SEPTEMBER 06,2016 BUILDING PERMITS9c (b-34a7
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EXISTING coNSTRUcTIOu, f]TERATToN fJ neNovarroN f] eeNenal REpArRs f] nrloc,crroil
trEt^l coNsrRucrroN: $ t*.a,
L6- L 182
APPLICATION
Nurber
(offlce ure)
,79.'Zi4t!t:;lt
BLoC( *: 'J Lor s: lLG
APPLI(A},IT,5 t.rlFII: ETS
IU#k!*{AT$OVER COUNTY BUILDING Pf;RFIITT
APPLICATI?II rYPr: RESIDENTIAL
LEAgt ANSIIER Alt qJrsl1ONS APPLICAEL€ TO YCIJft Pio]t(r
"ProJect ResPonslbiIitY"
CI TY:
DEVELOPER:
PRO]TCT ADDRESS:
SUBDIVISIOI{:
PROPERW O!.INER,S
$I|NER.,5 ADDRESS:
CT'f.ITRACTOR:
ADDRE55:
E!,IAIL ADORESS:
PRO]ECT COB{TACT PERSOI::J {,)\.'1
T.IEW RESIDENCE OT
CITY:
ACCOT.[HT
PHONE S:
\fL:N
,\ L.
.rrr' t{-ll*iBhN ilil; il
lflorr GARAGE f 4b srt=I lsuunoopt
-sF
f] cnrrruNu.rsE
-
sF
]+PLEASE CHECT( AND ANSI'IER BE
Is Any ELTCTRICAL, PLUIISIHG
If the project is a Reloca
Is there Electrlca] Power
ALt IHAT APPTY TO
fJ orr GARAGE $ oo*.* -t'lt t,
f] sronnct sH€D -- sF
OTHE*:
-
SF
flnoorrror.t
YTXJf, PRO]ECY:
--SF5F
TO TXISTING RESIDEI,ICE
fl eoor-
fl orcx
TOTAL HEATED SQ FT:u T0TAL SQ FT uiltDER RooF: l._r!:,:TOTAL ARIA 5Q FT:
TOTAL PROI ECT COST 1t-ess r-oq
PROPERTY USE /
OESCRIPTIfi OT
OCC1JPAHCY:
Uof,K: 5l
SF
tl
No
Sro
SIN6LE FAI'1ILY fl ourr-rx fl rowr+xruse
J l.)^.Stv f ":rr**:
h fits .pdesron B conecr 16! r0 w6tkyri! conpty wlfi fE SlsG Bulldhe Coda rid atr ohe, rpplc$le $sb ird kl l'u,ls
pnnnt $rvees C€nbr wii be ootiad ol any ch.nges h he apro\€d plani ilo spcciic.tiont o, ch"99)"T1IT:::DISCLAIIIEB I hereby ceniry ,lBl E0
aflO ordfistlces ard regulailons. -fhs NHC De
con[ac6, hbrmston.' *HOTEI Any wott
ohJNER/coNTRAcToR: I t
rr*r il*****ll****tlr**tPrldt liaac)rr*r**fr*t.r*t*4L
IS THE PROPERTY LOCATEO IN A FLOODPLAIN?
EXISIII,IG II'IPERVIfl}S AREA :
T.IEI{ II'IPERVIOIJS AREA:
P€rmits wsl b€ in \fiobtbn ot sle NC SLB aq, SJbFcl !c F
\\>><
**+l**'l+
-)/_
!,IATER: ffi .rrro
SEWER: s Crrur
l\
D ccnryun
fJ ceur
s3 sq rr EXIST LAit) DISTURBI}.JG PER}IIT I I*.l YTS S rc
ry sysrEm fl nnrvnre ueu I crxrnal wrlr-
sEprlc fl rnrvarr sEPTrc fl cor't'rutrw sYsrEM
TS REQIJIRTD FOR €IECT, IIIE(H, PLB6, GAS EQUIP, PREFABS & INSE.RTS '*'
:.;; (pAyABtE ro rer) flar'r Accn,t{T ffi *.rrtto l--'lo:scovtn
sQ rT
,lI*,*t***,ta***:tt****tl*'l*)*+**:i***+*+*t*i*tt****+'*'iti******.***ta+
.r+ SEpARATE PE
PAYI(ENT IiIETHOD: fI CO',
*{r t} *** t *t ar*tal* **'}**
ZONE:OF FICE R:
rEVrsto roAtt o4t\tt1?*:- t'**rr.=&J8/(roi orFtct u5€ oilLY)
SETBACKS: F:
FLOOD:
DArE: 3 [rc'iru*tlsl: -l33:-Zb'tZ
PIIONE
Approvall- CitY:DATE:
LH:
( -.?' ,,) , ',,t- ,i. s oF SToRrES: 'L
.nrr rrrrrtngl[1Ves ffi no
RECEIVEO Auo s&it#ln,ta
t'c;T c t t
HANOVER COUNTY BUILDING PERMIT )ot6-S6"c
?-
^lAr.rLU
NAIIIE:
€
/./ PLEASI
b
APPLTCATION lypr: RESIDENTIAL
A}IsHER ALL TJ{JESIIO'ts APPLICASLE TO YC{JR PRO][(I
"Proj ect Responsibility,,
APPLICATION
Number
(Offl<e Use)
, DATE: i , .1... I l'. i:
fl;9:,j-2i:.-.i :i:
lIP i ; :4..",
PHONE S: 9i:-;:t-1..::
$f; rtC Z!?i t'.:4::,
5Tr:'" Z'L?:')L44:
,SF
5F
APPLICANT'S
OEVELOPER:
PROIECT ADDRESS: -i:.: .,'erj.'r:a::a i,r.CfTY: i;:::r
SUBDIVISION: l-.iirfr- :BLOCK f: LoT *:
PROT}TRTY OI.INE&'S NA}18 :
0l.lNERrS ADDRESS; l:i:.i.::-'izarrn Dr.
C0NTRACT0R: ti.i.l. Ur:r,:r LICENSE fl: 1r:',J4
CITYI !1;:ir)sr-€.i,'iADDRESST i.5G -r',.{ 5";:r 't'::-: I
PROIECT CONTACT PERSON: a::eve ;uro
EXrSTING CONSTRUCTIOHt tr ALTERATION Q nrrrovarioru p eer,rennu REPAIRS I nrlocar:or,r
NEl,, coNsrRucrroN: f] enrcr NEH REsTDENCE or f ADDrrroN To ExrsrrNc RESTDENcE
.TPLEASE CHEC( AND AiCSI,J€R BETOId ALL THAT APPLY TO YO{JR PRO]ECT:
f] ari GARAGE
--
sF I ner GARAoE sF I poRcH _ sF
0/
Ea$
l+cU
-1)
w
E)3*LlIZ
I sul'rnoon
--sFf] cnrenrousE _ sF
I coor-
--
sF
f oecr
f sronace sxro
OTHE R:
TOTAL HEATED 5Q FT:TOTAL 5Q FT UNDER ROOF:TOTAL AREA 5Q FT:
S OF STORIES:
Is Any ELTCTRICAL, PLUHBING or I'1ECH/NICAL ldork Being Done to th€ Accessory Structurel I Vur ffi *o
If the project is a Relocation, is there a Natural. Gas Linc on the Current Site? fl ves il Ho
Is thene Electrical Powen on this Building? JElyg5 ilr'ro
pROpeRTY USE / OCCUPANCY: E] STNGLE FAr'lrLy I UUnr-rX fJ rOwurOusr
contrac})f inhmaDrrfl'"'NOTE;AnvW$-lP{lrttmedW,OtrleAFlprrtriibFermilswillb6ifiVrdlotisnolllBNCShk La Fines Up Tr 5500.00"'
SIGI,IATURE:
+l!r*sr*ri{rtir*t*r{$?.t*rr(lit{ll']}ir-r***".*xr***r*rrrriirrr*.r'+r.r*+riyi.r++ra}r!{rrr4*..
I5 THE PROPENTY LOCATEO IN A FLOODPLAIru? N YES {TI ttO
r*f
(\, i
Ct,
C";o'
=l(;'(lo.'
C
Cr((l.(.
Es!*EXfSTING II'TPERVIOUS AR[A: lrl.r. 5Q FT
NEUJ IMPERVIOUS AREA: tt.';. 5Q FT
TOTAL ACRES DISTURBED: irr:\---
EXIST LAND DISTURBING PER|4IT: I-l ves [T] r,ro
wATER: p crcua [J conr,lurrry sysrEfl f] anrvarr wet.l fJ cerurnu wer-l
sErrrER: ffi crnun f] cerurnal sEPTrc I enrvare sEPTrc f] cofiiutuNrrY sYsrEtl
""" $[!i1,i,". 1,. I ' r.] :''i ttf(]i:rii) ;.:,i El..I:- ,'1-l!:. i'rfif;, .riS l;:.;:f , z,lir"CB"j & l.ltsklliS ""
pAynENr r,'rErHoo: t cas. f] cxecx (eAvABLE ro NHc) Jll anenrcm ExpREss ltl nc/vrso f] orscoven
r f,i * *+* **t **** t " x*E+ r r s4** *r** r i, *** r i+ &*s**r *** t r**+*t+ **.1*+ tJ + + * + *:t* . * * * { r r *! *+ r +** 1.*r ,r..) \ ./-.-* - *- -.L?p-\'r \. (Fr-rR otFl(r Ji€ frLY)tt-:-
,r*r.. R-A}0rrrc',rn:sErBAcKs' r'N tflrx, S iylnn,iqrt,hJl!4
Approval:-city: -*5Aru,$3o1b FL@D:
-
r -,-^ r lr n v.
