MARCH 16 2016 BUILDING APPSPRO]ECT ADORES
SUBDIVIsIO:
PROPERTY 0 l'lER'S iIAr'!E:
otri€R,S ADORESS:
,.&
APPLICAI{T,5 I{A'4E:
DEVELOPER:
-,
8
I'IATER: ll:J CFPUA
sEr.,ER: [l] cF PUA
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATTON TTFF: RESIDENTIAL
PlEAsE Al\sI,ifR AIT QJESIIO(S APPLJCASLi IO YOUF PRO]E(T
"Project Responsi bil ity''
8L0C( f:
CITY:
DATE:
lb' ilg
ZIP i
LOT S 2
SF
sF')fa)
APP LI CAT I Ot.I
tlunber
(Offl(e Us€ )
//77a
ITY
plioitE *:
PHON E
CONTRACTOR:
A'DREsS: -
\NN€-/Lwg l ,- CITY] WILAING'(ON
-
ST rVCap.?84\lKru(e* 630f \]\{-lk{,C
- LICE SC *:,
*,1ere\s'si gi/
sr :/ v- zI?.J 8q//
et) -5i I - Yq ll
EIIAIL ADDRESS: i ,v
PROJECT COI'ITACT PERSoN: -
Exrsrn{6 coNsrRucrro : f) ar-renarroN p nelovarrol ! crrennl nrrarns f]R€ tOCATlON
NEt{ COiiSIRUCTTOT: fl rReCr NEt,l RESTDCNCE o" ! mOTTION TO EXrStrtlG RESTDEiTCI
..PTEASE CHrc( Al{D AtlSl'JER BELO,j ALt T}IAT APPLY T0 YOUR pnoiECT:
fl arr canrct
-
sF I otr canace sr f] conor
-
sF
l-l sulRoor,r sF PooL _ 5F f] sroarer SHED _
f] eaeruouse
-
sF I oecx
-
sr OTHER:t.. rt ,,1--)
pt&{E 3:
Pro E t:
TOTAL HEATED SQ FT:. JI;J" TOTAL SQ FT UNDER ROOF: }EI{ TOTAL AREA SQ TT f22i
ToTAL PRolEcT CoSTrLe,.tou : S f4{a1." I oF sToRIEs: /
_/
Is Any ETECTRICAL, PLU|iBII{G o. Ectllr{tcrlt Work 8ei.hg Done to the Accessory structurel pl'Vat I lfo
If the project is a Relocation, is there a Natural Gas Line on the curr€nt site? f] ves fflo
fs ther€ Electrical Polrer on this Bullding? ffv"t f] Ho
pRopERw usE / occupatrcy, ffrr*ou rnr'ttr-v fl ourr-rx I rowNHousE
DESCRIPTIoN 0F t'loRK:
DISCLA'i ER: lrerebY t!6t ett irbrmslon in nrs ap?l.aion E coi'rct s.d a{ t'/orl will comply walh h€ Sr3ie Buiidhg Cod3 a.d a[ oh€r ?pplc6bl€ SraE and to..t Bws
and o.dinances..d rceulations The NHC Deveropmanr S€wrc€s c2nEr willbo noifi6d o{anychangls in t'e appmved plr!5 qd specifnaliois o.chanqe in cql@ro!
coilacbr nbmsion "NOTE ArlW.ork Pe'lotmoC t'/,O sre Aoptropr'€l€ Fem'ts*'l' be rn volalon o'lhe NC StaF B ,,|,
owNER/coNrRAcr *' ' Kns-,",k$z srflrrunr:.. 4r+r: t/,^.*"
,****:r*t(t**r(******+'l*:f*r****t**+*r**{'t**'ii*':ft'"***f'}r)r**'}*'t't*)r*)t'*
rs rHr pRopERry LocATEo rN I rloooplartl l--''l ves W,ro
EXISTING II'IPERVIOUS AREA:
-5Q
FT TOTAL ACRE9 DISTURBEDI
I{EU IIlPERVIuls ARTA:
-
SQ FT EXIST LAND DISTURBING PTNUTT' I'-] VES I-'] IIO
n corl'ruNrry svsren I eRIVAT€ r.,,E LL ! crl'rnal t"trlr-
cENTRAL seprrc I enrvarr srerrc ! coilMuNrw sYsrEM
..T SEPARATE PER}ttTS EIOUIREO FOR ELECT, I4ECH, PLBG, GAs EqJIP, PNEFABS 8 ITISERTS "'
,o*r* *rr*oo, E .ls* ff*rix (PAYABLE ro mrc) E aren:cAN ExPREss I rclvrsa I orscovtn
,*:r***'r+*'lll)tf:l:l+*****,}]t,},}**l**i******4*!tt***:l*')t'},lttl**'****+*****!t*,,*t't)t***,i****t**ii
{roi Offl(t Ult {nLY) Rtvlllo DATE e1r1l/i2
7^NE. OFFICER:SETBACKS: F:- LH:- RH:- B:-
Approval.: citY:- DATE:- FLooD:
-
A
8FE+2ft=
'!
