NOVEMBER 16 2015 BUILDING APPS,.|
&
NEI^I HANOVER COUNTY BUILDING PERMIT
APPLICATION
TYPE; RESIDENTIAL
PLEASE ANSI/ER ATL QUESTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
L5-29L2
&olt-,0)37
APPLICATION
Number
(Office Use)
APPLICANT,,S NA}IE i u.a;rl eru,-e
DEVELOPER:PHONE #: 97t)-2to-4634
ZIP | =!3f)_
ST :
ll:_ ZIP
:::_l=:
ST : l:J!_ zIP : :81 I 1
PHo E #: 9tc 2it,l] 4534
PHONE #: 91c-250-0391
RE
LOCATION
PROIECT ADDRESS: :i,i Bedr.jck .ourtCITY: r,Jirmi noro.
Tim EILenson
ALTE RATION R ENOVATIONGENERAL REPAI RS
ERECT NEW RESIDENCE oTADDITION TO EXISTING RESIDENCE
*'TPLEASE CHECK AND ANSWER BELOI, ALL THAT APPLY TO YOUR PROIECT:
SUBDMSIOI'I: st one i'brook
PRoPERTY OI^JNER'S NAI1E: , :,
OWNER'S ADDRESS: 2rl[] Eedr.:k crCITY:Wilminqton
CONTRACTOR: !-i;,..1d B ruce LICENSE f:
ADDRESS: 2 !'r it Bedrock CrCITY: wi.Imi nqt on
ElilAIL ADDRESS: dab6r26Gsmart .
com
LOT #:
PI|oNE f : 9:r-2ta 4634
PROJECT CONTACT PERSON:
EXISTING CONSTRUCTION:
NEW CONSTRUCTION:
a6(ts-_
3-
c\'"s
cs-
,<.N
DET GARAGE
-
SF
POOL
_ SF
DECK 134 SF OTHE R :
TOTAL HEATED SQ TOTAL SQ FT UNDER ROOF: 1320 TOTAL AREA SQ FT:
TOTAL PROJECT COST rress rorr : $ 8r.000 # OF STORIES:
Is Any ELECTRICAL, PLUI4BING or I'IECHANICAL t,Jork Being Done
to the Accessory Structure?T Yes No
PORCH
_ SF
STORAGE SHEDSF
SF
.SssFf : \
i2o 1324
If the pnoject
is a Relocation, is there a Natunal Gas Line on
the Curnent site? [ ves!No
Is there ELectrical Power on this Building?!Yes
l'-'l Ho
PROPERTY
UsE
/ OCCUPANCY:SIN6LE FAi4ILY DUPLEX TOWNHOUS E
DESCRIPTION OF LIORK: ,re r:1.1:r i.r .:.-rse .::qa r aqe and convert
it into a pool house with media ro
upstairs I,,le wiII add an interior stairwelf and rebui.fd the exterior s
tai rcase and Dorch
and odinances and regulations. The NHC Dev€lopmont Services cenEr will be notlied ol any changes in he approved plans and specificarions or change in contraclor or
conuactrr iflformadon "'NOTE:Any Work Pedomod W/O he AppropriaE Pomits willb€ in
Vjolation of the NC
staE Btdg Code and Subjecl kt Fines Up To $500.00...
OWNER/CONTRACTOR
: r.:r.r,r r,r ur:t,
SIGNATURE: I
DA
+ + + + ** + *+*+ +++* *** * * ** ****
*'I!'il
lil"]
IS THE PROPERTY LOCATED
IN A FLOODPLAIruI
I_I VTS
EXISTING II{PERVIOI'S AREA: 3]84 SQ FT
SQ FTNEW
IMPERVIOUS AREA:
* * + * * * * + r* + +,r* * )*,r:* * + ++,r** * * + **** * x
* + + *** * x:t * ++ + + x x,*
* * *
I NO
CFPUACOMMUNITY SYSTEM
PRIVATE WE LL CENTRAL l^lELL
CFPUA
CENTRAL 5E PTIC
f] rnrvare sEprrc
E cor4MuNrw sysrEm
*** SEPARATE PERM
PAY ENT IiIETHOD: I CrcI.|
ITS
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING
PERMIT:
N YEsI NO
I'IATER:
SEWER:
r REQTJIREO FOR
ELECT, IyIECH,
PLB6, GAs EQUIP, PREFABS
& INSERTS *+*
CHEC( (PAYABLE
ro NHC)
E Ar.rERrcAN
EXpREss
D r,rclvrsl I orscoven
(roR oFFICE USE or{ty) REVI5EO DArE O4l11l12
SETBACKS:
F:_ LH:_ RH:_ B:_
***********+*+*,F*,k******,F,k+*******+**,*******+,i*****+,t,N)k*x****+****,**+**********xxxx*****
ApprovaL:_ City:_ DATE:_ FLOOD:
_ BFE+2ft=
N
${oo
DATE: r!'12,:ol5
BLOCK #: 5
! arr canncr
_ sF
! surunoou
-sF
I onrrruxous e
_ sF
tr
tra
ZONE:
_ 0F FICE R:
NEW HANOVTR COUNTY BU I LD ING PERIVIIT
APPL tCAr I0N rYPr: COVI\,4[ RC I A L
PLTA5t AIISWT;I AtL QUtS'I IONS
APPLICAEIIi Ii] YOUR
PI]O]L(]
"Project Responsibility"
. ',ll r\ - r t t t',tlt , I -
15-2644
APP
t ICAT ION
Numbe r
(0f f
icc Use )
APPLlCANT'S NAXE: ROB ROI,IEF-C
ffi
CONT RAC
ADDRiSS
DATE: oe.
