
PRO]ECT
OCCUPANT/BUSINESS t,|A E:
PROPERW OHIIER'S NA E;s+3 /*a, l.,T tt<
OI.,NER'S ADDRESS: z
NEW HANOVER COUNTY BUTLDING PERI4IT
aPPL IcarIoN rypE; COII}1ERCIAL
PL€ASE ANSWER ALT QUESIIOT,/S APPI-ICABLE TO YOI'R PRO]ECT..project Responsibility,,
orl
LL<
AFFEEIT_IoN
Nunb€r
(Offic€ Us.)
DATE )./r t/z.t*
_ Pttot{E *t f(os 2003 t{
LV.I t// t ty6tr0AJ ruC zrP: Zfff//
1
_P]0 E s: Qf O E>txXtS
Y-t,
EI'IAI L ADDRESS:r
PRO]ECT COI{IACT P
If UPFIT - The Shell permit #:
IF Yes, what uas the prevlous Occupancy Type?Tvoe?ANCH DESIGI{ PROFESSIOI{AL
E]{GR DESIOI PROFESSIO'{AI-
DESCRIPTION OF !,IORK :
- LICEiISE f: I tl ro q
CITY:
sr:@ztp@r
st)t/l( ztPt z3*/ j*,.-4k:c&tg
Oc-'
f
CITY: I,IL / 1160',\)
PHONE
PHONE
(Che.l All That Appty)EXIST CoNSTRUCTION: T-l ALTERATIoN
lf Relocation, is there a Naturaul Gas Lrne on the urrent Site? ,-l
T-l CENERAT REPAIRS T--Ivtd;-; ruo ,s a.rospH,nr
ilP* .o*rr*r.rron, M
accEssoRY sr*r.trJfi
REM)VATION RELOCATION
xleneo'fl, vesf-
EREcr Er{ srRucruRE E FAsr rRAcx SHELL uPFrr E ADD To Exrsr srRucruRE
***T* IS THIS A CMT{GE OF OCCUPAT{CY USE il,]YES
is Klthe
Is Elect Power on this Building ff yes tx,,
l{eu Occupancy l9FE8 18 18: g.{Bt
d L, ,e-PH
Pu
4to2q?q570 Nc REG *
'ql"??l6n( Nc RE6 *:
P 6ll Av J,9zqzl
7/ 39AUrt\< / f\a\s
OWNER/CONTRACTOR:
(Ooalfs)
Nole: Demotilion notricatons E ssbeslos
NEW TMPERVToUS AREA: 73 362_
PROPERTY USE: EOFFTCE f| neSreunaur MERCANTILE
hsYrac\ i-rt SIGNATURE
(DHHS-3768) whe$er rhe l.cihy or building was lound totlAP) 3r (919)707-59aO al t€ast lO days prior lo the
# OF UNITS:
* or sroRresl- -l-
# OF FLOORS:
SO FT
coNDo orHEr 8 lrr r,ne9J:
IFICATION
DISCOVER
:---- BFE+2f1,AVN
PERMIT FEE: I
removal permit appljcations are to be submined using the application lormcontain fubesbs or not. you are required io c€lllh€ Na0onetEmissioo Standarcts ror Hazardous Air Potti,ranb (NESdefiDlition ot sny fadtity or h.,itdino. see Asbeslos web Sde
OO
hhp:/lwwe, epi.suate.nc uyepi/asD€sioyahmp hlmt
TOTAL PROJECT COST 4t1500.BUILDING HEIGHT: I ZTOTAL AREA SQ FT -6500 SO FT PER FLR
TOTAL SO FT UNDER ROOF f OF STRUCTURES
ACRES DISTURBEO: Z- O Exsr LANo DtsrunarNc eeRurrz .[- vrs J- r,ro
SQ FT EXISTING IMPERVIOUS AREA.. ')
WATER TXCFPUASEWER: IIicFPUA
SYSTEM v ...qF
COMMUNITY SYSTEM
CENTRAL SEPTIC D Tl WELL TI zONtNG USE CLASSmlvATE sEpTlc DToMMUNtTy
EDUC APT
PARAIE PERMITS REQUIRED FOR ELECT, MECH, PLBG, GAS EOUIP, PREFAAS E INSERTS
LH RH
PAYMENT [4ETHOD l- crsu J- cHEcK (PAYABLE To NHc) f - AMER|oAN ExpREss
ZONE: OFFICER
(FOR OFFICE USE ONLY)
SETBACKS: F:Approval:_ City:_ DATE_ FLOOD
A/ISA
Comment
CONTRACTOR:
ADDRESS:
B
oiJr y
NEW HANOVER COUNTY BUILDING PERI,IIT
APPLICATI$J rvpE: COITTTIERCIAL
PIEAS€ A SIJER Arr QUESTIONS APPLICAETE TO YOUR PROIECT..project Responsibility,,
,,, I
Ro$a\Q*
aP-meamN
Number
(ofIice Us.)