tti*t.,,-t,vj t> t,t A. Trtr'k ^ - 1,* c r< t /L.., .n *Tqal I
0L ho ulc vvfuy n
,-l
?at
o \,
RECE|VEtj FrF 01201$
;\NEW HANOVER COUNTY BUILDING PERI4IT
aPPLIAriott rYPE I RESIDENTIAL
PLEA5E Alis!,rER AlL qlESIlOr{s ApPL!(A8L€ IO YoUi Plalaa,
"Project Respons j.bility''
.,.. : ),
Ce, r\
.mi
APPLICATiJII
Number
APPLICAtIf'S llAlYlE: A!lan!ic Construcrion & ConEufr DATE: I/3Q /\6
DEVELOF ER:
PRO]ECI ADORESS:
SUSDIVISION:
II0 grookshire
PHONE f: l:0 t..lt {lB5
ZIP:2s409CITY: Hi imin
8LOCK ts
PROPFRTY OtINFE,S LlaMF ! .:^r.ie Tv.er
! sunnoou _ sF I nool
--
sr
sf troecx _ sr orHERi
STORAGE SHED
LOT *
PIIONE tlr 910 5rB 5l;,
SF
SF
I No
oriNER'S AoCRESS: 110 B:ooi.6n::-sTt !q zIP: ?a4r9
CoNTRACToR; A!lanric c,]l i!rucEion 6 consulcr:o
AODRESS: 5103 llarrna club Drive CITY: vrilrlinqEon sTi tic ZIP: ?a{c9
PIONE S: 9ro {at 4386,EIaAIL AooRESS: :1.ar'racc.bui.1ders
PnOl ECT C0 TACT PERSotlr
EXISTING CONSIsUCTION:ALTE RATION FIENOVA ' : I]N 6'IiERAL REPAIRS RE LOCATIOIJ
NEx COr.lS IRUC rror{: n EnrCr NEl^l RESTDENCE o" f, aOOrrrOt TO EXISTrNG RESTOENCE
.'PLEASE CHECX ll'lD AllSxEf, BELOt4l ALL T!1AT APPLY T0 YoUR PROIECT:
! nrr canacr
-
sF f orr cat,rce sr ! concH
-
sF
C:TY: il:imrnq!cn
il] enrenHousr
rOTAL HEATEO 5Q FT: azoo roTAL 5q FT UNoER R00t : 2:oc ToTAL AREA SQ FT; zzoc
TOTAL PROIECT COST 6ass roi : I 7oo0 * 0F STORIES:
Is Any ELTCTRICAL, PLUIIBING or nEcHAr{ICA! ltork 0€tnt Done to the A(ccssory Structu.c; f Ves
If the project is a Relocation, is the.e a tlatu.al Gas Line c,] the Current Site? Dves E] ruo
Is thene Electrical Power on this Building?I ves I no
PROPERIY U5€ / OCCUPAIKY I SIBGLE FAIILY OUP LEX TO,,I'IH0USE
DESCRIPTIOI{ OF IIORX: This proi.c! is to !Ct[qv! asphalL ql4qles and renslal] per cc4e new a..halt
O!{lf ER/CONIRACTOR : At:an!ic constlucEion rl con.iLrl! SIGNATURE I
(p.tnr xt..)r*.1. '. r r.r*. r. r r ar I r r' r ! !rr t.a !t r arr.i.*iir""alrrrt
IS THE PROPERTY LOCATED IN A FLOODPLAIN]YE5 NO
olsc! lM€F- rh€r€oycenity h.r.l nbrnauon n nrs applrcakn $ core.raro d v.or(,it cofpiywdr bo slare &r,tii!] code and 3[ otna, rplrabE sl,E a14loa.iles
ao odi.rlcei:.(, ioguralanr Th. NtlC O.rolAio.r S.toicos (,nBt *i[ bo nolred olsny dranles h he appov€d pbnro.d srErl.lrss d cnsg. n co.rd.rrr o,
c.^:a-.D,.bfabn. "' oTE Ary \!o.k Pa&rn.c tYro rhe aorrop.aE po,i 'J war D? n va rrl(1. o, |he Nc sDc BLg code 3o( s!b,e.r ro F ines l& Io s$0 0o "
EXIsTING IHPESVIOUS AREA:
--
5Q FT
NEl,l II{PERVIoUS AR€A: _ SQ FT
HATER; M CFPUA
SEWER: Z CFPUA
TOTAT ACRES DISTUREED:
EXIST LAflD DISTURBING PERIIIIi I]-l YES NOI
conmurir.rl svsrem ! pRrvATE l,rElr-
cENTRAL sEPTrc ! enrvarr srerrc
CENTRAT WELT
c0t4l'4uN I TY SVSTEI
..T 5EPAR/TE PERTITS REqJIFED FOR ELECTJ I{ECH' PLSG' GAS EqJIP' PREFABS 8 INSEPTS t"
PAYfiENT IIETHOD: E COS,cHEcK (payaBLE ro rxcl I aarnrcor rxeness rclvrsa E ort.or.*
zoriE :OFFICER:
App.oval:- city:_ oate :?-lVt lbrt
U1( qirY) ! qrrtstD OArE 6r.,ltl:2
s' r, t{6rH, tllflr..,Qp-a'1[1
ooo:
-
-
X ere*:.r=
?-15 S{: TEACK
.PERhIT FEE: t--
t
a
Cofineat:
LICENSE *I
PtloNE s: 9ro.ir3 4:e6
R COI.IT{TY BUILDING
aPPLICArIott ryPEr ColS,lE RCfAL
PLEASE lraSUX ALL Qu€SII0a6 AppLICAaTE rO y{In proltcr
-ProJect ResponslbUltf
APPLICAXI,S Al.E. l{atth6r xor6l
DEVELOTEt: .Bloonin Brands Iac.