f,; i5
DEVE L0PER; uRBAN BUrlDrltG coRp
C ITY: w:uqrllcrou
PHoNF f r ..1.) 'iau r'1,11
2lPr:rcPR0.,ECT AoDRESST
slo NCA::J 4Ttl
oCCUPANT/8USINES5 NAr'lE; BROoKLI'r'r ARrs ciNrER
PRoP€RTY 0WNER'5 NrMt: DAVE
-\AlH:!\s
Ol.ltilER'S A0DRISS:
5i5 NCRi;i 4?H
TOR: U
CITYr llUtcaar a4fxi,\{z rp: 2-?4o2-
PI]ONE #
s
9'.a .';i:2.r1"1
C ITY; wI;,MIr,;GTo)rT:
nc IlP
/)
I
ST
lil
*:
4to (+3 otIIVA I
L ADDRISS
PRO.I ECI CON]ACI PIRSON: Mr'tr 9 -A .228 _
3r3,1
EX IST CONSTRUCiI0N:!
lf Rolocador, is lherc a Natural 6 ds Lrno on thc C trrr
ALTERAI IONRTNOVAI ION
q0t srtc ?
GtNrcAr RtPArRS
l-l nrLOCArror,r
Enu r\ Br06 sPi- {rtRtu,f]vc'
(Chorl
All Irrl Applr)
YesI No
NtW CONSTflUCTIONI
I TfiTCT NiW STRUCTURE
ACCESSORY STRUCTUR[:
f] rnsr rRncx
I srrrLL
I ulrrt
I eoo ro rxrsT sTRUcTURt
lf UPtIT
- The Shell Pernril #ls ect Power on this Building
I vesI NO
..'". IS IHIS A CHANCI OF OCCUPANCY UST?
It Yes, lvhat was the Previous 0ccupaflcy Type? -E!!SS,IS_ l,lhat is the NDv/ orcupan(y Iyp
ARCII DTSIGN PROTESSIONAL: ROB ROII,?-] ;:ict.:T:IJT PH:
910.::9.:13'r NC REC lr 122sc
fNGR Dt S IGN PRofESSloNAr' MCDol"igLL:f,'G:i.itERrll.PHt
9:a.21a.37.,'7 NC RtC #i 23913
OTSCRIPTION Of IIOR(: R;IjCYATE ixlsT]NG : FL.CRS iF 3U:LDI]JG
Yrs ffNo
e? Aar
I
DISCLAIMEn. T Iurror ccrtrfv that rlllr,ornatron ,n th,5 dDoliL.lron 's (o, ucl dnd all wor\
and local rdws and (,diaa,r(e! dnd reo.rldt,ons Ihe NHC Derelooment Ser/u es Ce.ter tr
o, cndlqe in ronuactor o, "orrtaclo' 'ifonrdlrol "'\OIL Any Wo'L Pe,lormc,l W'O ltlp
Subte(r'1o Frrres lJ0 To
i500 00"'\
OWNERrcONTRACTOK
IY lIA M? 1}4+vS
CDdc and dllothcr ao0licahle Stdre
,rooroved olans and iircoficarrons
lroll ol Ilrr NC Slalg Bldg C(xle n,,d
b M or boysag€s pr€p€rsd or sdvsd h thia *ucrrm'l
I v e s r No,!Ths PmpstyLoc8bd hlho fbodphln?[ vcsNo
th lhe s1rl.r trL rlg
SIGNATURE
(o1lrirh.)
co,rEtil Aoboalos o. not Yor, 3.e l€qui.ed b d tho Nal,o.ial Emi:d*xl Sboderds lo. Ha:ando(s Air Polhrtar6 (N€SHAP) s! (913)707*5950 ot t€st 10 dsF prlo(
tl tle
d€.rdrbn d.nyhcllty o.biHir* S* tub.ab W6b Sila ht$r,|ll/wr.6d.rho.rE ur€Cssb.ctdrhtip.htnl
TOTALPROJECTCOST: .