_oer, 2./t r/2.19
- PHONE TI f(a S ?oa, t{
1,,/ / I nt ,y6\-o^J lJa n@,r
I
c,
1
APPLICANT'S MitE :
DEVELOPE
PRO] ECT
OCCUPANT
R: 6S, grrl
/BUSINESS iJAitE:
PROPERTY OTiIER'S NAIIE:q+7 /A<, knT tt<
OI.'NER,S ADDRESS: 2 CITY:
. PHONE *:
CONTRACTOR :
ADDRESS:
-r>LICENSE #: t q 90qcrw:
QIO 52tx<t9:r4l/ ZlPt - .2& / /
stlUJ_zrp, Z2q/i
O.,
<t ra ,{
Z
E MAI L ADDRESS:
PRO]ECT CONTAC TPE
EXIST CONSTRUCTION:
It Relocation. is th
No
Et.J CO STRUCTIO :
ACCESSORY STRUCTU
Plot{E S:
P}ONE *:r L:1
ere a Nalural Gas Line on the Site?t:es
((he.l All lhat Apply)
ALT ERATION REiIOVATION GENERAL REPAIRS
l-l no tS BLDG S trPRIN
RELOCATION
KLEREDI-; yesf,
Frnecr NEht srRucruRE FAsr rRAcK n sHErL E upFrr E ADD To Exrsr srRucruRE
Is Elect
r**** IS THIS A CI|AIIGE OF OCCUPAIICY USEr l-,l1lhatIF Yes, what was the previous Occupan cy Type?
If UPFIT - The Shell penmit #:Power on this Building fi yes lX ro
::t,s..* i-'-- :,i,'E! iB lr1ri,iF.ls the Iee Occupancy
P* q/0 2q?1s70,nr@-Nc REG s: -trZaZz_Nc nrc t,a7iT
I[Efi trrrro, pRoFEssronA
EI{GR DESIGN PROFESSIOI{A
DESCRIPTION OF WORK:
L:
L
P6$l Av J,dur<-
AU ) \'.,</fr.\s
ls tood or beverages prepared or served in lhis slructure?f- vesffi Ho ts The property Locared tn The FtoodptainT-L ye{-L
all other lpplicable State
NoDISCLAIMER: thereby cenity thal alltnfomEton inand.toc€llaws and oadhanc€s and regulatons. The
StSigiCB Elffif#J tiionrrscror i;'ormat'bn' '-
this _applicaton is coned and altwork wi compty w h the SEte Buitdrno Code end
il89Pi1"J.,[,Tf; "t$#s::gr3ilylfE#gi:.,"J**"*l*r;Ji,:li"]lilLr#.Dlans and sDeciicationsNC State Bldg Code and
OWNER/CONTRACTOR:
(Oiralitid)
Nole: Demohtion notf€tions & asbestos
4tsYrotcX.'.n SIGNATURE
sile: hflpr/www.epi.stale.nc,us/epyasbeslos/ahmp.ht
BUILDING HEIGHT: I 1
SQ FT PER FLR
* op srRucrunrs-f
rD
rernoval pemil epdicatons are to be submilled using ttt€ appticaton fonn (DHHS3768) s,he$er lhe facitiry or buitding rBs tound toconiain asb€stos ornot. you are required lo c€llthe NaUonalEmission Standards for Hazardous Ai, pollutanls (NcSHAP) ar (919)707-5950 at tessr 10 days pd;rrolh€demolirion ol any facitiiy or buitding