PHONE
g{a dN$&# U +eoryq-
tsFE+2ft=
CITY: Irlrlntsqr-:;rr
Elt,l.AIL ADORESS:PHONE #: 9 ;*2:.;,: i'-.i2
T0TAL PROIECT C0STtesst-c'r; : $ ,,:, :c: .li:
arxl (,,,:!rlsnros &ld reg-la{ons. The NHC Develcpmexl Seruic.:s CeFle: slll be r}ctii*d ol dly r.hanges n he appr;'n on lBtir or
OL^JNER/CONTRACTOR i f '-c...:, (.::-.::r:
5F
RECEIVED AUG S C
APPLICA|ION'YPEI RESIDEI,ITIAL
AIISIJER ALL QUESTIONS AP}I,ICA8LE TO Yfl,lR PRO]ECT
-Project Responsiblltty-
APPLICTU\IT'S NA}IE : rommy sneed.
PROPERTY Od{ER,S
O NER,S ADDRESS:
CONTRACTOR: Il)orlpson Reeto!;tiol], dle servlro tfl{ LICETEE S: 6?933 _
ADDRESS: 6616 Llj.Edni]-r. wav CITY3 H1linlnqqon
EI\MIL ADDRESS: eso*erdeerr4rroofrewhaflover. com .._ PI|ONE
PRoIECT CoIiITACT PERSON: romrrv sneed
,W t0: tlxr,,n,,dn1,u;,1, f/?!fi/ OtL 'n't'"*z'{-"\' i*,-;/'5
!, NEW fil[I$vEn CoUNTY BUILDING PER,{TT &t -WZ
vi*, APPLICATIO
Numb€r
(oFflce use)
DATE: !!l!!12!!6
DEVELOPER: Thompson Restoratio.!. dba Servpro of Nei,r HaEcver_ PtlOIilE *: 910:?62-8180
PROIECT ADORESS: rEci Harrefield Llr CITY; HllmjnqEon ZIP:2a{11
SUADIVISION:BLOCK #: _ LOT $:
t.lAME: nyra Teiada PHONE #: -l-:-@.Zl2g_
180r Haitefield t,:1 CfTY; i1ldaqcon ST! NC ZIP:t?!4f1
ST:gzIPr ?840s
#: gro-:6?-grso
#: .@!!3L
.}PLEASE CHECK
fl arr eauce
A!'ID AI{s}IER EELOI,I
_sF
r{ArEn: ! crpua E comluNrry svsrru I pRrvArE r,rELL ! cerutnar wrrr
5EWER: E creur I cENrRAL.sEpTrc ! enrvare see[c I coHMUNrfi sysrEH
iiT SEPAf,AfE PER}]ITs NEQUIRED FOR ELECT, XECH, PLBG, GAS EqUIP, PREFABS & II{SERTS 'Ii.lIpAyuEr{r AETHoD: fi cos, flcueo< (pAyaarE ro mc; I otrnrcAlr rxnn:ss E,,rcfvrso E orscoveo
+* r*****f,*****rN *** *,i+ i( +*+d< r*+ * ** )* *+ * * *:**:l**** *,*,i **rfirrrt*** **,t rtt t+* *,}+ +*r$*** * )* * ** *++ t **:f ii t,t
(roa oFFrcE rJsE ollrY)
SETBACKS: F: LH;
IEVISED DATE 9,1/IIl12
B:
Approval:BF E+2lt=
It
PER]4IT FEE: $
ExrsrrNc coNsTRUcTroN: fl nrrraarrolr ! nelrovarror,r fl e elreul nenmns ! RELocATToN
NEt{ CONSTRUCTIoN, ! rnrCr t{Er,J RESIDENCE o. ! nOOttlOlt TO EXISTTHG RESTDENCE
ALL THAT AFPI-Y ro YOm PRoJECTT
! oer eauer sr ! eoao
--sF
f] surunoou I eoor sF ! sroaroe sleo 5F
! enrelnousr sF E DEc(SF OTHER:
TOTAL HFATED 5Q FT: ;roo TOTAL 5Q FT UNoER ROOF: _TOTAL AREA 5g FT:
TOTAL PROJECT COSTG'ssLor : $ :g.ooo # OF STORIES:
Is Any ELECTRICAL, PLUIIBIi{G or IIECHAI{ICAL lrork B€1nt Done to the AccessoFy Structure} [ Ves fi NO
If the project is a Relocation, 1s the.e a Natural Gas Llne on the Current Site?. Ives f] Uo
rs the!-e Electrical Power on thls Bui.ldinE? f]ves ff ruo
PROPERTY UsE / OCCUPAflCY: @STruETC FAMILY EOUEIEX ! TO{NHOUSE
DESCRfpTION OF [,JORk: Slructula! repai.E due tso water loss a! hor.e,
DlACfAlMEtt lherEby c€(|ry ha! arl lnbftalioo in ,riE Eppncsdon Ii conEct nnd allwork wil complywtll me $tab &rilding Cod6 ffd sI ofier aplrcrble Sratr snd localkwg
and od in lncls and rEgulsftrs. The NH C Development Sd rvices C.€ntr will t€ notfied Ol aoy ch.nge6 ln dl€ sppmved plans li( SecillcEtions or dr@Se l0
con..r&br lnbrmsdon. '"NOTE:Arry lvork turlormEd w/O ule Aporopfleb Prmit!wlllbe h Vlohlltrn of rhE NC SiEE thg
OhJNER/COMTRAcToR 3 SIGMTURE:
(Prlnt Ne.e) I ' /*+,**,t+*'tr,i*!r*,***++++*,t**{i!*,r+++,}*{.+++*+ai.t ** r.{.,t,i,r a,r *r **ta ** {. *** *!N ,t !i,r
rs rJE pRopERTy LocArED rN l rtooonurrl ffi vrs E no
EXI5TING IfiPERVIOIJS AREJ:
--SQ
FT
NELI II4PER\IIOUS AREAi _sQ FT
ZONE:OFFICER:
TOTAL ACRES DISTURBED:
EXI5T LAND DTSTURBING PERMTT: fi ves f] ro
Comrent:
city:DATE:- FLOOD:
RHi
ii:'j j)l'::) Au6 2 2 t0l6
NEI^I HANOVER COUNTY BUILDING PERMIT
APPLI1ATI(N TYPE I RESIDENTIAL
PIEASE ANSlillR ALI QUESTIONS APPLICABIE I0 YoUR PROIECT
'Proje€t nesponsibility''
2btb#31t@
APPLICATIOI.I
Numbea
(offlce Ute)
DATE I 8/:8/16
PHOiIE *: 910-?9s-3005
APPLICANT'S t.AllE: McAdams ticmes LLC
DEVELOPER: HcAdams gomes LLC
PROIECI ADDfiEss: 1512 liansbrouqh c!CfTY: $l lminqEon
BLOCK S:LOT S:
ZIP:28411
10SU8DMSIoN: Han6brouqh Farltq
PHOII EPROPERTY 01./t{ER, S
OI,l/NER,5 AODRESS:
l{AflE: McAdams Hoinee LLC
6625-C Cordon Rd CITY:."i1minq!!4
*: ll!:l:!jl!!!-
5T : l!!_ ZIP : 23111_
LICE SE #: 59eo? ACCOTNT S:
CITY: J.i_].!q!9!9E_- ST : J9- zIP: -?!3Ll-
CCNTRACTOR: HcAdams H9!19s lul
ADORESS; 6626 -c cordon Rd
EIIAIL ADDRESS: bi anca@mcadams home s . net / qradv@ cadamshomes.net
PRO]ECT CONTACT PERSOT{:?im Ravnor
PlOt{E f: 9ro- 361- L2z3
P[() E g: 9io-508 - 2298
EXrSTrflG COISTRUCTTON: fl AlrenrrrOt I n:rcvlrrol IerNenrl REPATRS E RELOCATTON
NEr{ CONsTRUCTIoN, tr] erecr NEN RESIDENCE o" f] eOOlttOtl TO EXT5TTNG RESTDENCE
TTPLEAsE CHECI( AND ANS}JER EELOI{ ALI. T}IAT APPLY TO YOUN PRO]ECT:
|7l att Ganacr ,0, sF I oer clnncr sF E] PoRcH ]L- sF
fl surunoon SF fl coor-
-
sr
SF OTHER:
f] sronacr snro SF
5FI cnceruousr SF fl orcx
TOTAL HEATED SQ FT: r6?e TOTAL SQ FT UNDER ROOF: f!j3- TOTAL AREA SQ FT: 208s
TOTAL PROIECT COST iress r-<,rt : $ r:s.ooo * OF STORIES: 2
Is Any ELECTRICAL, PLUMBING or IIECBA,IICAI Work Being Done to the Accesso.y St.ucture? [ Vet [l No
If the project j.s a Relocation, is there a Natural 6as Li.ne on the current sitet f] ves fl Ho
Is there €lectrical Power on this Buitdingl l-il ves f] ro
occuPAircY: Isrrucrr rnr.rrr-v ! DUPLEX E ro]lNliousE
h,ORK: Erect 3br, 2 bath srrrs-IllqEily lSqC !i!