-t, oo.EUILDING HEIcHT: N,/A
pRopERTyusE: norFlcE flnesraunmn f]uencarur[e
!EDUC
NAPT
N
WATER: ECFPUA
SEUIER:
E CFPUA
ElcoilMuNny sysrEM
DwEu DzoNtNG USE C|ASS|F|CATION:
LJCENTRA! SEmC LIPRTVATE SEpnc ncoMMuNfi sysTEM
@NDO OTHER: ns SEMBLY
flucrusr Iorscoven
.- SEPAFATE PERMIIS REOUIFiED FOR ELECT I,IECH. PLBG. GAS EOUIF PREFABS & INSTH I S
'-
N
zoNE:-oFrrcrn, {toffiSff,ott_rn, RH: B.Approvar:_city: ----]ITEI- FLooD,-'
-*"'-""--;.,-;^=
I
trCtNSt *: 59O1 I
P 0Nt
PHONi
# OF UNITS:
ToTAL AREA SQ FT :
-€;lt_ Sq FT PER FLR:
11::__ * OF STORTES: z
TOTAL SA FT UNDER ROoF: j*@- # OF STRUCTURES:
i * Or rt@RS: i-
ACRESDISTURBEO:
N/A EXST IAND DISTURBING PERMII?
tr YES EINo
NEW IMPERVIOUS ARE,U
r;a SeFT EXSnNG tMpERVtOUS AREA:
N/A SeFf
Rgvr*o DAIE
!/l 1/12
PAYMENT
ME1HoD:
flcASlt fiorecx leevleLE To
NHc) filue nraj,l exnness
commenl A v
PERMTT FEE: g...-
a.olS-r
O11>
t5-2644
/,
t7
\z\
NEW HANOVER COUNTY BUILDING PEHMIT
APPL I
CAT I
ON TYPT: COVIIIERC I AL
PLtASt ANSWIR ALL QUTSTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
APP
I I
CAT ION
Numbe r
(0f f ice Use)
PROJECT ADDRISS: s1s NoRrH 4r'H
OCCUPANT/ BUSINESS Nrtl4E: BRooKLt'tI ARrs CENTER
PROPERTY OT,JNER,S NTMT: DAVE NATHANS
oI{NER'S ADoRESS: s16 NoRrH 4rH
CONTRACTOR: rsr
ADDRTSS:
EI\iIA I
L ADDRISS
HONP E#,lLW
ST:
uc ZlP:28401C ITY: wrLMrNGroN
L ICENST #:
CITY:ST: Z IP:
PR0JECT CoNTACI PERS0N: nos norurno
PHONE #
PH0NE #: e10.228.3r3?
EX ISI CONSTRUCT ION:ALIERAT ION
r'
lf
Relocalion, is there a Natural G as Line on the C urr
NEW C0NSrRUCTt0t't,
! rnrCr NrW STRUCTU
ACCISSORY STRIJCTURT:
(Checr
All That Apply)
RENOVATION I_I CtruTNNT REPAIRS T-I RTLOCATION
enr site?
Ey;ENo rs Br-DG spiJ KIERED?
E ves
Pro
RE
E FASr TRACK
n sHrLL
E upr rr
E ADD T0 rx rsT sTRUcTURE
lf UPFIT
- The Shell Permit #ls Elect Power on this Building E Yes E m
rs rHrs A CHANGE Ot OCCUPANCY USE?
EYrS EruO ""'"
lF Yes, what was the Prcvious occupancy Type?
!!!g4IM_ ffiat is the Ne\,!
occupancy Typ
e? ASSEMBLY
ARCH DTSIGN PROFTSSIONAL: RoB RoMERo ARCHITECTPH:
91o.228.313't NC REG #: 122s0
ENGR DtSIGN PR0FtSSloNAi: MCDoWELL ENGINEERINGPHt gao.2'to.3'74'7 NC REG #: 23933
DESCRIPTION OF VI,ORK:OF BUILDING
hioodorb eag€s Frpsld or rdlrld h ura trrtrez I ves
fl lo bTte Prqerry lacard h Ih. Fbodpbht?
