OCTOBER 30 2015 BUILDING APPSAPPLICAT{T'S MIIE :
I{EW HAITPVER COUNTY BUILDTNG PERI'IIT
APPLIcAfi$'
mE.. COilI,IERCIAL
PLEAjiE I SIER ALL QUESTmilS IDPLICTSLE T0 tluR PROIECT
nProj.ct tGsponstbll.tttfl
Baker Roofno ComDany
oors _
ro3g3_
RECE;VEDgcrl4tOS
t5-AqA3
APPLICATI
ilurSGr
(offlcc ur.)
DAtEt 19L1472n15
a
DEVEL(DER:
. NIA t63to
PROIECI ADDRESS:
€e8'Soarolina Beach Roadcrw: Wlmirlgton
occuPAl{T/BUs[,rEs5 AIrE IMyrtle Grove Fire Station
PROPERW or{ER's ilAr{E: New Hanover Counly
0riER,s AIXTRESS: 220 DMsion Drive
clw: Wilmington
Baker Boofing
LIcEilsE #: 5812
aDonEss: 517 Mercury StreelCIw: Baleloh
EiUtIL ADoRESS: ahinson@bakerroofins.com
PRoIECT CO{TAcr PERsot{: All
PK'NE ':ST:EztP:4L
ACCOorr f:
sr:!qzrP:27603
Pr€ E s: 910-799-7585
PtoilC sr 910-44i!-0193
ARC}i I,ESIGI{ Pf,OFESSIflAL 3 N/A
EtlcR DEsrGx PtoFESsro aL!
ffi
DESCRIPTIOI OF K)RK: lnstall nef,, TPO Rml sysbm
b lbod a borrqaoc popsld a
svrd h thb sfrrtu €?
flveu [m h nre Prop€,ty t-ocsbd ln 1lr tuoflaln? p ves
fl ruo
TOTAL PROJECT COSI:
$68,150.00 BUllDll.lG HEIGHT:30#OF UNITS:
TOTAL AREASQ FT:8600 SQ
FTPERFLF:8600# OF STORIES: 1
8600# OF STRUCTURES:
PH: NC REG *:m'ETdEdffi Nc REG *:
0it{i, Frrilr)le Ddrer ndn lo.r l-t-b lrtrdd Ftrll+pt krr.bb.ri dU rrll! tr..Flcer h (D*fiSsrL)rflrih.t llra ntdhe nhrdb
crrilh A.t-.6i.1Yo|r m Eqrrd b..I tr N.iqrl ffilt &,.rt b. H.rrdo.. At tolluhl (t{EStlAP)
{ O19}1,7{UD.i ld 10 d.rr Fb.b !l.
&ndftn d 'l, b.ltU a hllrte. S- A.bO \tlb * ldDrivrlr*..pl3tr!6.rcu&1.@b-t6hhnp.htnl
TOTAL SO FT UNDER ROOF:
ACRES DISTURBED:
-
NBIV
li,lPEFnnOtIl AREA
_
# OF FLOORS:
D(sT rrND DrSTrrf,sNG pERnrmEyEl ENO
SOFT E(STING IMPERVIOUS
AREA
,l
1
SQ FT
PRoPERTY usE: EoFFrcE flnesreuae^n fluencnmr-e f]eouc flapl lcoHoo OTHER:
WATER:
SEWER
EtrI
CFPUA
CFPI'A
E]@MMII'IrYSYSTEM []l/vEr EIZONINGi S€ CI.ASSIFEAIION:
--
frc=nrnt serrrc E p-RvATE
sEmc E-coMMUNny syErEM
-'S€PAMTE PERMITS REAUIREO FOR ELECI, MECH. PLBG. GAS EOUIP, PREFAES & INSERTS
''
(FOROmCE UgE
OlfY) FEaEEDuArE4nr^2ZONE: OFFICER:_ SETBACKS: F:_LH: RH: B:Apprlval: crtr-DATE:--FLooD:---BFE+tr_
AVN
PIONE
*: _
Ztpt 28412
CO TRACTOR:
(ch..k ALl Thrt Apply )
EXrSt COTJSTRUCTTOT:
! ALremU(,{
E REI{O,ATrO
m GE EnaL REPATRS
E RELOCATTq{
tI
Relocoton, is rher6 a Naruml cas Llne on tne Einem site?
[v"!-[ llo ls BLoc sPiiiKLEReoa
I ves
[ ruo
ilEH coNsrRucTlot{:
! rnecr NEr STRucTuRE
fl rsr rmcr
I sxer-r-
E r.prrr
f] aDD To ExrsT sTRUcTUnE
ACCESSffY STRUCTURE:
If UPFIT - The Shell Permlt *: Is Elect Poi,er on thls Bulldlng E Yes fl to
..... rs rHts a cplcE oF fiqrpAlcy rrsE?