olscLAlMER I hereby csrli, bat s[ inbrmation in lhis 4plicaton ls co,r€d an6 alr wo.lwill comply wirl h6 staG Buildn0 cod€ 5nd all other apglhabb stab and locallaws
srd ordi.ances and rEgularions. Tho NHC Oe\eJopmenl SeNrcas CenE. willbe noifed ola.ychanles n ne 6pprc\ed 9lans &d
corlt&rcr in brmalon. '_lloTE: Any wort ,,erlomed wo tr€ Approprlac Permns t{dlbe n violation ol lhe Nc sraE 8lc! code
Ol,lNER/CONTRACTOR: Adam sosne SIGNATURE:
*,|.+*,|,|rr*i(,r*,r,r**.***.***rr(l!'lilil.,l-**'.***'..'*'rr.r'rr.'+**'r.,t,*****
IS THE PROPERTY LOCATED IN A FLOODPI"AIN? N YES E TO
TOTAL ACRES DISTURBED:
EXIST LAiD DISTURBING
PROPERW USE /
DESCRIPTIOI'I OF
To t50o.0cr"
EXISTING IIIPERVIoUS AREA:
-SQ
FI
NEW IMPERVIOT S AREA: SQ FT
ZONE :OFFICER:
Approval:- city:
(roi orFtc€ usE orLY)
SETBAC(s: F; LH:
*** rt r* * r ** *** 1* *
PERI.IIT: E YEs NNO
tfvtstD DAIE 04,/11/12
RH: B:
wArER: fl cFpuA D coMMUNrry svsr:m ! pRrvArE WELL f] crlrul wrll
sEwER: fl cFpuA n CENTRAL sEPrrc I enrvrre sEPTrc E co.,lMuNrrY sYsrEt4
Ii.sEPANATE PERSIIS REQUIRED FOR ILECI, IIECH, P186, GAS EQUIP. PREFABS & IiLSERTS "'
pAyirrxr ETHoD: D cosx Ecxtcx (PAYABLE ro u<; flsrlt acconr E nczvrsl I orscour*
I t* r * rr,t,i i*,1t *** **.,t *** I *,i,1 I *it + rt ** ** *,t * t l,t t * ,t*,r *,. * !i,i lt *t ** 1l+ * *t 'i *ri ** **t* *'tl +'i*ri 't*t't t*** * t
Comnent:
DATE:FLOOD:BF E+2ft=
Jr*., ,rr, $--q3a!c
20 tb- s832
NTh, IIANO,I/ER COUNTY I]LJILDINo PERMIT
'
APt, I.I:ATIIN rypf I lt IiS,IDEIr TIAI.
ptEAsE Ausl.hn alt (rurslrotrj ApptrcABLE To youl pflorEcr
"PrSject &'esponslblIityl,
suaDlvlsloldr T\r.__F*l(s . _ sm -_d **
*..?
f0l\,lTllACT0n I *J r..t I LItrNs[-79'
^DDnE.s.si
tt_{t__0tde+_U$$td_.ft.^$::!r:qurrry, *}aisail- :* sT; rrlc xrrZs,t|Jlnlll Annnrss: , fnrrchae[€-kuls*.hu,-{rfii,rrrs.2!,, crl/h - PH0NE ,}: *F
^Ppr'rcANT'$
rhr'rr: tlys.rt :re!lJ"r. q.,r? _ _oafft gfjefit-*
fi:idir
lurslg
APPLICAT'IO}I
. Number
(offlco ilse)
RECEIVEDAUGSOzofi
APpt.rcANT'$ thilE:
rnoPEnTY ol/N[,r's HMI:-j4gLfrsL-t-tr,*^ *(rr,(,,* -' ptONE.,t! Z1b-$530
rrirNrn,.s Ar)onrssr laU* "{xlLd"tsL_}r,va _ .- a@ir,lq ilp- E
p n,r ri{:r c,rrT^c, prh soor r *- -f{Lgh r"oj -Ullk'Iirsr:ruc'corusrnucrrorufJaltenarroru'f,nearovauol-[crnrnar"
fiEp^rns fl nrlocarrou
NFI{ coNsTnucIT0l'l: Wr"ur.ct I',81, IrEsiDENcr or fJ ADorrroru T0 ExrsTrilc n[s]DfNcE
PH0NE,]f 3#:figk_*
Plloilf lt: agl.Zfoc
F*si*16!<
$rt't.[AsE CIEct( ANO ll.lstdE'l 0EL0t' nLI TI|AT lFpty T0 youft pn0]EcT!
f,am cAM6E . *o , uo flurr 6A&^6E _--*- sr
l--*J-surunoou -**--sr: [J pool _ sF
IJ encrutrou,sr sr ff orcr __ sF
diooot d{lo .- sr
l-[ sronner sHEo .-_'-.-.sF
0'lllEfi: _ Sli
Tot/\t. tJEA'rrD 5Q l:1': z,tg1 . mlAL SQ Fr UND.TR
'100F:*_3/_ff.*
ToT/u. /1REA 5Q FT:.ffi"
'l'OIAt- P[0][CT C05']'0.ossrort : $ 4{or<to.6 {t OF STgnIfS: -*1.. S .
Is ilny'f;l-ticTtllcAli lrtull0ril6 or llfcltl'llJlcAl.!,tork Belng 0,0ne to t,le 4cce$sot.y gtrrrcture] lJ Vuu lI{ UoIf the proJrtct ls n flolocatloh, 1s there a Nitural Gas Line on the Current 51{:e} ffiVe-r'ffi po
rs tlrere Electrlcal Poh,er on thls Bulldjnet Eyes tJoro
FfiopEnry usr / occuplrvcy, l-f srNGLE FA.,tIry
DricJirPTroN flr l'1ofll(,
.-----
8,,(t1 {.,,^l
otdN E rr / coll't'fiACl'oli :
+llirrtl
,:;!+*',+*-.*;r*+ ** r+ +***+*+++l*r,titi{tittl *++;}rr ***+*++* +**+
Ts TII pnapE8Ty [0cA'nD rN A Ft-ooDpLArNT m 'ur ,:ffi rn
fXI5Tr,,l6 It4PEllVIoUs AR[A: *_ 5Q FT
Nl-!,, II,|PE8VI0U.S A[tllA: 3,911 tn ,.,
uAirn, drrron [J countuurw sysrm' [J nnrvnrr NEIL n crl{Tnlt IIELL
sr,ror,ili ffirru fll crlrrnm .srprrc fl enrvarr sEprrc ; coilourry sysrEtl
* **+ +,i+*++f ++*++ *+,+*+:r*"++1r*r**
'I.OTAL ACN 0lSTUn0fn: O,OF
rxIST tA}J0 DrsTUBrtrNG PrnflrTr El yes E*{ uo
_- ./[ | ouelex l_qf'rouuousc
*+* SfPASrr[ PEBHIrS [rQur8ro FOA EIECT, ilEifl, plB6, 6A5 Egt rp, pnErAEs & $ISERTS .t,
PAYr,lrilr r,t*Tlloor -fficasrl fJctrect (pAy,url.E.ro lr{c) ffiurenrrau urrnuir .HIrVrrrn lSorscourn*+*++++ {,t5r+ r1*\+*t+,r+**tt**++*t+*;}+*++,tt*++{.****,r*,r*+++*+++r++*+****++*****+*******++.*+
i? , HU': J { ^^ {l (r,r o,rr(E ui€ 'rnyr r . I i'vrs*o D^r. o4trtrlzzorrr:6* fiontt,,t,rr: )t|t---.--+ sfTfl^c1s: r lh'. Ln:*ft. ntr: X" f ,"t_
Y,4 L- t, - f, r';n, | Itt.. ,^A r v -,r-1- 'Ti7-^lt.,--milk;k"l
'X Yt t LD( 1f- J-t]
n -ititsttj*tr **r #*il,,u, r HZ/. cry*- #*,; FEr: g /Y21"
.lr &*qa !
i:ilv ln$$*cti*n ft*Qt*lre*, ? i *'?${'ur"i:
RECEIVEDAUOBOIOI
tlPPl-ICiNT' 5 [rllrl'tE :
DEVfiI-OPER:
PnolECT ADDIIESS: 4
sultDIvlslol,l I fXc._ _5i_r_ K r
PROFERTY Oi,JNI|RJ$ NAI,'IE :
OI.JNEII'5 ADOIIESS:
c0r\.lTltA(T0lt t
ADDnrssa $!__
EI.IAIL AI]I'8E55:
]::or..r coitrAcT reRsou:
@6""?, Dwalomc,rt. uuc-
NEI^I |"|ANOVER C0UNTY BU.ILDI'\I6 PERI,IIT
ApP LI UTIlN IYpf ; RESIDEI'ITIAL
pr-tAsE ,l,su6n ,ltt Qtresrrotri AppLrcAsLE To youft rBolECT
'?roJ ect Rirs pons ibility,,
2ol(*963 (
tb2s((
APPl.ICrltl0l'l
Number
(off.Ire Ulo)
perr, Bln l$
PrroNr! ll: ,191t38Ob_
zrP: ?3414
3g
CITY: . _Cl+ft( hn_..- ST; l,)* 7Jp, _Zgtttp1
LICEN5E tt -lt31l
CITY: Lclalrd
r0T
. cdr\
sr:Nq zu,; 2845!