E ves
[l no
DISCLAMEn: I hereby cemfy that all rnformatron rn
thrs application is correct and all work will comDly with the Stato Burldin0 Code and all other dppliLable Stdte
and local laws dnd ordinancei and reoulat 0os. The NHC Develoomenl Servrces Cenler will be nolili{id of anv chanoes rn the aooroved olans and sb€cifrcdtions
or change rn
conEactor or contractor riformalron "'NOTt: Any Worl Performed W/O the Appropriate P6rmrls wrll 6e in Violalroi of the NC Stale Bldg Code and
Subjecl'lo Fines Up Io $500.00.''
OWNEF/CONTRACTORSIGNATURE:
(o'..rirts
) Fltt tsrE)
tldr: DG.rblido.r nolifc&n8 a 6b.6to. rdr.vd pc.n*
rppll$ltg .rr io b. at.nlhd rulE t€ @lirdo.r fo(rn (DHHS37€8)
uirotld ,16 h.&y o. tulldho wB io{rd b
rgllnir A!h.6& o. not You 6rs EqutEd b cd th. Nrf..l.l En s.i,l Sb.d.,d3 lb. Hlz.rdous Ah Pohnat s OESHAP) .t 819)m7{9m * lad 10 d.F Fh. b {'E
dG.rElBoo ., .ny HIt o. hldiE[ S.c A.be W6b
SiEi ttts:1iir.r{.qiltdarlc.lrJlC,hb..rD.drdp.tdnl
TOTAL PROJECT
COST: 20o 000
ACRES DISTURBED: N/A
Exsr LAND DrsruRBtNG PERMm
nYES
ElNO
NEW IMPERVIOUS AREA N/ASQ FT EXSTING IMPERVIOUS AREA:N/A
OTHER:lsseMgLy
SQ FT
WATER:
SEWER:
CFPUA
CFPUA
Va TICOMMUN]TY SYSTEM T-]WEI.I
E cenrnar- sesnc
fl PR-IVATE
sEmc
DzoNtNG usE ct AsstFtcAToN:
flcoftn UNrYSYSTEM
", SEPARATE PERMITS REOUIRED FOR ELECT, MECH, PLBG, GAS EOUIP PREFABS & INS€RIS'"
pAyrr,ENrMErHoD: EcAsH f]cnecxleavmtEToNHc) Earcncexo<pness EITMSA Doscoven
(FOROFFICE IISE
ONLY) FEVI8ED DAIE 4'I1l'2ZONE:_OFFICER:_ SETBACKS: F: LH:_RH: B:_
Approva
Cty: DATE: FLOOD:___BFE+2ft=_
AVN
Comme PERMIT FEE:
$_
APPLICANT,S NAFIE: ROB ROMERO DATE: 09.15.15
DEVEL0PER: SRBAN BitrLDrNG coRp. PHONE #: sto.'/62.a747
C ITY:
wrr,r'{n'lcror.r Z lP: r.:c
BUILDING HEIGHT: N,/A # OF UNITS:
TOTAL AREA SQ FT:.9-W- SQFTPERFLR:
:.zrz #OF STORIES: z
TOTAL SQ FT UNDER ROOF: 6.
saa t OF STRUCTURES:
r * OF FLOORS: I
pRopERryusE: EoFFlcE f]msraunam
luencmmu
leouc f]pr Econoo
,'ai'twl
NEI^J HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE; RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLI(A8LE TO YOUR PRO]EIT
5- 3oa:
io
tnT
APPLTCANT'S NAIiIE:
DEVELOPER:
"Project Res pons
ibil ity"
Jo,.^tlr. Bl*rlr^rl
APPLICATION
Number
(office Use)
onre: Io .aQ-B'
0dPHONE #:
PRO]ECT ADDRESS:
SUBDIVISION:
PROPERTY OWNER'S NAME:
OI^INER'5 ADDRESS:
)o
A
(
CITY;
CITY:
4 LrcENsE #:
\3'113
crv: Ld. I
11
STORAGE SH ED
PHONE $:
SVt, Ol,ff
sr I t^tL zP I A.Xq
a7
t ,[irro:fl|'{of
PHONE #: 5\C C -7*,7
PHONE #:o1
neiStt_cl
F*"
Ei4AIL ADDRESS:
PRO]ECT CONTACT PERSON:
TOTAL HEATED SQ
CONTRACTOR:
ADDRESS:
PROPERTY USE
/ OCCUP
DESCRIPTION OF I^IORK:
ATT GARAGE
-
SF
suNRoorl
_sF
GREENHOTJSE SF
DET GARAGE
-
SF
POOL SF
! concH
-
sF
SF
SF
n,40R4 sQ Fr uNDER ^oor,4bqolTOTAL AREA
5Q FT:
1J,11_TOTAL
TOTAL PROIECT COSTtLessLott : $
Is Any ELECTRICAL, PLUI'IBING or fiECHANICAL work Being Done to the Accesso.y Structure?