?)16wToTAL AREA SQ FT : _ \( 0OTorAL so FT UNDER Ro'oFi -
TOTAL PROJECT COST
AcRES DtsruRBEo. Z-o Exsr LAND Dtsrunerlc eenuru f ves f- Ho
SQ FT EXIST|NG TMPERVTOUS AREA: d)
# OF UNITS
# OF STORIES: /
# OF FLOORS
coNDo orHEr $/rs ,,4-L
SSIFICATION
BFE+2ft,
WATER XCFPUASEWER; It'CFPUA
SYSTEM ? ...s
PAYMENT METHOD:
l-l WELL TI zONtNG usE CLAmlvATE SEPIC ETOMMUNTTY
NEW IMPERVIOUS AREA: 3 3 362-
ZONE: OFFICER
Approval:_ City:_ DATE_ FLOOD
APT
COMMUNIry SYSTEM
EPABATE PERMIIS REOUIRED FOR ELECT, MECH, PL8G, GAS EOUIP, PREFABS & INSER-IS
f casu f- cHEcK (eAvABLE ro Nncl l- AMERTcAN ExeRESS
(FOR OFFTCE USE ONLY)
SETBACKS: F:
MCA,/tSA
Comment
LH RH
SQ FT
l,) /LDt,'6f oN sI
PROPERT usE: EoFFtcE I nesrnunar,rr ! urncrrurrrel-l eoucl-1
CENTRAL SEPIC D
B
N
_ PERMIT FEE: I
DISCOVER
8o,.ti.ud fD s,M!i
t #t ff{,til^lp@ srti/st
ITIfi,
lcll!l
/.2 /
;
APPLICANT'S M}tE :
NEW HANOVER COUNTY BUILDING PERIIIT
AppLrcArran rrpE I COIIIIERCIAL
PIEASE AI{S'EN AL! q,,E5T]OII5 APPT'CA8IE IO YOUR PROJECI,.pro ject Responsibility,,
,., I
AP-FITEITI-IcATIoil
Number
(OfflcG Ur.)
r, 2/r r/2.19DEVELOPE
PRO]ECT
O€CUPANT
R: 6E
- PtotJE f :Zoo3t5-L1
BUSII{ESS I{AIitE:
PROPERTY O!,INER'S NA}IE:+/*o, knf U<
Oc'
6Yo^-i rua : 28? rt
P}O E ':5T
05>t9
I
CO TRACTOR:
ADORESS:
?-D 1,"I "t^- LICE SE ':1u 90q
Zt?tZSL_//
ST
*:
TY: //Lt)/f r\)
!
crw:
EITAIL EsS:
PROJECT COMIAC PE
If UPFIT - The Shel.l permit #:
Exrsr cor{srRucrro : n ALrERArro* n *rrJlfii'rllj
ll Reloc€tion, E there a NattEt cas Lr Lrile;-;;;: Effi, -,,,"J,ffi ' il,r;accEssoRy srnucruiEi
Th.t rpply)
n GE EnA[ nEPATRS Tl iELOCATTO{vEi-f-; r.ro rs ar-oc selfiftxleneoT
TRACI( fl sfiELr D upFrr n aDo ro r IST STRUCTURE
.t- Y
all bpd|cable SbtE
f OF FLOORS
Exsr LAND DISTURBtNG pERMtr? -r yEs
EXISTING IMPERVTOUS AREA] C)SO FT
/ )')
ICATION
LH RH B
-T-_t5PTloNE f :
""r
IF Ycs, \,hat yas thc p
DESIGfl PROTESSIOTIA!:6II{GR DESIGI{ PROTESSTOTAL
DESCRIPTION OF }.'ORX:
TOTAL PROJECT COST
TOTAL AREA SO FT
TOTAL SO FT UNDE
ACRES DISTURBED
..... IS IXIS A CllAI{6E
revious Occupancy T)pe?