EyEs [ ilo ...'.
IF Yes, r'hat y.s thr Prcvlous Occupancy Type?
-
hlhat ls th€ llcr Occupanc), Iyp€?
_
I
I
PAY',IGNT METITO& ECASH ECIEcl( (PAYA8|.E TO M{C) [erUnCCOUm E}TG/USA IOTSCOWA
ultrlSar
pERMtT
FEE:0_
?ez rt- ?nq}
%rs---/NEW HANOVER COUNTY
BUILDING PERMIT
APPLICATIoN
TyPE: RESIDENTIAL
PLEASE AJ'ISI,IER ALL QUESTIONS APPLICABLE TO YOTJR PROJECT
"ProJect Responslbillty''
APPLICATIO,I
Numben
(offlce U5e)
|to c*AUGC -
10 fuo(etv-t
APPLICANT's
llAI.lE: David James & co DATE :
DEVELOPER:
David James & Co
ESS:
PROPERry OuNER'S NAflE: t^J
OhINER'S ADDRESS:3
CoNTRACTOR: David James & co
,IDDRESS: 308 o1d Dalrv Rd Ste 130
PHONE f:
crw:zrP:
BLOCK
f: LOT #:
PHONE
#:
CITY:Sf I t.LzrP I Z!9 ?o-7
LICEilSE *: 39423
CITY: wilminqton sT: Nc zIP: 2840s
PRO]ECT ADDR
SUBDIVISION:
PRO]ECT COIiITACT PERSON: DaVid James
EI4AIL ADoRESS: dj ames0wr Iminsronbuilder, com
PIO E #: 910-443-3184
! oer
crnrce O sr
! eoncn
-sF
I eoor-
_ sr I sronacr SHED
_ sF
SF OTHER:SF
NGLE
FAMTLv
I ouer-ex
I TOI^]NHOUSE
Exrsrrrrlc co.{srRucrroN:
f} nlreurroru
[l neHovarroru
[ cerenal aecerns
fl RELocarroN
NEr{ CONSTRUCTTOru:
! rneCr NE}t RESTDENCE
o" El mOrrrot To EXISTING RESIDENCE
*TPLEASE CHECK A'{D AIISWER BELO{ ALL THAT APPLY TO YOI,R PRO]ECY:
larr enmcr
O sr
! suruaoom
_sF! onerruxous e
_ sr
! orcr
TorAL HEATED
sAer:OD6( NMloro. rO Fr ur{DER
RooF:- rorAl AREA
sQ Fr:
-
TOTAI PROJECT COST 1r-ess rotl
: $ooo# OF STORIES:
3
rs any ELEcrRrcAL, PLUIBrNG
or i'tEcHANrcAL
wo.k Being Done
to the Accessory structure?
! v"r [l r,ro
rf the project
is a Rerocation,
is there a Natunar Gas Line on the curnent
site? fl ves [l Ho
Is there Electrical power on this Building? [lv"s fl ruo
PRoPERTY
usE
/ occUPA
cy: Efsr
DESCRIPTION OF I.IORK: fiq OV&ful'woa S \rue
t,.,rvrlaar I d+ors
DISCLAIMER I hoEby ceniry
'|at
al inbrmation in
his appljcatbn is conect and €[ wo
and ordinances and €gulations. Ths NHC Devebpmenr Serulces CenErwjl be noified
cont'ac
br inbrm aton. T iNOTE
: Any Work Pertonnsd
w/O h e Apprcprats pefin tc wi
OIdNER/CONTRACTOR:
MU'I KI,'NAY
rkwillcomplywih he SEle Buitding Cod€ and aU 0!16rappticable Stac and
hca aws
ofanychangos in fie apploved pbns 6norchan0e in
coniractcror
b€ ln Violation oflhe NC S
b Fines Up To
$500.00"'
SIGNATURE :
* i.)** !*
*,i*,* * *:*:* i*
iEvISED oArE 6!/11112
rs rHE pRopERry LocArED
rN A FrooDpLArN?