tu:18ZJBt6 _
tt; 782-ZSt:b
%
PI0r,,E
PIIONE
ExrsTrNc'c0t'lsrRl,crrbN: fJalrrnlrroru' I nENovATroNT 6E,,JEML REpArBs I nrlocarroru
NEiJ CfiNsTItrl[TIoN: [frnrcr NftJ nE"5Tr]ENCE o|
*$PL[ASE CIIICI( ANO ANsI..IEN OEIOI:' ALI T'hr APPLY TO
dorr 6ARA6E h\ -.- sr flrrrr 6AR,\6E
tf *++'****;t+t** ++ +'* *++*++*+*JIi'{iJti:}********l**,rr*r+r***** *r+*+*+***r+** + + *+*+**:}**+ *+**+rF
rs Tlr[ pnoprRTy L0CAT[0 ril A Fl.000pt.ArN] fJ yES [r r,:o
EXISTII,JG Ir'lPEflVI0Us AREA: _-*-:.---. SQ rI
tJEt,, fi,tpEIlwou.s AttEAi --113,{*tq ot
++* 5rPAftATE pfRilITs nfQurft[o F6R TLECT, flEcll, plB6, 6A5 ESJrr, PRErABS & ]t's!:[TS is+
p^yl,rf,NT nrnrop: IIJ .osrr fl orecr (pAyrrarr ,o ru.) ffi er,ruucru r*o*riu . tll ,;r; '-
m orscoven
'l+++;ld:,t ** ****:|* | dr*+**,$:t *********+,Fi.+***+***++++,f ***,f *++rF*++**l*:r+++***+tlr* *** ****++:l+**:;
L] morrroru To rxrsrrruc nEsrofNcr:
VOUR PRO]ECT: ,
sr ffeoncrr /-11 .uni] sronner snro__.sF
l'o'r L,1Enrrp 5Q FT: 19pq ToIAL sQ rT uNDER noo1, 3t3'?L T6TAL A,IEA sQ p1; cr.lOr.tlo
l'oT/rl pROIECT C0ST[essr-or) , $ /f,qrlot # 0r ST0nIrSt l.f Ifs Any El-fCTnrcAL, PLU,{BIt'rG or HECIIAiIICAL trlark Belng Done to the Accessory Structurei ffifl Vuu ffi Uorf the proJect is a ltelocatioh, .is there a ruhturat 6as l.ine an the curtent.sitel ffiyes'fr1ruoIs there lllectnical Por.rer or thls Buitetinel E Ves fi fo
FRoprnTy u:ic / oEcup^ ucv: p{xn6lE FAfirLy fJounlrx I lowrurnusr
DEscaIf,rroN oF r,Ionr(: - _gu{d__5on[.-. "r**,_ty &x{*, x.JJ
lrttCtAl-tEil l"r"by;"{fy tt;
0nd ordhan.as 6ttd ragrl:lbns. ]ho NIJC Dseohprna0l $oMces Csnbrr.ltll ba nollled olanychangss h fio .pprouad phns anrl sfl'cilicatbls or.hsog6 h coflrnchriroonracb, hhm*ton' "rllOTE,Aay work Porrormed wro Ule Appropdats Permlkluii be h Vlola&,n otrba NC stats ai*g,co{ro aio #b}+r b frnss Up To Ss00.00-,
ffisuHnoou *_sF
fJ enrrrunalsr __ sF
[J poor-- -sr
fJ orcx --- -5F OTI1ER:5F
*
T0TAL ACRES TTISTUfiBED l
EXIST LAND DISTURBII{G
f] rnrvare sEprrc fl conruuurw svsrrr,l
0'ol
PENI,IIT: I:YEs El ruo/
tunicn r Hrcrpun [-f cor'r,runrw sysrEn fJ rnrvarr h,rlr f] cr]lmAr trELL
sHltrER: ffi *nua fJ crarrnnr. .sEprrc f] rnrvare sEprrc f l coprruurqrry sv:5H,IER:
do
$Loc( l,:
6tr"o 15'^r.-No r4.a.rA. ilo l&t-?,Ai'* - 8 f,3(
&
APPLICAIiT'S MITE :
DEVELOPER:
APP LICATION
Number
(office use)
NEt'l HANOVER COUNTY BUILDING PERmIT
APPLICATTON rYPE; COftttilERCIAL
PLEASE ANSI,IER ALL QUESTIOiIS APPTICAEI-T TO YOUR PRO]ECT
"Project Responsibility"
;. CLARK HI PP
-
DATE: 18AUG16
PHONE #:
PRoIECT ADDBESS: 41os B wRrGHrsvrLLE AVE CITY: wlLMrNGTow ZIp:29403
OCCUPANT/BUSINESS ilA E:
PROPERW otlNER'S ttAr,lE: Mr(E puFFy PtOl'lC *: elo s47 5?07
ot{l{ER' S ADDRESS: @ CITY: lLLUlIgIq_- Sr: q zIP:@
CO TRACTOR: KIVA CONSTRUCTION, INC. LICETISE #: 14795
ADDRESS: 228 N FRoNr sr. surrr 202 CITY: !LLULIEI9L-
EfiAIL ADoRESS: crrARK@Hr ppARcHrrEcruRE. coM PHoI{E
PRO]ECT CO''ITACT PERSON: .; CLARK H]PP PHONE
ST: Nc ZIP: 28401
*| 9Lo-231-7 946
*i 9to 23t 't946
(che(k all lhat Apply)
Exrsr cor{srRucrro : El ALTERATToT I nrrcvrrror ! e enrml
lf Rclocalion, is lhere a Natural Gas Line on the Current Siteu Ives [ ruo
*x...r Is THIS A O,rAt{GE
uas the Previous Occupancy Type?IF Yes, uhat
ARCH DESIO{
EI{GR DESIG
conbln Albostoo or rlot You aro mqulrBd to crll tha Nalomt EmBslon SEndar& ior Hazrdou! Ar Pollui6dt3
dofiolldon ot lny ,!dUY or bulldlnC, Sog Arb..b6 Wbb Slb: hl$rti/rw.epl.E1ab.nc.u8/apuarb6b./6hmp.hmt
TOTAL PROJECT COST: <Sro, 000 BUILDING HEIGHT: -Lgl_JryI-:ql_
TOTAL AREA SQ FT : ],SO FT PER FLR: :jl__.tgl5.L-i_
TOTAL SQ FT UNDER ROOF: a . s is sp # OF STRUCTURES: 1-_1g31S.T-1-Ne1_
NC REG ':NC REG *:
DESCRIPTIoI,I OF WORK: MrNoR TNTERToR RENoVATroNs
ts lood or bevsagos tropand s ssvrd tn rtis srnraue? flves [} lro b The Propsiy Locdod h rho FtoodCah? E Yes E No OIJf,-
Slate
owNEFycoNrmcron, J. et4atc Htrr
",onorr*ul
ACRES DISTURBED: NoNE
NEW IMPERVIOUS AREA: NoNE
Exsr LAND DrsruRarNo peRlrrrz l-']ves [ ruo
SQ FT EXISTING IMPERVIOUS AREA:
whouEr $e tadlity or bulldtlo w3s bu^<, io
.! (919)m7-595o ai bosr 10 (bys prbr b ule
# OF UNITS:
#OFSTORIES:ag.;
TOFFLOORS:1 ( EX ISTING)
SO FT €
=8e)o
n(D-oc
(Do-.o
r\:,(rt
E
nrprrns l-l RELocATroir
rs ar-oo spnrn-xleneoz I ves I No
NErd coNsrRucrroN, ! rnrcr NElt sTRUcruRE f] rrcr rnacx ! sxrr-r- [ urrrr E aoo ro Exrsr srRUcruRE
rs Elect Pou€r on this Building E Yes E tlo
6056
pRopERTy USE: EoFFrcE [nesreumxr @uencanrru leouc flepr EcoNoo orxe*
WATER: mCFPUA fl CoMMUNITY sYsrEM fl WELL DzoNlNG usE cLAsslFlCATloN:
SE\,\,ER: UICFPUA IICENTML SEPTIC LIPRIVATE SEPTIC fl COMMUNITY SYSTEM
Approrral: OI- City:FLOOD:
- -
Zoru-X- ere+2ft--. .A . ,V. N
"- SLPARAIE PERMITS REO'!]I'EC FQF EIECT,I.'ECH, PLBG GAS EQUIP. PF['ABS 6 INSIRTS'"
PAYMENT METHoD: ficesn flcneo< leaveetE To NHc] finr,renrcex eenEss E Mc/vtSA Elolscovrn
zone: CB orrtcEn:
(FOR OFFTCE USE Or{L$ ,
.JSETBACKS: r:Nl\ uNlr RH:NlR B:r{/&
Commentn4tzr
buJdir.n
ACCESSORY STRUCTURE:
If UPFIT - The Shell Permit #:
oF occuPAlrcY ustr flvts [| iD t*.**
what is th€ ilel{ Occupancy TyPe?
PROFESSIO{AL: J. CLARK rirpp. dlpp ARCHTTECTURE PH: j_l!_fryg_
PROFESSIOML I NP.PH:
Nolo: DenDllton notlficatlons ! 6sbcl6 rsnoval pormh aprlar{or|s lrs to bo rubinltbd u3lno ih6 apdEano.l iorm
tv_rn
t PERMIT FEE: $
REVISED OATE {1 li12
RECEIVEDAU6S OM
ApFLrCiNt'r5
ocvrtoprn:
PNO][CT AOIJIIESS;
P,toPf ATy flhlNER'S Mrlr,lE,\\l*
ol,JN[nrs ADDnr.ss : \L$o
rlnll Aoontss: .161gh4&l
1'oTAl- llEATlD 5Q FTr 'Lr'4P !
IICENsE {l: 7SX7l
crrv: - LrlI-CI*.] sT:Nqzrp: 6rlgt
ploNE rr: lil.ASl;E-.
ldrl*,.e f-un Ztpt R.tlZ- Wrla,r,n{fun __ Z\p;fi.llL
fll0rl( ll; 0-
- - t3'f ,,, 19_17 ".
PI0NE' il: t?t - z<1 - rLa|\
pttolJE ,,r 1trL:Zgl| *
Piloi,E iti -l€t.zto6
CITYI
CITY;
,,tro)ECT cor{TACr rrh.sor,r; l$,rS!*e-l KItl*f::
ffr-s'rrt{6'c0t'l5T8ucTr0l,l: I at.rrn,rrroil' I] nrnoyriroril_f errurnni REpAlts f ru.ocarrox
NH{ C0NsTfi.tC}r0ltl: l] rnecr },fl., Rr"srDrilCr or lJ nDDrTrot, T0 ExrsrrNo REsroEi,cE
++,r",:nsE cHECt( nNr, At'Sll['t ttH"ot,.ALl. TI'AT Appty To you& pno]EcT:
finr 6^M6E 1oZ . uo t*J orr 6 RA6E sr l#aaat 3Jo ,.rr,
.
flsurunnolt .---sr If p001.- sr t*] -sronnoe srrr)--'sr:[] cnrrruHouse-*__ .sr f]f orcr _ sr 0rttrn: _- -- .sr:
rrLArr:t) 5(l ,-ri 'L;q!! |OTAL SQ fT\,lNDf;R n00f : 2t"17*
Pnolt:cT C05T6as:ror1 : $;/*,-.-tr.:{\ \ lrl il oF STorrIIiS:
'l-r1"p1_ roTAL sQ IT,&,{NDrR roor:: i,l,
;sror) r g, /*,- .-tr.:t, \ lJt # oF sro;rt:s,TOTAI.