ffi v"t
I rvo
If the project
is a Relocation, is thene a Natural Gas Line on the Current Site?
E Yes
rs there Electrical Powen on this Bu j.lding? I-l v"t [X! ruo
ANCY:
EIr NGLE FAI4ILY DUP LEX Tol.^JNHOUSE
and ordinances ard regularions The NHC Developmenl Se re.willbenotfedolanychangesrnheapprovodplansandsp€cilicalionsorchanqeincoorrac!oror
contaclor rntormaton "'NOTE Any Wo'dle Ferrrl\ w,rrbc n v'ora1on or ll'e NC
srsle Brqg cooe ard Sub,ecrto l,nes u, Io 5500 00"'
SIGNATURE: JONg,9r,..K"IJOtl,NER/CONTRACTOR :
WATER :
E CF PUA
SEWER : m cF PUA
*;f ,F + ** * * + *,k + * *
IS THE PROPERTY LOCATED IN A FLOODPLAIN?
EXISTING IMPERVIOUS AREA:
_SQ FT
NEtrl IMPERVIOUS AREA: _SQ FT
YE5
! commururrv svsrrm
I pRrvATE r^iELL
I cenrnar srerrc
f] pRrvATE sEprrc
ncasH ncHEcK (PAYABLE
ro *rc) E
OFFlCER
NO
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERMIT:
CENTRAL !JELL
! commururrv svsrem
w
YESNO
N
*1* SEPAIIATE PERI1ITS REQUIRED FOR ELECT, IIIECH, PTBG, CAs EQUJP, PIi!FABS & INSERTS **'
PAYI4ENT i4ETHOD:AI.lERICAN EXPRESSfiClVISA DISCOVER
*******,r***xxxx)***;*,r**.r*)t*****************************,t**********,1***********)k**********
ZoNE:
_
(10,1
oltIcE usL oNLY) REV:ISFo
DAII 04111/17
SETBACKS: F:_ LH:_ RH:_ B:_
Approval:_City:_ DATE:_ FLOOD:
_ 8FE+2ft= _
AVN
Comment:
PERI'IIT FEE: $
G{1
BLOCK f: LOT S:
EXTSTTNG CONSTRUCTTOT)r:
! nrrrnarrOl,r
! ner,royRrtror,r pcrruenar neearRs
! RELocArroN\/-
NEW CONSTRUCTTOT: p enrCr NEW RESTDENCE o"
I mOrrrOt TO EXTSTTNG RESTDENCE
**PLEASE CHECK AND ANSWER BELOW ALL THAT APPLY TO TloUR PRO]ECT:
[ferer _ sr orHER:
1rcrtt]ottu I oF sroRrEs: 7
NEt^jHANOVER COUNTY BUILDING
APPLICATION TYPE; COMMERCIAL
PLEASE ANSIi/ER ALL QUESTIONS APPLICABLE I0 YOUR PROIECT
"Project Responsibility"
'ilf-/Nq>
PERMIT L5-3220
APPLICATION
Number
(Offi(e Use
)
DEVELOPER: SoutheL.n rndustrial consrrucrors
CITY: w1lm1nqt on
PHONE #: lrt,.r.r-l,ta,
PROIECT ADDRESS:
f9i I aasrte Hajne F.oad
OCCUPANT/BUSINESS NA E: southern Industrial Constructors
OWNER'S ADDRESS:
, , ,--:- -. ,,,.:.! .i- , i
Inc
CONTRACTOR: Southern Industrial Constructors, Inc.