ByEs E no l\/o
5 folYnt
EXISTING II.TPERVIOI'S AREA:
-SQ
FT TOTAL ACRES DISTURBED3
liEI{ II{PERVIOIJS AREA:
-SQ
FT EXIST LAND DISTURBING
PERIIIT:
I-'I VSS @r,to
uaren:
! crnue
[| comauNrry
sysrEl,t
I cnrvare wer_r_
! cENTRAL wELL
SEITIER:
! CTRUA
I CENTRAL
SEPTIC
ffi ENTVITC
SCrrrC ! COi4MUNITY SYSTEM
*+* SEPARATE
PERi'lrrs REQLTRED
FoR
ELEcr, tlEcH, PLBG, GAs
EgJrp, PREFABS
& I{sERrs {..{
pAyrErr
rEr,oo: lcrsr flcxecK (,A'ABLE
ro
nol [*e*r; ;;r;, --tr;r;;;;" -florscoven
*,f,i * ,r. )i:r ,r
*** )r*+**** * *** **** *(I itli,l?1"] * * **** * * * * ,*,r:r * + ,l,r *,r *:i *,r,i ,:r * ,*
r )i + + ***
(FOR OFFICE USE q{!Y)
ZoNE:
_ OF
FICE R:SETBACKS:
F:_ LH:_ RH:_ B:_Approval:_ City:_ DATE:_ FLOOD:
_ BFE+2ft=
PERIIIT FEE:
Conme
nt :
r-i\.
_&'
PHONE #: 910-443-3184
XTalQ.ovq *lcts biK
ffi
NEI^I HANOVER COUNTY BUILDING PERMIT
aPPLICATIoN TYPE: COIVIMERCIAL
PIEASE ANsI{ER ALL QUESTIONS APPLICAELE TO YOUR PRO]ECT
"Project Responsibility"
APPLICATTON
Number
(Office Use )
APpLICANTTS I'lAl,tE: rqan Really services DATEi la/261t5
DEVELOPER:
verazon wireless
CITY: wr.tmin
PHONE #: 5r7-l?r ?5oo
ST: MA ZIP: o 2116
ST:
Tx ZIP: 7so 24
PHONE #: 9?2 583 -oooo
PROJECT ADDRESS:
603 East\rood Rd
OCCUPANT/BUSINESS NAME :
PROPERTY ONNER'S NAME: American Tower Corporation
oNNER's ADDRESS: 115 Huntinston Ave 1:Lth Floor^ CITY: !9stson
CONTRACTOR: Ericsson rnc LICENSE *:
CITY: plano
59156
ADDRESS: 6l oo Leqacy Dr
EIIAIL ADDRESS:
NC REG #:
NC REG #:PH:
DESCRIPTIoN 0F WORK: add/replace anLeIrnas, RRUS,
fiber lines, laycaps Eo exlsLing cell lower
PH:
or.han6e in conlractor
Subtectlo Fines UpTos500 00*'
OWNEFYCONTRACTOR:{a SIGNATU
Nole:Demolldon nolifcatiois & asbesiG r€moval p€mlt appllcaUons are io be submined uslng ihe apBicauon lorm
TOTAL PROJECT COSTBUILDING HEIGHT:
TOTAL AREA SQ FT :SO FT PER FLR
TOTAL SQ FT UNDER ROOF:
_ # OF STRUCTURES
DCFPUA
E CFPUA
ls food or beveragos propared or seryed in this structure?
nYes E No ls The Property Locar€d ln The Floodplaina
! ves
! tlo
DtSCLAIMER: lhereby
cerilt rhst all in{ormation in thiscorecl and allwork willcomd
I Servrces Cenlerwill b€ noti,
y wiih lhe Stale
chth
nqd alrorher applcab e SIaie
and local latrs and ordilatiNHC
Bldq code afdNOTE:Any O the Appropriate PermlV]I"
wnerher lhe tucillry o. bulldlng was found io
9)707-5950 al lean 10 days prio.loihemntain Asbsstos or nor. You are requlrod to call$e NallonalEml$lon S-tandards for Hazardous Ak Polldants (NESHAP)al
demolition ot any la.jlily or building. S€€ Asb€sios Web Site: hit!:/hilww.epi.stale.nc. us/epl,/albeslos/shmp.hL-nl
# OF UNITS
# OF STORIES:
# OF FLOORS:
ACRES DISTURBED
NEW IMPERVIOUS AREA:SQ FTSQ FT
pRopERryusE: EoFFrcE flResreunerr f]ltencaNr[e f]eouc !aer lc-oNoo ornen,
EXST LAND DISTURBING PERMIT?