FXrSTrl,c Illl,ERUroUS AII[4, . -.*_ .SQ fT ,otnt oaori DrsrrRBEDr o.o{
j.t11 'roTAl. AIiIA 5Q l-T: t
rs Any EtEcTlllcA{-, rruil0rtl6 or llEc}h}lrcAL Hork Bein} Done to the Accrssory Strrrctura} l-J Vu, H ruoIf the proJect' .is a ftelorat-lon, is there a tlitural fias Llne on tho current slte? ffiVes ffi ntoL: ther.e li.lectrlcal por,,er or thls lrrrildingiffiVes ffiUo
propfnry usr I 0ccl,p^rucy: t*l "5rilf6lr FAfiTLY ff OUer.rX fforr*uru
orsc,tlPTroll oF I'I0ll(: tr*1f!_l*rd:*g
;l rfyt
"t
rril,,
oiJr\,r:n/col,r'nACT0n : .__T-*:**f_yJ&c_G=iU_ srGN^TUne, ^Af4l t/-
NEH rr4pfinvrous AriEA: '9,!1q _sq.rr Fxrsr LA]JD DrsrunnrflG pmrr "l= r*, I:3 r{oI
uafsn: lfizrrua f] coru,rrrurw sysrf,.r fJ rnrvarr l,,nr. fl crlirnAl urLL
sEr(En: ll ffrua fl crnrrhr. s[prrc f] rRrvrrr sEprrc ff cor+rurrw sysrrH
rlt JrFnnlrE PEP,flrTS fllQutBfD FOlt Et ECT, fiECIt, pLB6r 6A5 EQtlrp, ,]nErABS & rllsFnrs u+
pAyurlrr,.rrnroo, lf cnsr lJcrscr (rnyAsrr.ro riH.y fionrrnr,o, o*o*rrr' ,m;;;;; lllrscoura
'r++* ++'t
745rr+6t\**+
**+*++t*+ir**+++**t*,f *++++*+*+*+++,***++++*++**+++,F+rr+**,r+r+***++*ft*,&
,,,u, f;-J*;;;, _1r"':r j_+'iiil:-ff ?,hul" rrr: X - nH:- X. 0:* ''*"'|DD^'1E 64/'\1t*
Approvral :. -_r clry r.] j , i t * oare rl l',i_lil FL00D: X org.rzf t_."**1,,ff{.jj'i--L:.l1i|Mril-*-.[|i6.-},o,-rn,u*,,rrr;$Q2/,"o
IYtii L*i( ti - tr3 -s {:*n si:-d-'1i11
,:rry rnspecr,nn n*qu,;, fi{}.*u*nr,
Lotb-88113
NH^l ,{ANO\/|:A C0UNTY BL,ILDINfi IIEAMIT.AI,,P
LI:ATTON Upf : RISIDENT.TA I".
ptf.AsE .Ailsl.rcl .ltt- Qurslrottj applrcigt! To y&rfi pffo]Ecr
',preJ ect lti:s pmsi bll ity,,
t(,a*3
AppLrcATrofi
I'lrmher
(offlce Ure)
aartt Slz6lra
^-9-,--f,r::l&l
suftnrvrsrou' *ThJffi--
coNlltAclott: 'i?usl l
o cL tL? , C{PJA
NEhI HANOVER COUNTY BUILDING PER'I'IIT
aPPLIcarId,t TYPr; CO{|1}IERCIAL
PLEASI AIISI{ER ALL QUESTIONS APPLICABLE TO YOTIR PRO]ECI
-Project ResponsibilitY"
Kevin Breed
44 Darlingtan Avenue
NA,4E: Zene, LIJC
A{E. Tarmy nrnofd
CITY: Wil-udnqton
44 Darlinglon Avenue CITy. I.lilmington
CONTRACTOR:Elevate Construction, IDc.LICENSE *: 66060
ADDRESS: 408 Birmingham Avenue CIW: Carolina Beach
Ef.lAIL ADORESS : infooelevate-construction.com
PRO]ECT CONTACT PERSON: Kevin Breed
Exrsr corisrRucrroN: E ALTERATToN n *rilifr;d 'nEiL** neearns I RELocATror{
I Rslocation, istlerea Naturat Gas Line on rhe -Cwrent Site? OYe;ONo lS BLDG SPR-INKLEnEOZ Q V"" QUo
NEu coNsrRucrror: 17 rnpcr NEtll srRUcruRE flrlsr rnacx f] sner-r- ! urrrr ! aDD ro Exrsr srRUcruRE
Metal 30006f lrarehou6e buildingACCESSORY STRUCTURE: Pre-engineered
If UPFIT - The sheu Permit *:
*..*. IS THIS A CHAI{GE
IF Yes, xhat Has the PrevLous Occupancy Type?
Is Etect Pouer on this Building O Yes E to
ls tuod or bsyBmgs preparad a egrrcd in tHs *uareZ Q ves p uo ts Th€ Prop€fiy l-oc#d h Tfre Eoodfl*r? ft ves pl ruo
oISCi-AIMER: I hereby cerlify fiat all inlormation rn flis appli€ation is correcl and all work
and local laws and ordinsnces and requlations. The NHC Developmenl Services Center w
or chanoe in contrsctor
SubFcr-to Fin€ Up ToSubFcl-to Fi
=9oWNER/CONTRACTOR: Revin Breed SIGNATURE:(odnd (Frin rqE)
co. ain Asb.6to6 s not Y@ ers Bqulr€d b csllihe N6tid€l Emb6l'l SEr&.d. fo( Hazt&us AIr Pdluffi (NESHAP) al (919)1076050 d lee6t t0 &F Fto. io $€
dsnotlbn of 6ny b<ility or bsildng. S€e AsbGtG W.b Slil6: hnpr vrfl.6pi.Ersr6.nc.us/epi/asbesto€/ahmp-mnl
TOTAL PROJECT COST. 160,000
161414p94 5'6 pJ . 3000
BU|LD|NG HEIGHT. 18 feet # OF UNITS: 1
sQ FT PER FLR- 3000 # OF STORIES: 1
# OF FLOORS: 1TOTAL SQ FT UNOER ROOF: 3ooo # OF STRUCTURES: .1
ACRES DISTURBED: O EXST LAND DISTURBING PERMIT? O YES OINO
NEW TMPERVTOUS AREt 4, s7s SO FT EXISTING IMPERVIOUS AREA 5,A72 SO FT
pRopERTy USE: fprrrce [nesraunalrl f]uencarnu [eouc [arr [mtoo orHER.war.house
WATER: FICFPTIA T-ICOII'MUNTTY SYSTEM T-lwEI T-IZONING USE CI}SSIFICATION:
sertle* plc-rer.re f]conner-sernc EdFiveresemc a-comuuunvsvsreut
-. SEPAMTE PERI,IITS REOUIFED FOR ELECT. MECH, PtBG. GAS EOUIP. PREFABS & INSERTS *
pAyltEr.trMErHoo: pcesn Qc+reo<peveeEToNHc) fterrrenrcaxwREss OMGMSA o0SCOVen
(FOR OFFTCE t SE OI{LY)FEVISED TTATE /l.I1/I2
ZONE:OFFICER:SETBACKS:F: LH:-RH:-B:
?pt(,- ?kr
PHONE
APPLICATIOT{
Nunber
(OFflce t se)
pg1g3 6/16/16
*. 910.599.9s95 _APPLICANT,S MIiE:
DEVELOPER:
PRO]ECT ADDRESS:
OCCUPAI{T/BUSINESS
PRoPERTY OiINER'S
Ot/'lilER'S ADORESS:
ZIP | 25403
ppg E *: 9L0.762.3076
sr: 19 ZIP:2jj!j-
ST: Nc ZIp: 28428
pHONE *:910.s99.9595
pHONE *i 910.632 .0632
oF occuPAflcY usE? oYEs ElNol$at is the iles Occupancy Type?
NC REG *:
5; TSrirT-ARCH DESIGiI PROFESSIOML:
EIIGR DESIGII PROFESSIO AL: ffi
PH:
ar' Tiffi15555- Hc nre
DE SCR IPTION OF hIORK: Build a new 3OoO6f ple-engineered trletal lrarehouse building.
Apgoral: CjIy:-DATE:-FL@D:BFE+&
,-_$l0D-
REeElvEO AIs 15 m Hfi{ovER couruTy BUTLDTNG pERMrr
APPLTCAIIW TypT: ftESIDENTIAL
PLI.AsE ANSHTB ALI g.'ESTIfl{S APPLICABLE IO YOUR P8O][CT
"Project Re:ponsibility"
z0 tb- 8853
i&*a5f 1
APPLICATTOf.I
Humber
(Office Use)
DATE. fi 1 ! .tt./'i't') t,
PftOIECT ADDRESS: "09 r'lcflri 1 :ar.1 nr.,
PROPERTY 0lSlER'S l'lAltE: Scl--Li t i]*r: i'::,'ici:
Ol'lNER,S ADDRESS: i,l 9 I,r.,:I-1: i i.ri: *r. ,
COiITRACTOR; Coasta.i Bui.i<iilr; corrcept*, LLC
EltlAI L ADORESS : s h a rr r:€ cc.r s Li'rbr,r r L *ii :rc conrcs E s . .:crTr
BLOCK #:LOr *:
ZIP: i8a I 2
2?