PRoTECT ADORESS: a719 Neu centrc Di. suirc x
oCOfArf/EUSI ESS Ar|E: Botrefl.h GrLJ.t r9{os
pRopERTy (I{|ER'S MXE: ari_Eo! property GEoup roc.
CITV: Uilr.iagto.
Od{En'S AITORESS I il20 raxlastor Ave. 7th lloor CJTY. lls, rolt
COaJTRACToi: vetrturo Colllructloq LrcE sE t: 6e3,1
ADoiEsS: ll Terr.ce llay
El.lAI L ADOnESS : rachlSyeEtur€lcoDltructLoa. coo
PRoJECT CO{TACT PERSOI: zach raeohour
If UPFIT - The SheU perrdt *:
.:
NET.J HAT'IOVE
,/
PER!,|IT 1G-330
I
APPLICATIOI'
llurber
(Ocflcc t s!)
OATE, t/27 /20t5
PHq{E t: 813-83{-367s
ZJP: 28461
ptfiE r: 770-360-8423
5t3 !1 zrP! rorTo
PHo.TE
ST: tlc ZIpt 27{03
,.335-8s2-19{6
PfloftE ,: 8{.rE
Exrsr corsrRucrror: f] rurenarrr, g *.,Jfriiii' 'b?.'il*,- nrprrns n RELocArr(x
H Rdocdon. B there a Naluat Gas Lin€ on the crrrer( Site? Q vtQ ruo ts Br-Dc spn-truxteneoz I v"" f,1llo
xEr co{srRt crroitt I rnscr xEr srRtrruRE I msr rmcx ! *re r-r- ! unrrr f] ADo ro Exrsr srRrrcruRE
ACCESSORY STNUCTT'RE:
..... IS THJS A OituGE
IF Y€s, *rt Es the prcvlour Occupency T)D!?
AROI DESIGI{ PiOFESSId{AL;
Is Elect Poi.e. on thls Building O yes I rO
l Q ves Qt m .....
Llit ls thc t{a Occupmcy It/D€}
OF OCqPlxCY USE
Ctacn DESIO{ pfiOFESSI(r{At : vlncent lflri.Lioata Ptl:
--
trc REG t:
Pfli 9t3-742:saEO p6 3g6 3. 0{ 159{
DESCRIPTIOII OF }ORX:b a-.cE\ | '*^) qt
b bod or borrtec trlpd€d a Evod h na arnref Qlvos (f rrro b lhe Propsty lacd hTp Ft@dClft? O va p xo
(r-,GrittD)l5la Dartlolor ndLlldr a rE .r.Erd Fi #dr l!b b ri.!U(*E tE Tt*.dottb (u{r{s-{r68)atrlrtrydhJl lr-hrdbadalt Lb-a a,rot Yq, ..! iqltd 5 d tr lSad E rlJdi &r6kld(r'.ll Mrr 0Ea i(gl97orjta, r h t0tF FlrDrrdil!&r.art t ly rLaiie- 8- Lb ltS * ftgr,r,rlw..9l.rrro.nc-u/a0ucD6tod!,tm p.ttnt
TOTALPRO'ECTcoST: 9'15,000.00 8U[.OtNCi]GGHT:I
TOTALAREASOFT:+/- xoo SO FT PER FLR:
TOTAL SO FT UND€R ROOF' 5527
'OF
STRUCTREi:.