EXISTING IMPERVIOUS AREA:
[ves [uo
WATER:
SEWER:
flcoMMUNrTY SYSTEM
IIWELL EZONTNG USE CLASSTFTCATTON:
f] CENTRAL SEPTIC LI PRIVATE SEPTIC ECOMMUNITY SYSTEM
". SEPAF-{TE PERMITS REOI]IREDFOR ELECT,IUECH. PIBG, GAS EOUIP, PFEFABS 8II]SERTS
PAYMENT METHOD:
[casH [cHecK (eAvABLE
ro NHc) EAMERTcAN Expness
I racnrrsr
I orscoven
(FOR OFFICE USE ONLY)REVISED DATE 4N'12zoNE:_OFFICER:SETBACKS: F:_LH:_ RH:_ B:
ADDmval: Chv: DATE: FLOOD: BFE+2fr=
AVN
Comment PERMIT FEE: $
PHONE #: ?oa-5?? BTBs
ZIP
i 284os
PRO]ECT CONTACI PERSONI PHONE #:
(Check A1I That Apply)
Exrsr coNsrRucrroN:
z] ALTERATTOru
! nercvnFOt
f] eetenal neenrns
! RELocATToN
tl Relocation. rs rherea Natural Gas Line on the Current S,te?
!ves !Uo IS Bl DC SPRINKLERSD?
[ v". INo
NEW CONSTRUCTTON'
! eneCr NEW 5TRUCTURE
! rasr rnACX
! SXrr-r-
f] Uerrr
I nOO rO ExrST STRUCTURE
ACCESSOqY STRIJCTURE:
If upFIT
- The she1l Permit #: Is Elect Power on this Building E Yes E ruo
****. rS THrs A cHAflGE oF occupA1cy uSer
flvrs [rc ----,
IF Yes, $rhat Nas the Prevlous Occupancy Type?
_ l.lhat is the Nel"l
Occupancy Type?
_
ARIH DESIGN PROFESSIONAL:
ENGR DESIGN PROFESSIONAL:
RECEIVED OCT 2O ?OS
NEW HANOVER COUNTY BUIIDING
APPLICATI ON IYPE.. RESIDENTIAL
2ote-lO3af
PERMTT?EZ
l5-U+Ll
APP LICAITON
Nmber
(offlca U..)
APPLICANT'S iIAI,IE I
DEVELOPER:
PROJECT ADDRESS:
PROPERTY OI.INERJS NAflE:
OWNER,S ADDRESS:
C0NTRAcTon I
ADDRESS :
ETIAIL ADDRESS:
ffin edaaet 613 sr
I surunooll
-sF
I eneeurousr
_- sr
Al',lCY:
tr
PLEASE AIISIIER ALI qU€STMIIS APPLICAELE IO YOI'R PRO]ECT
ftProJect R'esponstblllt)r''
CITY'
BLOCK *:
PHONE
pIoNE $:187$o6
*rPzre :ffi!
sr,!!zre'i[$!l
PttoNE *: '?t7.?,80e
pnow *,
TllLztot-
,trce *' 1*11
blaatlh-CI TY:
fl orr oanace
-
sF
fl rooi
-
sr
LICE
,
PROJECT CONTACT PERSON:
-iirsrmc
coNsrRucrroN:
! ar.rrmrroH
! Remvlrrou'crrurnni Rgparns
! nrlocnrrott
NEt' CON'TRUCTI.N ' ffeAeCt NEI'I RESTDENCE o"
! eOOtrrou To ExrsTIN. RESTDENCE
I,'PLEASE CHEC( AIJO ANSI,EN BETO}' ALL THAT APPLY TO YOUR PROJECI:
TOTAL HEATED 5Q FTI IIT?Z TOTAL Sq FT UNDER AOOT:
fifi_ TOTAI AREA Sq fi'3''17 fiE$
TOTAL PROJECT CO5TG.$Lo0 t 5 Tsorooo # oF SToRIES: I
rs Any ELECTRICAL, pltflsl16 or 6ECHANICAL l.lork Belng Done to the Accessory Structufe?
[ Vg1
[ lo
If the project
ls a nelocation, 1s there a N;turat Gas Llne on the Cunr€nt Sttef
[Ves Ilo
rs thene Electrlcal Power on thls Bul}dtng?
Eves E No
d* rn hoq sr
E sronace sHEo
-
st
SF
l-l orcr sF oTltER:
SI116LE FATIILY
I DUP LEX
lg[ ror,rlttous ePROPERTY USE
/ OCCUP
DESCRIPTIOI'I OF ll,OR(:tr"td ho,rsr.