Is Elect Porrer on thls Building Yes l(io
,5F€r lg lgrB{ir
OF OCCUPA'ICY USE? TLhet
vrs I 16.....ls tfii ricr occupancy
rQ_PH :q/tLzf?q5|! Nc REc o,9zfzz_
PH 4tL4LgiAJL K rE '7/39
ls lood or beverages prepared o( served in
$8c*,ur", , ,.r"0, -n r, uret ol intoflyr.tDn rnarld.local layrs snd orumsnc+ snd rcgublirns The
C,#.T13 PtrffiT ft fff,f-so, ii,o,Instion -'
lhis srruclure?f- yesfY No ts The property Located ln The Ftoodpl 'f,
il$##ffi ffi "ffifr #'#d{ffiffi ff.dff ffi ffi "#s,H
Bldg Code alld
OWNER/CONTRACTOR
NoGr Ocmoliuon norncalons 6 sstEstos renbvrl pe.nfi lppt alons arc to De iubmfled u5lr8 tr appu..tion tonn (OBHS-3768) wtEu€l ltE ,acliryconoln AsbeiDs or nd yo! brc'equned lo callrhe Na0on tEmission SEndards to,Ha,'rdou6 atrPolurants (NtsHApt6t (919)70/-5950sldemolllDn ol any raclny or buitding
lrl /qry:r"t ;-n S|GNATURE:
See Asbesbs Web S
?)16w',
7f oo
ir8: htrp/wywv.epl siale oc uYeprrsb€slos/ahmp hlmt
BUILDING HEIGHI ,l z roF uNtrs
# OF STORIESSO FT PER FLR
R ROO * or srnucrunES
NEW IMPERVTOUS AREA: 3 3 362-SO FT
PRopERTy uSEr DoFFtcE ! nes-rruaaNr f| MERCANILE I eouc! nprR coruoo orxer 3 J'
Z-o
WATER
SEWER
SYSTEM H3:Etl E3g[+HT#L:SR,.[?[.,,,,"38o',o,]',lto#sE.LASSTF
l,AFrIEpEPf!,tlT.\nl (liIrREl)tO,:ELtCI tftC! r,ttrG GASEeUp p,rLIAtiS!l|(SFF.]S
PAYMENT METHOD f cAsH f cHEcK (eAvABLE ro r.lrc1 f- AMERIcAN EXeRESS
ZONE OFFICER
(FOR OFFICE USE ONTY)
SETBACKS: F:
Approval:_ City: DATE_ FLOOD : BFE+2ftAVN
CTVISA
Comment
a5 ofz^/'. Sf^ct-s
PERMIT FEE
DISCOVFR
tu\b )v+
OT{NER'S ADDRESS: 2
zrp: Z3*/i
NO
lli
ta\r
'
a
9
?1'
NEW HANOVER COUNTY BUILDING
aPP LICATIoN IYPE: COIIII4ERCIAL
Prtast ANSl.rtR atL QUEsTIONS APPTICABLT TO YOUR P
"ProjeGt ResPonsibilitY"
PERMIT 7o$-zta6l#,2*APPLICATION
Number
(o{fi.e u5€)
i Lt-t/
APPLICANT'5 NAfiE :
DTVT LOPER ;'.Sr
PRO]ECT ADDRESS:0t
OCCUPANT/8USINEsS NAflE :
PROPERTY OWNER,S NAI4E:'{u 0 C..)Ktt\)e
ONNER, S ADDRESS:C,?ot 6L6A /vneh DD crrv, cdt
CONTRACTOR:t/e l €}{T Qi or nnlCt(-LICENSE f:
ADDRESS: /r ft\r STY 4uu CITY:
. Cc'
Le LAr!,O
EI,IAI L ADDRESS:Si Hcr.X-t LUALrc p-rfi-C (.1
PRO]ECT CONTAC] PERSON:i/A I - S ro-r o
DATE :
PHONE srQls -UzZ-J?3?
CITY: Lr.j i l-1.1 I t\Tb ztp:.?.flca
^l
PHONE f:a-6
rr-,st tLU:zrPl 3
ALtqsL
sr;NL zLP,?w)'l
O'l,Z 1
L
C;,
(tc
PHONE d:
PHONE I:gtc-Lz7 -7'131
EXrST CONsTRUCTTOI,I: ! aLTERATTON I nrNovarton
ll Rolocation, is thele a Natulal Gas Line on lhe Cultent Sile? Ll
[-l nrlocatror
PRTNKLERED? l-t Yes l-l No
(che.r Atl lhat APPIY)
GENERAL REPAIRS
E ruo rs BLDG s
uK r.,,!.r A-t
Yes
NE}.I CONSTRUCTION : I-I
ACCESSORY STRUCTURE:D eck_-Dh
If UPFIT - The sheU Permit f:
rr"* I5 THIS A CHANGE
If Yes, h,hat was the Pr€vious OccuPancy Type?
Is Elect Pou,er on this Building E Yes E to
oF occuPANcY usrl ft vrs EFp '-"'
Mrat is the Neu OGcuPancY TYPe?