, OF UN'TS:
paopE8ryrlsE: florrrce Blnesraun$n fJuencermr-e fleorrc fJarr f@w OTHER
Ii,ATER:
SE1IYEft
IISE CT.ASSIFICATION:
CFPI.'A @TflIUNITY ST€TEI'
... SEPARATF PE t]MITS REQ(
'INf
O FOR ELE(]T, MfCH, PLEG GAS EOL]IP, PFEFAE.S & IN:iLH I S ",
pAnrENTMEIHoq (fcasx Qoreo<(P yA8tEror*tc) Qeuenrcrnoeaess f,trrcrrse oolscoran
(FOiCFruscoitrn Rgl'BED DAIE {IIIlt2
EcoiilruNnys\ErEH flwErr-
lJcENrMr-sEprrc LlpRtv rEsEFnc
IONE: __OqtCERi_SETBA0(S:F:_LH: Rlt_B:Alrgrorral: CltlC__DATE: _FLOOD:___BFE+alrl UA
-t-.,,7 "-LT
x
CITY, creeosboro
Vab-
# OF STORIES: I
. t OF FL@RS: 1
ACRES OISN,RBED:- E(sT lrND DISTI,REIMi PETRMT?O\GS ONo
NEW ilpERVrOrrS AREA_SO FT flSTIM! tltpEFl/rous AREA _ sa Fr
7
[tz A->-
NEt{, HANOVER couNw BUILDING PERfitIT
AppLrcafiqt nas.. Col+tERCfAL
ptEtst axstGi atl QUESTIO S Appttc{rE m you ptorEct
:'i'i:;:i'?:::in.,
tc- 5rl
APPTICAITSI
snb!r
APPLIC$T, S M[I:
DEVELOPER:
PROJ ECT ADORE553 oa
PioPEiw oHitEi,S IAiE !
CL-,,^Slr:> "f-.-, (6rL Pe P[Ot{E
"*lo'n ctw:,a
oCCUPAI{T/ s$ElS MIE: C "..-\-.C..L^-l zfi
OT EN.,S
^DOIESS
I s..-e -i .q.'HtitE
*:
ST! _ ZIp:
PX)'{E f,!
I ves Erc
clw:
LICETEE *!>S
CIW: '^/. {
gr:_ ZIP:_
v.L
corJTRACmn 3
AOOnESS:(={ f,L,
1^,-! t,ss -t-s: t
E AIIL ADOTESS r:'J l 1 )-84 r>5
t(.31?LPNOJECT CO{IACI PEiSC{:
ery1 q1sryo{Sft.rr*rror tr.,,Jffiifiifi?'i1. . .
tf Rltocrum, 18 thsrc I NEtur8l css Line on th3 curBrl sile? [ vec-ft ro ls
EH co.rrnucrr : ! enrcr tte], srn cruRE ! resr rwr fl srrl
accEssonY SfiLlouiE:
PIONE *3
Is Elcct Po$!r on thls Buildl n8
T.iH**tr-,f.ffffi*;
r Dg--r,?Fn EI loo ro Exrsr sr rrnE
If UPFIT - the Shcll Pernit r:
tF Ycr, rfirt rrt thc
..... Jl rllls r cxtllcE OF OCctDr cY usrt $1qgPl.Clrlo0r occupancy TtDr?+l
l-_r_l h,ttt t5
Arol OESto{ PrcrESgtO ltt fi-
In
tha t{crr occupancy lDc?
<_\.-"8
-..e lA &
r cEr c.
Pxr J c1. q46,1
P8:
itc iEG *:6s9
tJC REG
':
EXGi 0t5r6r{ proftssloMr:
DESCRIPTI0II 0F [ORK:
. ZONE:-OFFICER:
(FOROFFTCE l,6toi{u
SETBACKS:F;_IH:_RHL BL
BFE+2fi=
I
ct +:A>a'--r E
6
e
"rq'1 3a)+
iEl/EtD oArE (lwDATEI- . FLooD:Apporrll: CDc-
Ury
A v
PERMIT FEE:
,9rYa€)ya
++\_
rh.
DATI
b lbod or bqr.ne.. Ft .nd or ..r,v.d h U* rrutnfi[yer I m
(S. L\^,r b \tSS
(O.t,
^-\-?TOTALPROJECTCOST: J5 \-
TOTAL AREA SO FT. J66o
TOTAL SO FT U'iIDER FOOF:
ACRES DISTURBED:-
NEW IMPERVIOUS ARE& l./ , -r^ e.t E r
PROPEFTYUSE: Brrm Ehrsnumrr
WATER:ECFPUA
ECFR,ASEWER:
E*o
EIeurc Errr ElooirDo
Eosco\En
E tt
PAYltEirr tlETHoD: ECaSX
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATTON TYPE; COMMERCIAL
PLEASE ANSWER ALL QUESIIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
tre k-rb)Dq1
L6- 406
APPLICATION
Number
(office use)
APPLICANT'5 NAME:Lumina Stat ion Comme rc ia1 LLC DATE: .^2 . 1L'r . j,i I6
PROIECT ADDRESS: tira.l Easr-w.,od F.d. 10!r
OCCUpANT/BUSINESS NA E: Griind Crr Enlrerprises, Inc
PROPERTY OWNER'S NAIiE: :unLina srat-i.n :.!..Lrrer
O[^INER'S ADDRESS: 88rI l.{arina pklrv
CITY: l", r rrrnqt on
CONTRACTOR:
ADDRESS:
CITY: Itr'rtle Bedcir
PHoNE *: (t i 3 ) 81E -.r.r.r I
Sf i ::_ ZIP i 23.)1 2
ST: _ ZIP: _
LICENSE #:
CITY:
EIiIAI L ADDRESS:
PROJECT CONTACT PERSoN: Eriri Biafock 1843t 2r3- 1612
PHONE S:
PHONE *:
If UPFIT - The shell Permit f:Is Elect Power on this Building flves Ero
***** rs rHrs A CHANGE oF occupaNcy usrl fives I
IF Yes, what was the Previous Occupancy Type?