DlsctAlME Ir I hsaeby c€.try h.l tl b b.meuon ln li ls spPlc€ion lsco.r€cl snd dlwdtk rdllcooplywllh ha Otat Eildn0 6do ad al olh€r sppllclb,€ Slale ard loa.ll3w5
fid ord ln arcs3 ard regulallonS' Tlta NHC Osvslopmenl So lYlcssC€[hr Mi b€ nodllod ol&)ychangos ln $e stprDved dan! and 6pool!.allons o, clltole h cont8cbr or
contacbr h6 m.ron. '-NOIE: Aiy lrybd( Parlomod W/o ho A$,0![1316P€.mlk wflt
t€ h vlolatlon ol th6 N C sEla Bldo CodB andb
fhs! t p To
$5m.0O"
Ot{NER/CONTRACTOR
'
-T:au$rr ?"r-uttf. &d?-SI6NATURE !l^-----
**r***r,|,1{,,r,t rt,* r****** *****$!'lllil"}r*{i** r**+ *** *r, +1,* *'i.,t tt+ *t* *++i'
+r'i.l,l**++**{.**++ ***r **
IS THE PROPERTY LOCAIED IN A FLOODPTAIN}
E YES EIUO
ExrsrrNc rtpERvrorls AREA;
-:-
sq FT rorAL AcREs DrsrunaEDr O'09 ./
NEr,r $rpERvrot s aneat 91577 sl.w ExrsT LAND DTSTURBT G
rrntlrrl
I VrS ffiUO
l,rArER:
MgFpuA ! co+tururw svsrrN
! Rnrvnrr tlrtr.
I CENT&AL IIELL
sEr,rER:
ffcFpuA I crrurnal srprrc
f] PRIVATE sEPrrc
! cotlt+..utrrv svsret't
**} SEPARATE PEi}IITS REQUIRED FOR ELECI, I{ECH, PTBG, GAS EgJIP,PREFASS & ITSERTS I1'
PAY ENT I'IETHOD:
tr CASH
I cnrcx lmvaalr ro Hrcl AJTERICAN EXPRESS
E nclurro
I orscoven
*'l* a i"i,r*,t ,t*
**** *l**r** *++t***,lt** *+**f*****+*'|+*t,i** 'l.,li('l l.ri,l.1'*:|l t*{** +++***{t ****:tt+ i.*++** *
zoNE, -Q-r< oFrrcEn:
nDDroval: cltv
(ro[ orfr(E u5€ olLY)ffi . sErBAcxs: rr!{gu
: [.rrr,,. onre
: la[r6lr(rrooo:
-
,+aH, S,{a,
iEvls€o 0AIr 04/11/12
BFE+2ft-
l^lrr lnanaall,.,a n^o,
n,^- fiComnent:.
',7ir; ll h,HvWllvl I AVtlUltE\],
,i0.ffiI0$itrl,-1e93
SUBDIVISIONi LOT II;
ZTP I
,
RECEIVED OCI 2O ZOT
NEId HANOVER COUNTY
BUILDING PERMIT
APPLICATION
IYPE; RESIDENTIAL
PI,EASE AIJSHER
AI.I. OI,ESTIO'IS APPI.ICA8LE IO YOUi PROJECT
rProject Responstbtllty,,
CITY:
BtocK s:
5
h.
*
CITY,
LICENSE S:
&01S-/ o;^,/
?E? 15. LqT3
APPLICATION
NuIl|boF
(offt.. Use)
APPLICANT)s ilAl'lE I
DEVELOPER:
PRO]ECT ADDRESS I
SUBDIVISI0N I
PRoPERTY ot lNERrS NAI4E :
Ot,lNER,S ADDRESS:
CONTRACTOR I
AODRESS:
EtrlAIL ADDRESS r
PHONE
fl
oaru,bhalq
:7t2.2so?
'7 ?f!.st'
I
{r*r, fl8 sr
f] sronacr sHEo
--
sF
LOT f:
PHONE
f:
srrl$ zwr!@Q
{t&:rrlr?,r\61
paone
*; -1i7,z&ol
PnoNE
*: 112,.2tg6
SF
.
:lor..t coNTAcT PERSoN:
ExrsrrNc coNsrRucrroNr
I alrrnerroru
f] nrnoverroil._f] orreRai RspnrRs
I neloclrroru
NEr.i CoNSTRUCTTON
, ffeneCt NEU RESTOENCE or.