CITY : '* - lni r
LICEiISE g: rlr5l
5T: rrr: llp;2.${ ii
5T: n,: ZIP; .::li4t'iCITY: iliirn_i,rl
PHONE f : ,rr i)- r9i*.?irt.J
PROIECT CONTACT PERSOiI: lr:-,.::,.'. sr:i:i'r
filEtd CtrIISTRUCTIOI,I :
**PLEASE CHECK AI'ID
SF
sF f] PoRcH
-
sF
fl sronrcr sHED
-
sF
OTHER: irsdi.':io:} J ,'8 SF
DESCRIPTIOfi' OF
'1"' {- t'.t {< .
DISCLAIMEH: I hcretry certily *rat all rnbrmatiofi in fli6 splicatiifi is conect and a8 work wd comply win he State Building Code ard aE oher 4rplh6ble StaE md bcal ,8ws
and ort'hancr$ iild ragutatlons. Th€ NHC Devgtlpmenl SeNices Cenbr *dl tI€ notfied of a.ry chongcs m ?le approt ed plans and spedtL:atbns or
convscmr in&matofi. ""NOT€: Any Wori( Frerf*nfipd WIO he Appropriab Permiti wll be in Vblatbn of the l'{c SlaE Bdq Codt
owNER/coNTRAcToR , ,T /'atr t -', ' .4;,SIGNATURE:
(Print Harc)****,***:i*+*+**:rf,**+*********t*+r,********ri{<****{.**,*t***,I*{.,t*r.****x****i.,tri+********:t,t**'l**
I5 THE PROPERTY LCICATEO IN A FLSOOPLAIN? [-I VES iluo
TOTAL ACRES DISTURBED:
ExrsT LAND DISTUBSTNG PERr,uT: ,:J vrs I"5l ruo
trtArER: [] cmur f| cowururw sYSTEM fl enrvarr xell fJ crxrnal wril
sEl*ER: fl crnua f| ceNrnar- sEprrc [l enrvare sEprrc I corwlunrrry sYSrEt4
$ 1 Sfp*itAT{ ptiiXI?S EtqlIRgS FoR !LiC: , *L{lt: ,!*$, GE! !QU:a:, pESi:Ai35 & I!L!tn?S s'4
FAyrdEtlr tvrErxoo: fJcmn ftcHecx (pAvABLE ro tirxc) flnnenrc** ExPREss il ncrrruu florscoru*
.ii**++*+,*{.r+**-+****'.*,t****t:t******,1.r{.***t *!**:i*.*,t*r,l*t**tr*t!*it*1.}tr***if }****irF**lrlrxrrr-x
(FOR OtFrcE Usr G{LY)REVIsED DArr O4111/72
RH: B:ZONE:
-
0FFICER:
Approvtl :- CitY:
EXISTIFIG IT4PERVI&JS AREA:
NEH I},1PERVIG,J5 Af,EA:
sQ Fr
3?8 SQ FT
SETBACKS : F:
-
LH :-
Exrsrrt*c co{,tsrRucrroN: fl ALTERATT0N fl xrnovnrroru f e rr,renli REpArRs fi Rruocarronr
fl enecr NEr{ REsTDENCE or Q aoorrrou To Exrsrrhrc REsTDE}rcE
AilS}JER BELOId ALL THAT APPLY TO Yfr,'R PRO]ECT:
fl nrr GARAcE sF fl orr GARAGE
f] surunoom
-
sF
fl cnrrnHousE _ sF
f] eoor-
-
sF
florcr
TOTAL HEATED SQ FT: :rs TOTAL SQ FT UNDER ROOF : .-i ,3 TOTAT AREA SQ FT: 'i !"
TSTAL pROIE{T CoST(Lessloti: $ :rq,':-tt * OF STORIES: i
Is Any ELECTRTCAL, PLUIIBIiIG or FIECIiAHICAL trrork Bei.ng Done to the Accessory Structure? fi Vut fJ *o
If the project is a Relocation, is there a Natunal Gas Line on the Curnent Site? ily*r El *o
Is there Electnical Power on this Buitding? FII ves I-l ruo
pRtrERry usE / occupA!$cy: fl srr-rer-e FAflrLy f] u-rer-ex fl ro*nHouse
1r16p1; Add 14' lo iefl side of h,>use:,o ext,end;(iicnen anQ -i'.rinq ra'1g.. 34'j
DATE:FLOOD:BFE+2ft*
4/0"*
APPLICAI{T'S NAti{E: t;nare ::miti:
DEVELOPER: Coastir i B,;i j<jinq Concepts, LLC
Cf TY: '*: l-rir:"i:q'-l:i
SUBDI\f[SI0|,|: ]reiir.i. . j i:
AO0RESS: 5ll ;: 'i ra:. l.q enci Rd . ,
PHSTIE *: 9i'1-lls-23lti
PtlOf,lE #: !:e-rii"',18
u$\
RECEIVED AUO T7 2016
NE!,I HAilIOVER COT.I$ITY BUILDING PERHTT
APPLIcATIail TYPE; RESIDENTIAL
PLEA9E ANSWER ALL QUESTIOI{s APPLICABLE TO YOTJR PRO]ECT
'Project ResPonsibili'tt''
APFLICANT,S NAI.IE:rtrF.n ^-r:'viILI"I:NG;CN, :i.:
DEVELOPER:UEYELVTE^. :;* CITY:
Pr,olECT mOfeiS: i224 ?EI{BROKE 'jcr*9s DtlvE
SUBD:VISION: i'a):triril -
WiLMINGI'ON
BLOCX *:s:LOT
*:PHO}IE
PROPERTY Od!ER,S I.IA}IE: JCA}i TF'i.N(ST : riq ZTP; Z?aci;ffi;l;'^ffiirr,''?i-''ffi crrY: rsls::.'sg
CG,ITRACTOR: KEECO .T 1.]II,HI}:CIC$, LLC .::::-:,:-:;"K
AODRESS: ?.O. 3CX J25 airr,"ti.*rt.t*- sr: rL ztP': Z?q43
PHSiIE *t gtc -zcq-.sttg
EHAfL ADDRESS: legerrcblcinc8aol'cc'm
ffi;;;* PHor{r *i s\t-261-31?e
Exrsrlrc cs.lsrRu6rrou: f] ALTERAT1ON fi nettovnrroN f, cr*rnlr- REPATRS fl nrlmlrrou
ilGU CONSTBUCTToN: f] rnecr NErd RESIDgItcE or El morrroN TO EXISTII'IG RESIDEIICE
AtlD AilSt{:R BELOt'l ALL THAT APpLY T0
-
sF il orr GARAGE
SF
SF
YO|','R PRO]ECT:*,}PLEAsE CHE{X
I nrr cARAGE
sF EPoRcH Lsr
f] sronae: snro SF
SFOTHER: Co..,erqo Pcrci"r il5flsunnoon sF uu
POOL
DECKf, enrrNHousr SF
TOTAL HEATED SQ FT: # TOTAL SQ FT UNDER ROOF: i16 TOTAL AREA SQ FTI
TOTAL PROIECT C0STiuesst-ot) : $ -'l':lc'co # OF STORIES:
IsAnyELECTRICAL,PLUHBIiIGort.lECHAl,lIcALhJorkBeingDonetotheAccessory
If the project 1s a Relocation, is there a Naturaf 6as Llne on the
Is there El€ctnical Powen on this Building? [Tlves f] *o
pRopERrY USE / occuPANCY: fl srr'ler-r FAI'iILY f] ounr-ex ftro*nouse
DESCRIPTION OF I'{O&K:
structure? [ v"t El to
Current Sitel I v*t f, *o
?nlo B'fW
fts-ffi
APPLICATIOf'I
Number
(Offlce Use)
DATE: Eir6/16.
PH0i,IE *: '. -
zIP: S-
Porch-en l. ar
DTsCLATMER: r hereby cer(fy &at ail rnbrmatbn in tris appricarion is conect and ail work yrirt "o*ilm-L" s*tu Building ccde lnd all ofer applicable st"E and loc€l laws
and o'{iinances 'nd
r*suraliqns rhe NHc De!€rspn€ni serv*: j:flY Sjj:::l::":'r::,'X::m"-truiij"&*ff:Ii}:,Tffi: ;:llffi::'
:::JJ[:[TT:[::g"::iX]1,ffff":-?;.il;'rt'i'" ooo.*** Pemrils wirr be in Vioretion orne Nc sta*'
olrNER/cot{TRAcToR: KaECc ol1':Lur}icrc}i
-
STGNATURE:
* *** * * * * * rF* ,** * * * * * * * * * * * * * *(I!tIl Ji1"] * * * * ** * * * * * ** * **+ * * *r *** * 't* * * * ** *** * *
rs rHE PBOPERTY LocArED rN A FLOODPLATN? II vrs frl uo .','.