PH:NC REG S
NC RtG flARCH DESIGN PROFESSIONAL:
ENGR DESIGN PROFESSIOIIAL:PH
L(J t\io LDESCRIPTION OF hIORK:
ls lood or bovsagos proPared q s€rvod tn 0{s srnrawe? fives [ ruo b Th6 Propo y Localod ln Th€ Flooddaln?[v". I no
Code and all
lhe
E asb€sbs rdnovsl pomit Eppliaatons aro ro Do submiuod using ths spplicltion lorn (OHHS_3768)hcllity or buil&ro wls lound to
l!6rt l0 alays prlor blhe
conlsin Asb€stos or not You ar. rEqultod !o..ll ths Ntlionsl E nb.lon SudlIds lor Hazrdous Air Pollrrtants (NESHAP) sl (919)707 -5950 r1
Soe Asb€stos W€b Site: hnPjr*irs.3pi.stats.nc.usret osbostcrahmP.hunldernolitioo ol lny bdlity oI bulHing
TOTAL PROJECT COST:
TOTAL AREA SQ FT :
TOTAL SO FT UNDER ROOF:
ACRES DISTURBED
OA. /. BUILDING HEIGHT:
SO FT PER FLR: ._-
# OF STRUCTURES:
-.-
f OF UNITS:
f OF STORIES:-.--
, OF FLOORS
Exsr IAND Dlsrunernc eenutrr Ives f] no
SO FT EXISTING IMPERVIOUS AREA' SO F-
NEW IMPERVIOUS AREA: .....-.-
PROPERTY USE: EoFFlcE flnesreuraNr fluencetlrtue [eouc [aer f]coNDO OTHER:
WATER: ECFPUA COMMUNITY SYSTEM EWELL trZONING USE CLASSIFICATION:
SEWER: E CFPUA
trE cENTRAL SEPTrc E PRMATE SEPrc DaOMMUNITY SYSTEM
SEPARP.-I E PERMITS REOUTRED FOR ELECT. MECH' PLBG' GAS EOUIP. PREf ABS A INSEFIS ''
PAYMENT METHOD tr CASH tr cHEcK (PAYABLE ro Hnc; fielnentcen o<eness f]
rr+rri**r
ncrutsn I otscown
REVISEO DAIE '/1III2(FOB OFFICE USE ONLY)
Z.NE:-OFFIcER:
-
SETBACKS: F:-LH:- RH:- B:
Approvar:-city, -'ATEfJL;;;'-]^ |]u _-* BFilm=
PERMIT FE
Comment
E:$
EREcr NEN srRUcruRE I rasl rucx I sner-r' I uerrr I ADD To Exrsr srRucTURE
t
SlaIE
(
Noto: Demoliaon nolfcalions
CL
,<Clear Form Print eMail
NEW HANOVER COUNTY BUILDING PERMIT
AP P LI CAT I O N N'PE.. RESIDENTIAT
PLEASE ANSWER ALL QUESIIONS APPLICABLE TO YOUR PRO,JECT
"Project Responsibilitl/'
20 6-220 It#(
Application
Number
(office use)
APPLICANT'S NAME: Shane Smith Date: 01/06/2017
PROJECT ADDRESS:CITY: Wilminolon ZtP 28411
SUBDIVISION: Dunbar Landino LOT S: I
PROPERTY OWNER'S NAME: Steve & Candace Johnson PHONE #: 9'10-362-4563
OWNER'S ADDRESS:7448 nrnhar Rd CITY Wilmin.rton ZtP: 28411
CONTRACTOR I Coastal Buildino Conceots BTDG TICENSE #:
ADDRESS:518 Tr2ils Fnd R.l CITY: Wilminoton
EMAIL ADDRESS: shane@coastalbuildingconcepts com PHONE ql o-7qA-2RRn
PROJECT CONTACT PERSON Shrne Srnith PHO[{E: 910-264-2075
EXISTING CONSTRUCTION: ! Alteration E Renovation I General Repairs
NEW CONSTRUCTION: E Erect New Residence 7/ eddition to existing Residence ! Relocation
*I*PIEASE CHECI( AND ANSWER BELOW ATt THAT APPTY TO YOUR PROJECT***
[] Att Garage (5F)6 Det Garage (5F) 380 n Porch (SF)
n Sunroom (sF)! Pool (SF)n Storage Shed (5F) _
n Greenhouse (SF)_n Deck (sF)tr Other (SF)
ls the proposed work changing the existing footprint? E Yes E No
TOTAL SQ FT UNDER ROOF (fot ptoposed work) Healedi Unheated:380
TOTAL PROJECT COST (Less Lot): 5 57843
crFEE t8 2:tbPll
ST: NC ZIP: 28409
ls the proposed work changing the number of bedrooms? D YesA o
ls any Electrical, Plumbint or Mechanical work being done to the Accessory Structure 6
lf the project is a Relocation, is there a Natu ra I Gas Line on the current site? tr YesF
ls there Electrical Power on this Building? h Yes fl No
Prop€rty Use/ occupancy:F sinde Family ! Duplex ! Townhouse
Yes E No
No
Description of Work:
Build Detach oaraoe behind existino oaraoe.