! nOOrrrON
To EXISII G nESrDEr{cE
..PLEAsE CHEC( AND A!Isl.IER BEIO}I
ALL TllAT APPTY TO YOUR PRO]ECTI
pftrrr camer 613 se I oer canner f sr
I sur,rnoon
-sF
f] eoou
_ sr
I cRrrluousr
-
sr ! orcr
SF OTHER:
TorAL HEATED sa
rrr lF'lZ TorAL sQ
Fr UNDER
RooF: 4869 ToTAL AREA
sg rrrisU p
ToTAL PRoJECT C0STlressr.orl
t 5 230rOoO # 0F SToRIEST I
rs Any ELEcrRrcAL, PLUfiBING or llECHAtlrcAt
tork Belng Don€
to the Accessory
structurel
I ves
I rrrorf the prcJect
ls a Rerocatlon,
ls there
a atural 6as Line on the cument sltel lves fl ro
Is there Electrlcal power on thts Butldlng? Ef ves
fJ ruo
PROPERTY USE
/ OCCUPANCYI
I srrcr-e rnNrlv
tr DUPlrx Pt'rolmrous.
DESCRIPTION OF I.IOR(!
Br.t{To.pnhrrrt(,
s
DlSl(A[,rEe I harcbyc.dly
taro[ hbnnafoo h hte rprthgfon b corect 6nd .lt w6rk\rll compty
wth ho
6bt. qrtbho Code
8nd o.dh !nc63 and .Eg ularb.I!. Tho I{ltC Dovebpmerl S6rvL€! Cln ba vvllt D6 noliad o I an, ciaaloeo h lio aprrovsd lbn 6 snd
clntgcb, hbmaton. '-NOTE:AflyWork Porlo,n'€d WO rlelpprcpdsb p€mfi! w ba h Vhta$n oflhe NC
Sab Aldg Cod6
End al
ofEr 4pljcabl6 Shto and k cat t6w!
6pedlL6tlont o, dtang r h aontracbr or
andcl ro Flno ! Up To S50o.@..
or,{NER/cor{TRAcTont -T:Cuirf R.^r.O ee frC^.lf SIGNATURE
!
.,i+******+:i+***********r*r"$11i,lliltJ**
IS THE PROPERry LOCATED
IN A FLOODPLAIN?
EXTSTTNG TMPERVIoUS
AREA: , : sQ FT
l^----
****+++ t t+*t+*+r*** t,*+,t*t + tt*l ll**+ +**,it,t + t*** ***:t a+ff vrs
d*
ToTAt acREs oIsTURaED:
0.08
EXISI I,AI\D OISTURBING "*,,,,
-ft ,,,
I..IATER;
SEI.JER:
dE pua
D
ffcrwa D
NE!.I $IPERVTOUS AREA
I
iFot6 sa n
dno
REVISiD DArE O4lt!/12
:ltht
8FE+2ft.
,rr, $
h-1Ll
cor1r'rulrry
svsreN
f] pRrvArE r,jELL
f] celrRnt well
CENTML SEPTTC
f] nnrvnrr sEprrc
E coMtluNrry sysTEt4
(fofi ofFrcE usE oJLY)
XT' SEPAIATE PERi!IT5 REQUINED
IOR EIECT, IIECII, PLB6, 645 EQUIP, PREFABS
& JIISERTS 'r,pAynENr nETHoor
Ecrsn f]cuecr (pAyABLE
ro
^r,cl Eorr^r.on il;;, -E;;;;
florscovrn*r +* r(*:r+*,ti +*++* **,*t*,r '|,r***ri*,r*** r*+f,*,.+ri**+*+
***rt* **{.* *,r.***,r.r*
rr+***r*,ra**** f t***t*+
**
zorue
: Q-lf orrrcn:*t SETSAC(S:
rt25 LH,S,<I. nu: Pl,{ . g
Approval
i-- City: l.-lt ur,t OATE:
Connent;
FLOOD:
rl
Ir
#
NEW HAITOVER COUNTY BUILDING PERITIIT
APPLIcAfi$t ryPE; C${IIERCIAL
PLEASE A|ISXER
A " QU€srIo S APPLICASLE TO yoUR pROlEar
"Project ResponsibiLity,,
Q.as-ior8A
1_5-2955
APPLICATIoiI
unber
(Offtce U'e)
AppLICAt{T,
S l{/lIE: Donna Ray rritchell, RLA onrr :
T!_r e_2 oll
DEVELOPER: .n/a
PROIECT ADDRESS: 922 Halket street
oCCUPA|T/BUSIi{ESS Mr,lE: renPle
of Israel
PROPERTY
Oil ER,S
MHE: Tenple of Israel
CITY: .wj.Iningtoo
pt{O E *:910-610-34{2
l[P;28{0r
ptg{E S: 910-762-0000
sT: ztPi
st': nc zrP: ?W
PtotrE
s:
a)Q:htA *+z
P}G{E
*:
Crtll{ER' S ADDRESS: same CITY:
YCO',ITRACTOR:
ADDRESS:
(8i3 g. r-lv
LICE SE #:crw: [/ile1a I
EiIAIL AIDRESS:
PRO]ECT COI{TACI PERSOiI:
,CO
I
Check AII Th.t Apply)
Exrsr co srRlrcrro{: J7l ALrERArro
n R ENOVATIONIGEI'IERAL REPAIRSRELOCATION
n
Natural Gas Line on the Current Site?