ENGR DESIGN PROFESSIOTIAL: l']c Dowelf Consultins Ensineers. 1nc PH: (910 ) 2lt- 31,11 NC REG #: 018 518
DESCRIPTION OF t"lORK: 1sc sf Buildinq Add Interior Renovation - 1530 sf, buildinq, MEP
ls food or beverages prepared or served in this structure?I ves [ ruo ts The Property Located tn The Ftoodptainr I ves [ ruo
DISCLAIMER: I hereby cerlify lhat all information in this application is correcl and all work wll comply wilh the Stale Building Code and all olher applicable Slate
and iocal laws and ordinances and reoulations The NHC Develoomenl Services Center will be notified of anv chanoes in the aooroved olans and sDecrlications
or chanqe rn contraclor or conlraclor r"nformatron. "'\OTE. Any Work Perfo,med w/O the Appropriate Permrls wrll b:e in Vrolalroi of the NC State Bldg Code and
Subject-to Fines Up To $500 00"'
(au€ffsi) (Pnrn Nsme)
Note: Demolldon nolifcadong & asbostos rcrnoval p€mil applbalions are to bo submitted using th6 application torm (DHHS-3768) \rlrether the fuciliy or buildhg was found to
contaln Asb€stos or not. You are requircd to call the National Emlsslon S:landards for Hazardous Air PollutanE (NESHAP) at (919)707-5950 at least 10 days prior to the
demolition of any tacility or bulldino. S€e Asbestos Web Site: htp:/
^.ww.epi.slato.nc.usy'epi/asb€€to6y'ahmp.hunl
TOTAL PROJECT COST: BUILDING HEIGHT: .]O f I- # OF UNITS:
# OF STORIES: 3
# OF STRUCTURES:# OF FLOORS:
-
ACRES DISTURBED
RESTAURANT MERCANTILE EDUC APT CONDO OTHER:PROPERTY USE: EOFFTCE
WATER:
SEWER:
zcFPUA ECOMMUNTTY SYSTEM LIWELL DZONTNG USE C|-ASS|F|CAT|ON:
EcFpuA ECENTRAL sEpnc flpRtvATE sEpTlc E coMMUNtry sysTEM
", SEPARATE PERII,4ITS REQUIRED FOR ELECT. [/1ECH, PLBG, GAS EOUIP PREFABS & INSERTS *'
'A'MENTMETH.D: .=:::*?::.:-":,::l:.::.1:.::?*_n"_y':::)*T:::.:.F__:c.mse Iorscoven
?ito
(FOR OFFICE USE ONLY)nEvseo ome cnrliz /ZONE:_OFFICER:SETBACKS:F:_LH:_RH:_B: tbj$aDQX_:Approval:_ City:_ DATE:_ FLOOD: _ _BFE+2ft=b rctD
Comment
c€, c?, l-ltTH
N
PERMIT FEE: $
\9o
.:... r
.m
DEVELOPER: Lumijr:r sration commer.ial , LLC PHoNE #: ( 8 I I ) 8 ..1 8 - I I .l 1
ZIP.:84i.)3
(Check All Ihat Apply)
Exrsr coNsrRucrror: ! ALTERATToN I nrruovrroru ! cetenll neearns ! RELocArroN
tf Relocation. istherea Natural Gas Line onthe cwrent site? EYe;ENo tS gLOc spRlNxLEneoz I ves Iuo
NEW CONSTRUCTTON: E ERECT NEW STRUCTURE f] rASr rnlCr ! SXer-r- ! Uerrr I ADD To ExrsT sTRucTURE
ACCESSORY STRUCTURE:
NEW IMPERVIOUS AREA:_SQ FT
what is the New Occupancy Type?
ARCH DESIGN PROFESSIOiIAL: e3 s.u.lio llc PH: (843) 213-i512 Nc REG *: 112-3
OWNER/CONTRACTOR: SIGNATURE:
TOTAL AREA SQ FI : .!!-!.!--EJ- SQ FT PER FLR:
-
TOTAL SQ FT UNDER ROOF:
Exsr LAND DrsruRernc penl,rrra l-]ves I r.ro
EXISTING IMPERVIOUS AREA: _ SQ FT
[n /+.]-rb )Dctlf) L)
NEI^I HANOVER COUNTY BUILDING PERMIT
APPLtcaTIoN |YPE: COMI'IERCIAL
PLLAsf \5L,iEF A!L QUEsTToNS APPLICASLE T0 YOUR pRol€CT
"Project Responsibility"
L6- 40 6
do.
ffiilf4Y
APPLlCATION
Number
(office Use)
CONTRACTOR;
PRO]ECT ADDRESS:CITY: :.;ZlPt -
OCCUPANT/BUSINEsS NA,{E: .: .,
PROPERTY OWNER,S NAI'IE :
OWNER'S ADDRESS: ..