DIS€lAlMEi: I hereby certify that allthe information in this application iscorrect
laws and ordinances and regulations. The NHc Development Services Centerwill
information. ***NOTE: Anywork performed without the appropriate permits wil
end allwork willcompty with the State Euilding Code and all otherapplicable State and local
be notified ofany changes in the
lbe in violation ofthe NC :ffi;tulmlncontractor
owner/Contra ctor: Shane Smith
"Licensed Quolilier"
ls the property located in a floodplain? E Ye'
Existint lmpervious Area:
-
Sq Ft
Signature:
Fno
WATER:
TotalAcres Disturbed:
New lmpervious Area:380 Sq Ft ExistinB Land Disturbing Permit: E Yes F No
fi creua E community system I Private well n central well D Aqua
I CfeUA E Community System E Private Septic I Centralseptic n Aqua
Zone:
-
Officer:
-
Setbacks (F)
-
(tH)
-
(RH)
-
(B)
-Approval:
-
City:
-
Date:
-
Flood: (A)
-
(vl
-
(N)
-
BFE+2ft=
-
Comment:Permit Fee: S
7448 Dunbar Rcl
SEWER:
Afr-zz-o;
NEhJ HANOVER COUNTY BUILDING PERMIT
APPLI.ATI1N IYPE; Col.tiilERCIAL
PIEAST AflsHER At-L QUEST:oNS AppLTCABLE T0 yOUr pflOJfCr
"Project Respons1b111ty"
APPLICANT'S l,lAllE: 19rs51 S, cahoon
DEVE!OPIR:
PROJ ECT !'lilhington
oCCUPANT/EUSINESS f,lAHE : r,rn.lf a) I
PR0PERTY 014/NER'S i{Al'lE: psm6!.616 Jones pk ouners Associattoo
oL/ilER,s AoDRESS: t.iqg r,,,t",tu:" orir*. CITY: 6i16in9s66
CONTRACTOR: Bobby cahoon Conotruction, rnc.- lICEtlSE f: 5212 6
- CITY: 576,11 ST: 116 ZIP: 29529
Ei.'1AI L JHONE s: isz-ztg-tttt
PRoJECT CoNTACT PER5oNj t;;11ck rpock PHON E *t 252-zz9-qozt
(che(l All rh.t Apply)
€s
lral.ls on Spanish t{e1]s Pond 1n Laodtall
PHONE #l
. DATE:2-22-18
aFFmfiT-ro^l
tlumber
(0ffl(e U5e)
ZIP 't 28t05| 2044 spanlsh HelIs Drlve
E55 : 5o95yc6tro6r.o!! !ructlolqyahoo. coll
#Ex0NP
ST: ys ZIP:26495
ALTERATION
Gas Llne on lhgn
Current Site? f:
REI,IOVATION GENERAL REPAIRS T-] RELOCATION
I--rvo rs BLDG sphi'JKLERED4-- y€sf -NotlEl,l COr{STRUCTION:ERECr NEN STRUCTURE flFAST IRAC( n SHErL D UPFIT D ADD TO EXrST STRUCTURE
ACCE5S0RY STRUCTURE: seavral. /r€rai ning
If UPFII - The SheU Pernit #: N/A
.**r* Is THIS A CHANGE
IF Yes, vhat l{as the P.evlou' occupancy fypel
TvDEI
ARCH DESIGI{ PR0FESSIOiUIL I N/A
Is Elect Polder on this Bullding f. Yes li. N0
oF occuPANCY USE?r YES [. riO ....*
_ l,lhat is the I{eB oc.upancy
----.