CIYes
No IS BLDG SPRINKLERED?
Qves (f ruof Rslocdofi, is there a
r{EH
C0 STRtrcTIo,t:
! rnecr NEll srRUcruRE
I rrsr rmcr
f] stler.r"
! urrrr p] mo ro Exrsr srRrrcruRE
ACCESSORY STRUCTURE:
IF Yes, Bhat was the Previo{s Occupancy Type?
AnCH O€SIG PROFESSIOIA|_: Ironna Ray l.titchell, RLA
EI{GR DESIO{ PROFESSIO{AL :
.*r*. rs rHrs A crtarcE oF (orpAncy r.ser
f,lvrs Qtro.....
Is Elect PoBer
on this Buitding O yes 0 tO
lfiat ls the t{€fl Occupancy Type?
pH.
910-610-3442 C REG #: 440
Ptl: t{C REG #:
D€SCRIpTION OF WOR(: cEade
level deck for nel, galdeo area
k food or botrsaoes p,€p6.sd
d s$r€d h
t*r rrructrez Q ve" @ r'ro s ff'e etop.rty
Loced tn Th6 Ftood4aine
f,t ves pt ruo
all olher applicable Siate
olans and sbeofrat,oos
NC Slate Bhg Cod€ and
OWNEFyCONTRACTOR. Donna Ray uitchell . pQ:i SIGNATURE:
t{alo: Oaan$oar idlcdo.t! A
aab-E llrErd p6.rnit
app&ddrr
r! b ba an du.d ualtg fr amfcldo. e.'n (DHtts-srBS)
eildt.oJ Dlllulro waa hrld b
cdrtd.r Ar5-ba d rEt Yd,
r! ltqhd b d nE l{ddtal Ernbdo.l ffi b fbrrdcrs A& td[Ef6 0{ESHAP)
drrEfto.r d r.ly lbclty 6 b.l.fio. Sao Aabaaba S/S Sib: htrp.llift\, epi srarE. rE.us/6pt6sb6to./ahmp l1tn1l
.i (919)m7{S0 d lct 10 dry! pta b dE
TOTAL PROJECT
CQ$]; $ 12,600 BUILO't.IG HEIGHT:
SO FT PER FLR:
# OF UNITS:
TOTAL AREA SQ FT :I600sF
TOTAL SQ FT UND€R ROOF:
_
ACRES DTSTURBED. 2 5 0 0 sr
# OF STORIES:
# OF FLOORS:
EXST T.AND DISTURBING
PERMlT?ral YES
O NO
f OF STRUCTURES:
NEW TMPERVTOUS
AIIAt none
SOFT EXISTING IMPERVIOI'S AREA
USE CTA,SSIFICATION:
.., SEPARATE PEFMITS RIQUIREO FOR ELECT, MECH, ftAG, GAS EQUIP, PREFASS E INSERTS -'
pAyuEitrMErHoo: f,lcasn [oreo<leevnaEroNrc) peuenrcmo<rnEss orc {sA clorscoven
(FOR OFFrcE USE OntY)RFVIIED DAIE
'/'
1N2ZONE:_OFFICER:
SEIBACKS:F:_LH:_RH: B:Approrral: CiIr_DATE:__FLOOD:_ BFE+k
SO FT
PRoPERTY USE: [oFFlcE [nesremnr'n f]uencar.mLe
[eorrc f]APr flcoNoo orHERAcrivity cent,.
WATER: rACFPUA
sB/vEn:
fiCrrue CENTML SEPNC
SYSTEMn flWELL
PR]VATE SEPTICCOMMUNTTY SYSTEM
l0o
N
If UPFIT
- The
SheU Permit f:
golaasa
NEI{ HAI{OVER COUNTY
BUILDING PERIIIT
APPLICATIoII
n,PE: COII.IIIERCIAL
PIEASE AXSIER ALL QUESTIOIIS APPL(ABIE TO YOUR PNO]ECI
"P.oject Responslbllltt/,
15-2955
APPLTCATION
l{ultlb€r
(Officc Usc)
APPLICAITTS N/q,tF. Donna Ray titcheLl. RrA oare:
t!_1j_11!DEVELOPEn:,n/a
PROIECT AODRESS: 922
Ua.ket street
OCCUPAiIT/BUSIIiESS
ilAllE: req)le
of rarael
pROpERTy O$IER,S ,UUIE: remple
of rBrael
CITy: nilrlington
PK)|!E
*; 910-610-3442
ZIP:2A4ot
PH0NE
*: 910-762-0000
5T; ZIPI
sT ; Nc zIP: 2115L
PHO{E
fl: 9Lo-27o-1702
pfl0ilE *: 910-279-2s64
CiltlER'
5 AmRESS: satrE
CoJTITRACTOR: North
state Gardens
AIXnESS: L?015 uS Elghway 17 North
E AIL ADORESS
: rEtthew€northstategaldena.co!!