PHONE *:
CITY: :;,.r:? :.:..: i.
LICENSE *:3
PHONE *:
PHONE #:
firrr./tr tz/.7./a-"272-nE
ST: . -r ZIP: . ,r
ADDRESS:CI TY:ST
EII'IAIL ADDRESS:a e
PRO]ECT CONTACT PERSON:
(ah!(k All rh.i .,pr!ly)
EXIST COiISTRUCIION:ALTERATION R ENOVATION 6ENERAL REPAIRS RELOCATION
lf Relocation, is lhere a Natural Gas Line on the Current Site?I Yes -No IS BLDG SPRINKLERED"Yes I No
NEW CONSTRUCTIOi'I:ERECT NE!{ STRUCTURE FAST TRAC(SHELL UPF IT ADD TO EXIST STRUCTURE
ACCESSORY STRUCTURE:
If UPFIT - The Shell Permit f:
*..i* rs rHrs a cHANGE oF occupAr,rcy usrr flves T
IF Yes, rhat rJas the Prevlous occupancy Type?
ARCH DESIGI{ PROFESSIOT,IAL: ,
ENGS DESIGN PROFES5IoiIAL: :' ilr
Is Elect Power on this Bui.iding I Yes nruo
What is the New occupancy Type?
NO *1***
PH NC REG f
PH: 1 :'r NC REG fr: - -
DESCRIPTION OF IjIORK:
tls food or beverages prepared or served in this stnrcture?
DISCLA]MER: I hereby cerlity lhat rll intornr.lron in lh's spplcrt:cn 1s
and local laws and o.d e NHC Dpveloprne"NOTE Any worl
TOTAL AREA SO FT
-
TOTAL SQ Ff UNDER ROOF:
-
Yes D No ls The Property Located ln The Floodplsinz I v"" f] ruo
# OF STRUCTURES
da work willcomply
Center wrll be nolifie
# OF STORIES
f OF FLOORS:
Exsr LAND DrsruRerNo penMrrz n ves I Ho
SO FT EXISTING IMPERVIOUS AREA:
wrth the Stale Euilding Code and all orhe. a pplrcable Srale
Peio.med W/O lhe Appropriate
ol any chanqes rn rh
Pem'r s willlre at V o NC Sra
ni Services
g Coae and
SuUect
OWNEFUCONTRACTOR:
(o!.1!!.r)
SIGNATURE
Notc: D€moiiton noltfcstions & asb€5t6 rernov.l p6mil applbarlons ar€ to be sub.nlled using $e appt,cstion lorm (DHHS-3768) vrher€r
conErn Asboslos or nor. You are r€quired ro call lh€ Nslonal Emlssion Sl,sndsrds for Hszardous Alr Pollulants (NaSHAP) at (919)707-5950 al leasl 1
demo{idofl ot any iocility or buildiry Soe Asbostos W€b S[e: httpr/it r v 6pi stal6 rc.tdoprasbeslot shmp. hlnll
TOTAL PROJECT COST ru,49 d OF UNITS:
ACRES DISTURBED
NEW IMPERVIOUS AREA
WATER; EICFPUA
SEWER: M CFPUA
COMMUNIry SYSTE
CENTRAL SEPTIC
M T']WELL
L-.] PRIVATE SEPTIC
nzoNrNG usE cLASSTFICATTON:
E coMMUNTTY SYSTEM
SQ FT
PROPERTY USE; [OrrtCe REsTAURANT f]ueRceN'rte I eouc APT CONDO OTHER:
PAYMENT IvIETHOD:ficasx ficnecK (eAvABLE ro NHcl [auentcnr ExeRESS I r',rcrursr I orscovrn a
(FOR OFFICE USE ONLY)FEVISEO OATE 4']/12
ZONE OFFICER:SETBACKS: F:_LH:_ RH: B: ll/11,} Jl5{:,xliApproval:- City:- DATE:- FLOOD:--
-
BFE+2ft= lS,) ., 15 l\r{;.A v * sll'-ltt^,\'1aComment PERMIT FEE:
c F , (.", !{ iril
at
t I V-/
DEVE LOPER :
APPLICANT's NA E: DATE: ..- :'
. . i. r. :..ri r' ::.ri ,ir.rr.,
BUILDING HEIGHT
--::--SO FT PER FLR:
C l.P',
(#i
*No ?\qns-ry
RECEIVED FTB 22 ?O16
APPLI(AT,/T'S tlAXT
CEVELOPER:
PRO]ECT ADORTSS:
0CCUPAI'IT/3j.}SIIiEt5 l{alE i tr s.i
PRoPERTY O'll1fn'S IAJ.€' ..in l
0ll Ef,'S ADORESs: ir Er,l :::l€
CO,WRICToR: r:3 Inc
ADon€Ss: :232-1 ritr
II.AII ADORESS: d
PRoIECT C3,[TiCI PERSq{: :cr.oIir,
NEi'l VER COUNTY BUILDING PERI*IIT
APP Lt c artort rYP;r (0I'I4ERCIAL
alilrtl arL Qufs]lots IPTTICABLE To Ywi ri9lacI
"Proje<t Responstblllt}P
)otrq ZLg I
APPLICATION
l{ullter
rxrsr colstnucuon: f] llr
tl RCacdo.! 16 ri'6r8 I Nalural Gas