NC REG fliPH:
ENGR oEsrcN pRoFEssroNALr-- PH:- Nc flE6 E:-
DESCRIPTION 0F l.loRK: 1fifr-iflflli- of vinyl seawall/retalnins l{alls on Spanish '{eIl, Pond
ls tood or boveraoes prepared or sorv€d in thls structuro?f Yosf-, No 16 Tho Proporly Located ln Tho Floodplain{-.- Yef-
N8cf.ltv en, I n"r"uy
""niry
thsr all informadon ln lhls
efld local taws and o,dinancss and leoulalions, Ihe NHor ah,;do ln conlrlalor oi conlraclor '-nlormollon, "'NOSubls.lio Fin63 Up To 6500.00"'
applicsllonls conecl6nd all\,!ork wlllcomply wiur lho Slale Eulldino Cod6 Bnd all orher appiicablo Slals
C D.veloom€nt S€Mc€s Conloarrillb€ noliliod olsnv chanoos in th€ aooovod olans and sDecilicalions
TE: Any Work Perlofiod W/O tho pproprlsl€ Porm116 wlll 5a in Vrolalion ol lhoNC Storo Sldg Codo irnd
OWNER/CONTRACTOR: reresa s. c.rhoon SIGNATUREI
.. SEPARATE PERMIISR€OUIREO FOR ELECT. MECTJ. PL8G, G\SEOUP.PREFASS& ITISEAIS
PAYIVIENT METHOD: fl CASH . 01ECK (PAYAELE TO NHC) r- AMERICAN EXPRESS r-
(FOR OFFTCE USEONLY)
DENJ
contain Asbosr,c6 or nol You er. rqurrod lo c.lrris Natlon.l Emlsslon Sbidardstor H.r.dowAIrPollt tonts (NESHAP) 6l(919)707-5950 ol hlrr 10 day! p,lor lo lho
d6molirio. ot any lacllity or bulldi.r. S€o A6bo3tDE Web Silo: h!9nrrrd0.opl3lrlc.6c.ulJo9uo3b6llo./ahm9.hl,nl
TOTAL PROJECT COST: l!:4f!:q_ BUILDING HEIGHT:.N/A
TOTAL AREA SQ FT I SQ FT PER FLR: .N/A # OF STORIES: N/^
# OF UNITS: N,/r
TOTAL SO FT UNDER ROOF: N/A d OF STRUCTURES: p71 il Or TLOoRS: ii7r,--
ACRES DISTURBEDI N/A EXST LAND DTSTURBING PERr\, T? J:YES Ji NO
NEW IMPERVIOUS AREA: r.rZa SO FT EXISTING IMPERVIOUS AREA: N/A SO FT
pRopERry usE: DorFlcE ! nesuunnnr ! MERCANTILED EDUoTIAPTTI oONDO OTHET
WATER:
SEWER:
SYSTEM
Tl COMMUNITY SYSTEM TI WELL Tl ZONING USE CLASS
I cenrnnl seerrc I Hvlre seertc B'ijoM[,luNtTYE
CFPUA
CFPUA
zoNE: [.}D oFFICER:
ApproYsl:_ City TE Z'zrr-lt FLOOD
IFICATION
N
PERMIT FEE: I
tvlc/'\4sA r DtscovER
*ro""d, q^;r<lt,
Jrff %.r"+,'"3 |o"dSETBACKS: F: * LH JI -RH *
It
Comment ffbh -
Ciii, lnpeclion Requrreo, I I 0.254-0inl
1_8-533
ADDRESS | 6C03 Neuse Road
EXIST CONSIRUCTION: !
lf Relocation, ls ther€ a Nalursl
,/\i
a
ti l'
cE
a
?ct€ - zzc^3
18 - 533NEhI HANOVER COUNTY BUILDING PERI4IT
APPLIcArIott TYPE: COiIIIERCIAL
PLEASE AI{STER ALL QUESTIOIs APPLICAALE TO YOI,,R PRO]ECT
"ProJect Responsibil1ty"
Wilnington
ap-FfTfi?idr
t{umber
(offic. U3.)