CITY:
LICE SE $: rc 0{?4
CITY: Hanpstead
PROIECT CoaTTACT pERSOil.
Bryan padsert
Exrsr coisrRucrro{: Pl ALrERArro{
tr *nffiird'
lf Rdocathn, b lhere a Nat-ural
Gas Line on ttre rrent
Stef Q
That
GEIIERAL REPAIRS
tr RELOCATIOITI
Yes
No IS BLDG SPRINKLERED?
flves
oNo
rf UPFIr
- The
Shell Permit #:
Is Elect Pou€r on
this Building O yes f,t rc
ARCH
D€SIO, PROFESSIO{AL: DoDna Ray
Mirchelt, RtApH:
910-610-3442 6 Xg6 s. 440
EII6R DESI6 PROFESSIOiTALI P8:NC RE6 II
DESCRIPfIo OF WORK: crade
teeel deck
f,or nerl garde! alea
ilEx
cosrRucrrct,
I enrcr Er srRucruRE
I resr ruo<
! sn:r-r.
f] urrrr Q AoD ro Exrsr srRrrcruRE
ACCESY)IRY STRWTURE:
dl oo|er agDlicablg Stale
Dlarls aE sEEcifica&xts
NC Srat6 8Hg Cod€ and
OWNER/COiITRACTOR. DoDoa Ray l.rirch€r1.PtA SIGNAWRE:e-b
Ndr: O6,ndlho
ndlcddts t at€fs Enord F,ronaodlcddr ds D ba
a6and uakt tEalCtcdo.t
bttl(Dills{r88} rt€{lq d h.{dro r6a
hnd io
cdthhlde o.
rd. You
i! n$and b d lh.iadand Enhddr
&.'a.na fu Han q! lf poa!86!t (91E
rr{S0
i td t0 d.yr rrtc b,r.d.iio6do.t oa any
fualty or h.[&EL
56 Asbe Y|reb
9l.| htErVYJlr.opl-ststs.nc.'rd€rve3b€sl6/ahmp,hfi I
0{Esran
TOTAL PFOJECT
@ST: J12.600 BUILD|NG
HETGHT:
6la
TOTA AREA
Sq FT . 1G00sE SQ FT PER FLR:
TOTAL SO FT UNDER ROOF:# OF SIFTJCTURES:
ACReS DISTURBED. 2s00 sF E(ST
IIND DISTURBIT{G
PER rM
FI YES CINOSQFT O(ST|NG TMPERVTOUS
AREA
.- so F
# OF STORIES:
# oF FLOOflS:
NEW IMPERVIOUS
NrF& none
PRopERTY
usE:
fiomce f]nesreuurr [uencar'nru [eouc
[err [conoo orsstActiviry cent,.;y$E*Effi Effiu#t"Fffi","," ffi,jltrtrf#,F,cno'r ... SEPARATE PERMITS REQU]FED FOR ELECT. M€CH. PL8G, GAS EOUIP, PREFAAS E INSERTS -.
,AYMENT
MErlOo: Qcasx Qcxeo< leavaau ro NHc) oArrERrcrN E*RESS @uovrse
o orsmvenfrrm..................ft ....... i......[.[.. ...... ......- . ... .8...
zoilE:
ui{t\ oFF}cER:
Approval:
otr-
(FOR OmCE USE
SETBACKS:
oNLn
F:_NreDA]E
{flfi2
FLOOD:
I.(O ocirilttond lAe \cvrc.,t^)
#too
ffi
ts bod ot
b6rss0* Fapsr€d d swBd ln this stn
Einar Qv"" Qlr.ro b
rt. ftopqty Locd.d ln TI,"
tu@ah? Oves
Qtrc
..*.t rs rHrs A o{lltcE oF ocorpa
cy user Qves plo .,...
IF Yes, itat rras
the prevLo{s Occupancy Type? _ frat fs tl-e ts Occupancy Type?
_
# OF UN]TS:
{,b-rfu,