rEH CoxslxucTrfir I rarCr I srRUCr!,RE I rrsr rnrcx f] *reu I urrrr I ADD To Exlsr srRUcr(,RE
ACC€S50RY tl iUaTUnt:
Ir Efcct Poulr on this Eulldlng E] Yer Ino
IF Yer, ,rat rai tir Prevlo,Jg
CITY:''rtlE
LtCllrSE ,r ?r249
CITY: ri:r:rr:cn
(FOA oFFTCE US€
F P
51: \'a ?IP: 2etc5
PHOH€ |i 910-6a,r-3{24
Pl{cWE sr r:i-€;.r-ai?r
!ubb.::oot ln exi.rl.: !t.:!ncli
revsso rE ar']u2
D(iI : C2l:2/:C!6
P!€llE * | J:::ll!:i::l_
ST: "*c ZIPi:r<05
e'&lA
BFE-2t=
PERMIT FEE
($.<l iU li.l ^rtlr)rcn ?l n:rorlr:or l-"'l cexrml xrpuns fl REloarrrox
on lhe Curont Sils? Llve6 LlNo lS ELDG 3 PPIN(I FREo, MYes LlNo
If UP,IT - Ihe sh.Ll Pe.nit *
..r.. Is Hrs a oiA,*iE tr oco:pmcy usrr f] ves B no *-.
upln<y fyp.] lrrat 1r tltr itsr O<<up.ncy Type, _
PN:
PH;
(C nEG ,l: __llc RE6 ii -.-
k lood oa bdveao€g p.lpa6d or h ulo st, r*-ro? [Ycs $ Ho f fm Ao6ty
OESCRIPIIOT,I OF h'OR( I P'
AfiClr DEStGi PROFE5SToML:
EtGi 0E5IC.i PRoFI5SIOMLI
dird6.rrttg!.,/ rn*tnq 9- aa.tr*
TOTA| PROJECT COST: :2.5ic. t)
( t+oo
zorc@2-orRcen,
App(o!d: f )lL
.dEt ,1d lil \do/t .iU.omry si?l in€
( Srliq C. r! dl b. na:5.it .l.dI.rJdnod '1 O th,lrrrqu! 2deL
OWNEPJCONTF,ACTOR:liib I .i. n SIGNATURE:
t.l.: O.6CIld! idit l,!o.d I lrldl.. rrrE!.l .arir(sr $ ! t itnlt d rar! ln. rodlc.ior! Lrh {O}OtSlr6t) r}6ds. r! 6dri. c, tLll'E w- rd,f b.cih At ar c, id, Yql r. f.qJr.d !o crn fn'..16 S.d.,t tr l.rd.or Ar Fohrri EEghrF) .1 {t I OTCr-SX4 ,r ha t a crrr ,rt, r' 0r
5!n EE/,e *..!'. B6,r.iElH.t
",fi!n,
BUITDItlc HEIGHT:6rl fr ! OF UN]TS; !'
IOIAL AREA SO FT :,16 SO FT PER FLR
-
, OF STRUCTURES: :I OF FLOORST r
, OF $TORIES: 5
TOTAT SO fi UNDER ROOF: :
ACRFS DISTURBED:Exsr LANo DrsruRSrNc eenurr flws fi No
NlW IUPERUOUS Ar T:A SO TT EXISTING IMPiRT,IOUS AXEA
PRoPeRTY usE flornce f]
CFPt]A
C'BJA E coMM
CA\TR&
SYS-;:M
iC PRIVATE SEPTIC
ErirE-r-
-! SE,4t t€ .)e.rut!S n al-qA,jrfoe E!a:r uEot p!8c Gr6 €olJp. pRaraEs a NsiR rs -
PAYUENT METTOD: f]CASH f](pAyABrEro NHg fJAHERtcAil EpREss fi!]ucrvrse n usc,olcr
wAlEir El
S€riERi E
N
sCom
Oty: i6lLrt 9 ooD:
Lti
Cry l,spoctrol pqu,reo
9i [25{.0iii
I
P80tE t:
CfWl xil.iiiqlon Z:p:!3rol
f]u:n*mr-e fieouc IA.rr [colroo orrcf,: s.-q!:1.{ll
flzoNhlG USE CLA9SIFiCATION:
D coMMUNnY sySrEM
*No ?\onsq
RECEIVED FEB 22 2016
NEI{ HANOVER COUNTY BUILDING PERMIT
aPPLI6AT lott rrPE: Co}$IER€IAL
PLEAS€ ANSI^IER ALL QUESTIOITS APPLICAELE TO YoUR PRoIEC,
"ProJect Responslblllty"
)otk -2)K I
occuPAflT/BUSIXE55 t{AIqE: Maso.ic lerp]e
COI'ITRACToR; Disaster one, rnc LICEIISE #r 24249
AIDRESS: 1232-r Kitty sauk Rd CfTY: Ei]ming'-cn STr Nc ZIPr 2e405
EIiAIL ADoRESS; dliblin?disasrerone,con
PROIECT COiJTACT PERSCN: Dc. K:bl.in
(Che.k All thrt apply)
Exrsr co{sTRucrror: I alrrmrrou RENOVATIfi{6ENERAL iEPAIRS n RELOCATION
NstlralGas Llne on the Cured Site?tr Yes No lS BLDG SPRINKLERED?ffives fiuo
flEW CorisTR ! rnrcr EH srnucruRE tr TASI TRAC(tr sHrr.l ! urrrr ADO TO EXIST STRUCN'REtr
ACCESSORY STRUCTURE:
I R6bcdon,is dlere a
t cTrot:
ARGI DESIGII PROFEsSIOI|AL:
ETIGR DE5I6I{ PROFESSIOIAL:
PHI
PH;
NC REG #: _
NC REG *i
DESCRIPTIoN OF hloRK: ilepLace ?j.re Datnased ceili.q Beams adcii ng rubber roof 1n exterior e!a1!weli.