APPLICAIT'S llAllE: 1E.g.. S. Cahoon
OEVELOPER:
PRO]ECT ' 2044 Spanish wells Drive
OCCUPAIIT/BUSINESS MltE : r,andf at r
O}.IilER'S ADDRESS:I74 9 Drysdale Drive . CITY: 11irmi
- DATE :
PHONE #:
ZIP:294s5
- PIO E #i
on ST: Ns ZIP:29465
CoiITRACTOR: Bobby cahoon construction, Inc.- LICE SE S: eztzo
ADORESS: 5OO3 Neuse Road
El,lAI L 3 bobbyca\oopconstr!ctjigltyahoo, con
trrY: Grante-ST: Ns ZIP:2g529
- PIOIE #; 252-24g-\6t7
PROIECT CONTACT PERSO{: pq1s161 1p6g1 . PtlOf,E *: 252-229-4a2-;
(Check all That Apply)
EXIST CONSTRUCTIO{
lf Relocalion, is lhere 8 N
NoNEr{ COISTRUCTTO|{:
ACCESSORY STRWTT'
: Tl ALTERATToN Tl RENovarroN
atiEl cas Line on rheEnent Site? l-.
GE]{ERAI REPAIRS T-'I
l-- r,ro rs BLDG sJFT{r
RELOCATION
KLERED?|-- Yesf _
EREcr NEr{ srRUcruRE flFAsr rRAcK E SHErL E upFrr n ADD r0 Exrsr SrRrrcruRE
i sest all/retaiolng !l.118 qn Spanlsh Wells Pond in landfall
'.... rs rHrs A cHAilGE oF occrrPlr{cy usEtr yEs lr. in ..'..
IF Y€s, rhat ras the prcvlous Occupancy Tlllle? _ t{hat ls the ilcri Occupancy
TvDe?
ARTH 0E5Ig{ PROFESSIOML: N/A PH:ilc RE6 f:
ttc REG *:-ETTGR DESIGII PROFESSIOI{AL LN/A PH:
DESCRIPTION OF HORK: rnTllflffii- or vinyr seaual-r/retainlns warts on spanlsh WeIls Pond
SIGNATU
Nol.: D.mollho nolifcalions E asb€do3 rudroyal pormlt appllc.lirn3 ar6 to b. eubfilt!6d uaim fic epdicrt,on brm (DHHS.3768) riclhor lhe facility or bualdinO wss found ro
conlaln Aslr66to6 o. nol. Yot, e.€ Equlrad lo cel the Nollon5l Eribslon S!.ndad3 for Hszrrdo@ A. PoIubnB (NES}IAP).t (0tg)707€050.r lolrt 1O d.y6 f'rior io th€
dqndidon ol sny lbdllty or bulbing. Sec A6be.b. W.b Shr: htpr/w*\r.cai.stat6.ncuC.pl/trilb.rto./ahmp.htnt
TOTAL PROJECT COST: S53, o?8. oc BUILDING HEIGHT: N/A # OF UNITS: NiA
TOTAL AREA SO FT
TOTAL SQ FT UNDER ROOF: r.r/a
ACRES DISTURBEO: N/A
NEW IMPERVIOUS AREA: x7n
PROPERTY USE
SQ FT PER FLR; .Hra
# OF STRUCTURES: N/L
# OF STORIES: p7a
# OF FLOORS: N/A
Exsr LAND D|STURBTNG pERMtr? r yES l- NO
CONDO OTHET
SQ FT EXISTING IMPERVIOUS AREA: N
loFFrcE I nesraunlrur ! MERcANILEE EDUoEI_ Aprf]
SO FT
WATER:
SEWER:
SYSTEM
I-'']CFPUA [-'I COMMUNIW SYSTEM T-l WELL N ZONING USE CLASS
flcreua flcerurn+ seelc E hlvArE sEplc EtCoMMUNtry.. SEPARATE PERMITS REOUIRED FOR ELECT, MECH, PLBG. GAS EOUIP, PREFABS 8 INSERTS
IFICATION
PAYMENT I ETHOD:t- crsx l-. cxecK (eAvABLE To NHc) f- AMERIcAN ExpREss t-_ racnrrsa f-- otscovER
ZONE: OFFICER:
(FOR OFFTCE USE ONLY)
SETBACKS: F:LH BAooroval: CitY: DATE FLOOD BFE+2ft:
Comment
L7
RH
N
2-22-\S
PROPERTY OIiNER'5 tlAltE; pembroke Jones pk Owners Associatlon
If UPFIT - The Shell Permit *: N/A Is Elect pouer on this BuildinB [-. yes l-. NO
OWNEF/CONTRACTOR: rere"" s. cahoon
PERMIT FEE: :