ADDRESS: ij
101 Trianqle Drive
E|['IAIL ADDRESS: f,rnJ . le,,risLase..onl
PROIECT CONTACT PERSON: gn.l.; :qorris
LICENSE #: :r52l
CITY: Rateitlh
CITY: wr
Im:.ngton
ST: NC ZIP: 2 r 611
PHONE f: 9 r o
- .:r
{ :1
- -l o 6 l
PHONE f: I1C- 5 t l- 94 8 a
If UPFIT
- The SheLl Permit *Is Elect Power on
thls Building
I vesI NO
'l**** rs rHrs A cHAt{GE oF (rccupaNcy usrr
lves T
IF Yes, what was the Previous Oc€upancy Typel What is the New Occupancy Type?
ARCH DESIGN PROFESSIOi,IAL:
ENGR DESIGN PROFESSIOT,IAL :
PH
PH
NC RE6 #:
NC REG #:
DESCRIPTION OF WORK: Pour a foundation pad for the Glvcol Tank and
Coolinq Tov,rer in AE
ls food or beverages prepared or served in this structure?
flves
fi r,lo ls The Property Located ln The Floodplainu
I ves
[l no
OISCLAIMERT I hereby cerlify lhat all information in lhis applicalion is correct and allwork willcomply wrth
the State Building Code and all olher applicable State
and local laws and ordinances and reoulations. The NHC Develooment Services Center wrll be nolrfred ol anv chanoes rn lhe aDDroved Dlans and soec fications
or cl"ange rnconlracloror contra(ror r"nformatron "'NOTE Any Work Performed wO the Appropnate Permiis will 6e rn Vrolatr6n of lne NC State Bldq Code and
Subjecr-to Fines Up To $500 00"'
OWNER/CONTRACTO SIGNATURE:
(Ou!l6er) (Pdnt
N.mo)
cootain Asb€6tG or not You are Equircd to call the Nalional Embslon Standanls fur Hs2ardous Air Pollutanb (NESHAP) at (919)707-5950 st le&st 10 days Ftor to ttl€
damoliton of any fedlity or buiHing. S€o p6be3ba Wob Sire: httsr ,vrvw.epi.state.nc.usy'6d/asb€sto6/ahmp.hlrnl
TOTAL PROJECT
COST: I,'cC0. .1r BUILDING HEIGHT: N, A
# OF UNITS
R: Michael Br: i ns on
:l
TOTAL SQ FT UNDER ROOF:
--
# OF STRUCTURES: I
ACRES DISTURBED 0
NEW IMPERVIOUS AREA:
l
# OF STORIES: I
# OF FLOORS:
EXST LAND DISTURBING PERMIT?
N YESNO
SO FT EXISTING IMPERVIOUS AREA:
TOTAL AREA SA FT :LL22SQ FT PER
FLR: - i .r.l
1122 SO FT
pRopERTy usE:
lorrrce !nesrnunlrur luencnurLe
!eouc APT
CONDO OTHER:
rndusr L L3l
WATER: ICFPUA El COMMUNITY SYSTEM
fl WELL flzONtNG USE CLASS|F|CAT|ON:
SEWER:
- CFPUA
- CENTRAL
SEpTtC
E P-RTVATE
SEpTtC g-COtvttrlUr.trw
svsreu
.'SEPARAIE PERMITS REQUIRED FOR ELECT, It,lECH, PLBG, GAS EQUIP. PREFAAS & INSERTS
''
PAYMENT METHOD:
flcesn Icxecx lervneLE ro NHc) flnlaenrceru ExpRESs [lracnrrsr flolscoven
(FOR OFFTCE USE ONLY)ZONE:_OFFICER:_SETBACKS:
F:- LH:- RH:- B:Approval:_ City:_ DATE: FLOOD:
___ BFE+2ft=
AVN
REVISED DATE 4/11/12
I
Comment PERMIT FEE: $
/rD
APPLICANT'S NAl,lE: ssqllrer DATE:-llll-llll
ZIP i i,; '
PROPERTY OhINER'S NAl.lE: General Elecrric PHONE #: 910-411-3061
ST: Na ZIP: :8'ta2
(check
Atl rhat apply)
EXrST CONSTRUCTTON:
! ALTERATTON
! nrruOVlrrOru E14ruennr- REPATRS
E RELOCATTON
lf Relocation, istherea Naturalcas Line ontheCurrent Site?
[Ves flNo lS BLDG SPRINKLEneOZ
I ves
fluo
NEI,{ CONSTRUCTION:
E ERECT NEI{ STRUCTURE
! TIST IRACK
E SHELL
E UPFIT
N ADD TO EXIST STRUCTURE
ACCESSORY STRUCTURE:
Pcur foundation pacl
fcr c1ycol Tank &
Coolinq Tower in AE