d(*)r***********
}IATER: fi Creua f] cop*rururTy sysTEll f] enrvlrr urlu fl crNrnnl i'lell
,t*i*, ffi.rruo fr.r*r*o. sEPrrc f] enrvrrr sEPrrc f] ccx'rmuNrrY sYsrEr'l
-l casri f].rr.* (PAYABLE To NHc) flnnenrcAN EXPRESS Ll mc/vrsr [--l orscoven
PAYl,lEttT METHOO: L
*,i++*t*+++****+ft*******+********+*'t*!+***{'*****+*******+****************************(***
EXTSTII*G II'IPERVIOIJS AREA: .---.- SQ FT
T,IEI,{ II{PERVIOUS AREA: i?6 SQ FT
(FOR OFr:CE UsE ctllY)
zo$E:OF FICE R :SfTBACKS: r:
TOTAL ACAES DISTURBED: #
IXI5T LA}.ID DISTURBING PEfifilIT: J*I YTS I UO
REVTSEO DArE A4/rl-ilz
LH:-- RH:- 8:-
Approval : CltY:- DATE:- FLooD:BFE+2ft=
AV
I
r$t,
'&,
'..:." _-
AFFLICANT,5 I{AF1r :
OEVELOPEB:
NEW HANOVER COUNTY BUILDTNC PER{'4IT
APPLICATr}N rYPf : RISIDENTIAL
pLEASt. AHSL,TF au- Qrrt'rlot,s APPLIcAgtE T0 Your PRO]tCr
"Project ResPonsibilitY"
'1 i t -( DAT.:oi'"i;tu u
ffi,- crrv:ip;r**-* zrP:r)-'**
ploxE s: L\)-r, C- tc'\
Sr:
-
ue ::rka jri
?,au Wtr'o
pffiilEr
lrlunber
(ofti(e use)
sr'lyi-ztpz2t 4.k'
*: I ra i'la i,
* (l'2't)fYE
sr
sF rlfrt'itJ
SQ Fr: ti4l -
PRO]ECT ADBRESS:
SUBOTVISIO}T;"-/, ^, ,/\s.,.-!.,- BLOCX $: -.--- LOT $:
--*PROPEf,TY OI4HTR,5 tlA},IE :rrr l, U \,p', * ti Gtcil*r- : }}.f,.
oh$lER's ADDRESS: J3;::it -[t"'{f-X,iJ: {.J .:' ( f CIrY: lrrtt"qrr.'l*+
CONTftACTAR:,.LICEI{SE e: ,},fl f I'tiii,
t r,.,"firffk.,. r_ADDRESS;
IITAIL AOORESI:PlicilE
PIENEPRO)fi:{T COHTACT PTESON:
Exrsrli6 cot{srpu(tro1, fi aLrgnarrou I nrtlovarror I eeur*rl R;PAIR$ f, nrr"ocarroru
r..E1i,i c0!'lrrflu{rron, fl ERECT t*Et{ *rrror*aa o" f] aooruoN To ExISTtt{c REsrDEilCE
IiPI.EAST CHTCX AND AT',3!{Ti BEtOt{ AI-L T}1AT APPLY TO YOUR PKOf f CI :
f] noncu
-
sr
f] s'ronner sx€o
-
I eerrwousr f-l oecx sF_0Tii[R:
flrrr GAnlcr
-
sF I prr GARAGE
--
sF
ftsuunaor,r 1..3r.1... .,- sr f] PooL
-
sF
TOrAL HEATTO 5Q FT: 1,:.:dc' TOTAL 5Q FT
TOTAL pROl[{} C05Trr-uslort : $ !-9,S$a*.rc
]s Any ELftTRICAL, PLU*8Iiltr or HECHAfiICAL Work Eeing Doce
If th€ project is a Relocation, is there a Hatural'
Is there Electrlcal Powen on this Euildjngr [Ei*t
UNDEB ROOF: 1".'a TOTAL AREA
f OF STORIES: I
to th€ A(ce5sory stru(tu''€l f,|'fit E no
Gas Line ofl the Current Site? f--1 ves E no
fl*o
* -a''''pRoprRTY UsE / OCCUPA}€v: l-LfSrmclr FAHI LY I oueurx ff ro*uxousr
',t - t'$ES€fiITTION OF hl0R,(: L.'ii i I I /-, t, '
7 4t;kL--\3*4ldt"U l\/*1,!(.Ar*nL--' t"1:-+rt5" '\\l* tt r ^r { ftt{:.:-"1*'4'.kr :4vfc'{1.:!1:}r':-:!_:::::::'-t
ad ar54snaa6 rq!,l Egutaisrd ThG Hh{C tryelBpEei! Saftc€i CanEr sil b€ aslir!6d ol *1y cna."ges n itt aEgoY*d pS.s an, Spfcifcstitns G' cilsngc in coruacD' ol
contacbrinbrfrsron...NOTE r.ryWortPerlumedW/oFeApprop.irtePe,m{sw{lbenVpbtf,nql*Et'tcSlse$irfgCoceendSu4lcrr?iftrsttrtIo$5000Y"
i i, rf r +r* *r *:.*., * { r r.+ i +; | *(lllil Jllt] *.. *** r- i{ r* * i ran r.* * ", * " *-* *". *$ * *N r r**t* r *. + r i * t +* tr t
15 TI-iE PRI .F(R?Y LO(ETED I},I A FLOODPI.A]N? ff YES ffiO
/r(
PERHTT: I iYES I iN0
.4.
r,,rA,rER: ffi crnun fl corr,,luurry sysrEM f, nnrvare urt-l I crlrnal t^;rll
sEilEn: ffi trouo f] crr*rml sEprrc f] enrvarr sEP"trt [l co*r+u*:rY SYsrEM
... S'PAFATT T'fN*IT5 ETQUIRES TOR TIECT, T{ECX, Pt8G, GAs EQUIP, PBETABS 8 II,ISERl5'1'
*':::-:::11',j.
.. ,8,'::..?,T.'"'1.i:1',1"'.,',.l:.:T.l.F*r11T:"::i',"l'. - . -E.iY.',i::,..F",.',:::"*
ExISTltS l"ilP[*VIOUS AREA:
--*SQ
Fr
NEt^, ITiPERVIOUS AREA: *_ SQ FT
Approvalr 0l * city:L\)\1CI1 or.'i r
TOTAL ATftES DISTU&BED:
EXIST LAND DISTUBBING
aAEL BFE+2rt=
H
PtR!4rI FEE: $
'*r lnrrrr&rftr:n Dqryrrren $1f!.!f 11
n1
Comnent:
,, ,$/d""''n 'itt c'ii\"';
.A
FeX " 10 1e0- 1dVd
too NoOanx
PR0PERTY OiI]NER'S NAI4E: I\iev Hanover Cor:ntv ou^^rE
O!JNER,s ADDRESS: CITY:
NEI^J HANOVER COUNTY BUILDING PERMIT
APPLICATTON IYPT: COMMERCIAL
PIEASE ANS']ER ALL QUEsTIONS AP?LI'ABI.E'TO YOUR PRO]ECT
"proJect Responsibil,ity,,
APPLICANT'S 'AffE' DA-IEI 9/\7/16DEVELOPER: PHoNE s:
PRoJECT ADDiESS: 3515 Nor:th Ke.r Ave CITY: fli lmincrton ZIP:2g4_ol
OCCUPANT/SUSINESS NAME: New Banover fire services SEatio. *11
APPLICAIION
Number
(offtce 0se)
*: 910-798-7020
5T: ZIP:
CoNTRACTOR: Highland Consrrucrion TTCFNSE S: 25594
ADDRESS: 3302 Kitry Hai{k Road suite I00 CfTyr ,rtlminqton
EMAIL ADDRESS: kevin. ramse y0 teamhish.Lan.i. com pHONE
PROJECT CONTACI PERS0N: Kevin Rdmsey pHONE
Exrsr coNsrRuc',oN: n ALTERATT* I *rrJiffi!;'^i 'H??'ii-^,-
It Relocadon, is thera a Nstural cas Line on lhe currenr Snet Ives f]lfo
sT: NC zIP:28405
S:910-849-69r8
f:910-849-59?8
AIICH DE5I6i] PROFESSIONAL:
EN6R DESIGN PROFESSIONAL:
Occupancy Type?
NC RE€
#:
PH:
PH:
SIGNATURE:
(Pdnl NDm.)
€nlaln Asbsstot orool You srE squl&d to call uls Nsuonsl Embslon sugndsrds tor HEzard3; Alrpollulants (NEsHAp) st {919i707-sg50 rt l6a!l t0 diyr Ftor to th5damolltlon ot any r.drv or llildrng. s.. Asb.stos w6b sria: http:/ ftw.6plsrau.nc.u3/spi/q.!6sros/shmp.fitnl
ToTALPROJECTCoST: 11,688 BUILDINGHEtcHI:
TOTAL AREA SO FT :SQ FT PER FLR:
ToTAL SQ FT UI'IDER RoOF:
ACBES DISTUHBED:
# OF STRUCTUFES:
NEW IMPERVIOUS AREA;
# OF UNITS:
# OF STORIES:
# OF FLOORS:
SQ FT
N
(r - ?8os
rrelrns I RrLocATroN
rs BLDG spRrNKLExsor I ves !ruo
NEI'I coNsrRucrrolt: f] rnecr NE srRUcruRE I rnsr rRacr I snrr-r- f] uerrr f] aoo ro Exrsr srRUcruRE
ACCESSORY STRUCTURF:
If UPFIT - The SheU Penmit #;rs Elect Powe. on this Building f] yes [f rc
NC RE6
DESCRIPTIoN 0F I,JORK: Reonove drop cieling in txaini.tg,oom.ir.l roptrca, cteri\
ls food or b6veragos prepared orservsd in thls struc'ture? EYe" I No lu Th" properay Locat€d ln The Eoooptaln? f] ves f] no
Codo and all olher
OWNER/CONTRACTOR:
(odtur)
**,I*t 15 THIS A CHANGE
fF Yes, what was the Previous occupancy Type?
oF occuPANcy usrr f]vrs f] uo
. l4hat is the Neur
EXsr LAND DlsrungrNc peni/rrr l-lves l] rc
SAFT EX|STING IMPERVIOUS AREA:
pRopERryusE: noFFlcE flRrsraumNl [uencan-nle f]eouc f]aer f]cor{oo orxen,
ylIE!,EgItyA flcoMlruNtrysysrEM LIWELL ffzoNtNcusEclAsstFlcAioN:sEwER: ry CFPUA ff CENTRAL seelc fl enr-vnrE sEpTtc f]66urr,luurw sisrru
". SEPAMTE PERMITS REOUIREO FOR EL€CT, M€CH, PLBG, GAS EOI]IP, PNEFABS & II]SERTS -.