ls tood or bo\rsragG plrpd€d a s6vrd h tHs slnrof flves S No lg Thc Frr€pdry L6cd6d tn rn Rooapanz f] ves [l No
the Stals all ofier spf,llc€bl€ Stat€
Dlans and se.if elr(m
)rC Star€ Eldg Cod€ and
O\TNER/CONTRACTOR:Donald Kiblin SIGNATURE:
or.: Dcmdldar ndlk36o.E a..b.tb. r.nqud poflfilt.dlcrtorr rlb ba ertmlBad ldno,r eCkd€.r i rn (o+Olgs7it) xttodia dE fd}ry a tirtl(l1e w- thrd tocdth Arbdo. r nd. Y r.r.$rrrd to od fia rbdslal Emrdgl Msd.td Hc'?t crAr fuhr-rt fiEsfiAp) n (0tO7O/-g$0.! t.-t lO d.t Flabtd.nflon otrryt fiy dtult nC.3.. A.6.aro.l,it. SiE tr$//u,rry.i{'.ra.rElrrl.p0t t e,!fip.trnl
TOTAL PROJECT COST: 12,s00.00 BUlLDltlG HEIGHT: 69 ft.#OF UNITS: O
TOTAL AREA SO FT :SQ FT PEH FLR:# OF STORIES: s
TOTAL SO FT UNDER ROOF:L_. # OF STRUCTURES: L d OF FLOORS: s
ACRES DISTURBED:c Exsr Ler{D DrsruRoruc emunr fiws [lHo
NEW IMPERVIOUS AFEA:SOFT E(STING IMPERVIOUS AREA SO FT
pRop€Rry use EpFFrcE [nesrruuur [uencaurue fleouc fllrr Ecotroo orHER_ssEr:s:.!]_-
WATER: EICFPUA E ColTMUNrY sYsrEM EwEr f-']zONtNG USE CI-ASS|F|CAIION: _sEvrER: E CFPI|A ECENTRAL SEPnC I enVere SeenC acouuuxrw svsran., SEPARA]E PERMIIS REOUIFEO FOR ELECT, MECH PLBG, G,r's EQUP, PREFABS ! INSEBIS .-
"o*r*r Eorscoven
(FOR OFFICE IJSE O{LY) EVsEDDAIErfl!^2ZONE:_OFFICER:_SETBAC|(S:F: LH:_RH:_B:_Approvd:_ Cir}/:_ DATEI_ FLOOD: __ _ BFE+tr
AVN
Comm€l,tt:
(t ce rp CfQtlA- no
CL- yr senV l( roo
C
APPLICAffI,S NA|fE i pi.r6ter one Inc. . DArE:.JZC22.91S_
oEVELOPERT pHO E t:
PROIECT ADoRESS: 21 N. Front St. CITY: .rrrtilinqron Ztp:z84or
PRoPERTY out'lER'S NAIIE; p.lna piBened€tro PlloNE *: 910-54C-8932
o rlER',s ADDRESS: po Box 12236 Crry: l!f]El!g,_ 5T: Nc Zrp:2840s
APP L I CATIOI{
t{umber
(of+l.ce use)
PHoflE *:910-€04-8{24
PHoalE,l 910-60{-8424
If UPFIT - The Shell Permit #r Is Elect Pouer on thls Bulldlng El yes ft rc
r..i. rs Tsrs A olAr{GE oF ocatpa,lcy usrr flvrs @ o *.,.*
IF Ycrr rhat rar the Prevlou5 occupamy Typ.? _ tftat ts th€ L€r Oc(upancy Type? _
PERMIT FEE: $--