PAYMENT METHoD: flcnsN flcHecr lelvnaLE To NHc) flnr,lenrcaN exrness f]l,lcrursR I orscovrn
(FOR OFFICE USE ONLY)ZONE:_OFFICER;_ SETBACKS: F:_ LH:_ RH:_ B.-__-Approval: Clty:_ DATE:_ FLOOD:___ BFE+2ft;
Comment:PERMIT FEE] $
FEVISEO DATE {Alfi2
\(.-/ -\s ,;
,m,'
"'-,.;","''
APPLICANT' S
DEVELOPER:
I.[o ?\ans
NEhI HANOVER COUNTY BUILDING PERMIT
r-,. a ,- { APPLICATION TYPE: COMMERCIAL
l-XW U,.orrosr ANswER ALL QUEsrroNs AppLTcABLE ro youR pRorEcrT v \'/
0V H C 9t (lfui"'' ResPonsibilitY"
NAME: Highland Constructj_on
PROIECT ADDRESS: 3805 Hwy 421 norrh CfTy:
-
OCCUPANT/BUSINESS NAME: NEW HANovER crry FrRE svcs O I 2-
APPLICATION
Number
(Office Use)
DATE: 8/29/L6
.W
j- lmington
PHONE #:
ZIP:2a4oL
PHONE #: 230 GOVERNMENT
ST: r'rc ZIP z 28403
ST: t'tc ZIPi 283L2
PHONE
PHONE
#:910-485-6738
#: 910-849-69'78
PROPERTY OhINER,S NAME: IIEw HANoVER
OWNER,S ADDRESS: 230 GOVERNMENT CENTER DRIVE CITY: wrlu
CONTRACTOR: HIGHLAND CoNSTRUCTIoN LICENSE #: 25594
ADDRESS: T4O9 CLINToN RoAD CITY: FAYETTEVILLE
EI.IAIL ADDRESS : KEVIN. RAMSEYGTEAMHIGHLAND. CoM
PRO]ECT CONTACT PERSON: KEVIN RAMSEY
EXIST CONSTRUCTION: I
lf Relocation, is there a Natural
(check AlI rhat Apply)
ALTERATTON fl neruOvarrou @ ceruennr-
Gas Line on the Current Site? [Y"i[ ruo
E*o
the New
OF *****
Occupancy Typei
PH:
PH:
NC REG #:
NC REG #:
DISCI-AIMER: I hereby certify that all information in this application is correct and all work will comply with the State
and local laws and ordinances and regulations. The NHC Development Services Center will be nolified of any chang
or chanoe in contractor or contractor i-nformation. "'NOTE: Any Work Performed WO the Appropriate Permiis will 6,
Subjectio Fines Up To $500.00.'-
ToTALPRoJECTCoST: 3, I OO
all other applicable State
olans and soecifications'NC State Bldg code and
OWNEF/CONTRACTQR; urcHraND coNSrRUCrroN SIGNATURE:
(Qrl3tilierl (Print t{arm)
contain Asbestos or not You ar€ required to call the National Embsion Standards tor Ha'ardous Air Pollutants (NESHAP) at (919)707-5950 at least 10 days pior to the
demolldon of any fadllty or bulldlng. See Asbestc Web Slte: htQ#vnrl.epl.stab.rrc.usy'€pUasbestos/ahmp.hbnl
#OF UNITS:
# OF STORIES:
# OF FLOORS:.
EXST LAND DTSTURBTNG PERMTT? [VeS fl ruO
SQ FT EXISTING IMPERVIOUS AREA:
PRoPERTusE: EoFHcE ERESTAURANT [rr,tencnrurlE EEDUc EApr EcoNDo orHER:
wATER: ECFPUA fICOMMUNTWSYSTEM gfre* IIZONINGUSECLASSIFICAT|ON:
sBA/ER: EICFPUA ECENTRALSEPTTC )ZPRtyXeSEpTrC ECOMMUNTTYSYSTEM*. SEPARATE PERMITS REQUIRED FOR ELECT, MECH, PLBG, GAS EOUIP, PREFABS & INSERTS *'
PAYMENTMETHOD: flCnSn [cneCX(PAYABLETONHc) [AUenTCnNEXPRESS f]UCnnSn IoSCOVen
(FOR OFFTCE USE ONLY)REVISED DATE 4/1.I/12
ZONE:OFFICER:SETBACKS: F:_LH:.RH: B:_
Approval:_ City:_ DATE:_ FLOOD:
Commentr
SQ FT
REPATRS ! nrlOClrrOru
lS BLDG SPRINKLERED? Eves INo
NEI^J CONSTRUCTION: ! CNrCr NEI^I STRUCTURE E FAST TRACK ! srrer-I I uerrr ! aoo To ExIsT STRUCTURE
ACCESSORY STRUCTURE:
If UPFIT - The SheII Permit #:Is Elect Power on this Building I Ves E tr,o
DESCRIPTION OF I^]ORK: REPAIRS TO BATHROOM ERAMNG- WATER DAMAGE/RESET SINKS, DRYh]ALL, INSULAT]oN
ls food or beverages prepared or served in this structure? l-lYes E No ls The Property
TOTAL AREA SQ FT :
BUILDING HEIGHT:
SQ FT PER FLR:
TOTALSQ FTUNDER ROOF: #OF STRUCTURES:
ACRES DISTURBED:
NEW IMPERVIOUS AREA:
**{.{.* IS THIS A CHANGE
IF Yes, what was the Previous Occupancy Typel
ARCH DESIGN PROFESSIONAL:
ENGR DESIGN PROFESSIONAL:
occuPANcY usE? EYEs
What is
-- J=ff;i=a
kory,.gtdu%
Note: Demollton notificadons & asbGtos rernoval permit applbadons arE to be submitted uslng tre appllcaUon form (DHHS-3768)or buildlng was found to
.^ il6q($Ar{ovER counry ButLDtHG pERMrr *-jfrilWgf&
*e.d Eo ouo -,,,uuu
^,1ff:l'lffiI,fif;':::f#in: p*or'cr tr2$bW"ProjectResponsibility" rv - {ofl'ice ure)
AppgcANT,S NAM6; Ocoan Blue Pools & $pas of NC p31s.8/26/2016
pBCIJECT Apojsggl 220 Creekwood Road 6sry; Wilmington ap;3!111
SUBDIVISION:l"8T f ;
pRgpERfi O\ATNER,S NAM[: Stacey Ward pHoNE s. 91 0-232-5638
giA,NrR,s ApDRESS; ZfO Qryg$,ogg Rolg gryy. Wilmington 71p. ?8411
(oHTRAcroR. Ocean Blue L,99]s & Spas of NC 3LOG LICEIIISE S:rc764
ApDBESS: 30 Covil Avenue qry. Wilmingtol*.**..-... ST: NC vp' 28403
[MAlt ADDRESS: oceanbluewilli ail,com PHoNE: qql99-!93
PROJECT CONTACT PERSON:Susan Rowland PHONE:910-799-3022
EXIST|NG CONSTRUCflON:1f Alterstion [] Renovation l---l General Repairs
NEW COtrlSTRUCTlOfit: Il Erect New Besidence il lddition to Existing Residence i-l ielocation
..IPLEASE CHEC( AilN ANSWEf, BEIOW AtL THST 4PPTY TO f?UR FROTC'.T'*'
'I Att Garage tSFl
-
.L sunraom (5F)
I Greenhouse {5F)
-
ill Det Garage {5f} *---
fi Pool 156 555
fi oeck (sr) 640
il Porch {SF)
IJ StoraseShed {5f)
i:i other (5F)
ls the proposed work changing the exilting footprint? Il Yes lJ No
TOTAL $Q fT UHOER PIAAF {for proposed workl Heated:Unheated:
TOTAL PB0JECT CO$T (Less Lot): $50'300'00
ls the proposed work changing the nurnber of bedrooms? E Yes G No
ls any llectrical, plumhinf or Mechanical work being done to the Accessory Structure E Yes E Ho
lf the project is a Relocation, is there a Natural Gas tine on the current site? O Yes Il No
ts there Electrical Power on this Building? E Yes fl No
Fencing,
in{ormation, rv*NOTg k p€rfilrmed without !h€ .pproprirt* permlr: will be ln vlolaiion o, ihe tlc State Bldg Ccde and *ubie* to finer up to l$00.0O*"
OwnerlCsntractor:
"Licensed Quo{ifier"
Signature:
Property Usef Occupanry; El 5ingle Famity fl Duplex E Towahouse.
o.*apti"".tgror1. tnorouna dillmmind pooiwicancrete aeckina., poot cooe main drains, Pool code alarm&*Existirlfi"P-*gl cqde
ts the property located in a floodplain? E Yes E t'to
Ixirting lmpervious area; Q .-.'-.-.---* 5q Ft
NeurtmperviolrArea:919--Sqft ExistingtandDlsturblngPermitll Yes E Uo
,/
WATER: dcrpue il Cornmunitysrtem E privat€Well E CenyalWell E Aqua
SEWER: n cFpUA fl Communirysystem E Private5eptic [3 centralSeptic E Aqua f\A bgs,h(U-tgl\'{-$"{>
Zone: -.- Offlrer: $nthacks {r} --
{L}l}
-
(RH}
-_
(B}
-
tV\ rS \ cr\'
Total Acres Disturbed:
ds'\
Approval: Cityr
-
OEte:
-
Flood: {A} {V}
-
(lit} BFEr2ft:
Commenti F€rmit ,.",e ?S- .-
'
Print Narne