DECEMBER 8 2016 BUILD APPS'(,I(,3 )tttc-1IKL
ffi
NEli, HANOVER COUNTY BUILDIIIIG PERMIT
APPLIcAfidt TYPE: COI{4ERCIAL
PLEASE A S}.IER ALL QUESIIOIIS APPLICABLE TO YOUR PRO]ECT
"Project Responsibilitf'
t tt4l48
APPLICATIOI{
Number
(Office Use)
APPLICAI{T ,S [ArrtE: Frank Lewis
PHONE *:
DATE: 11-g -16
ZIP i za403
DEVELOPER:
PROIECT ADDRESS: 5814 oleander: Drive ,rnil,a
OCCUPAiIT/BUSINESS A E: Active care Chiropr:actic
PROPERTY OISIER'S tlA E:
O|JNER'S AIDRESS:
CO TRACTOR: Lelris Blrilders, rnc-
ADORESS: Po Box 14 64
EfilAIL ADDRESS : f rank.Q lewisbu.ilders i nc . com
crw:
LICEIISE #: 36299
C]TY: wrightsvilfe Beach
CITY: wi fmingLon
PROIECT COI{TACT PERSON: Frank lewis
PTIONE #:
ST: _ ZIP:_
ST: NC zIP: 28480
PHONE f: 910-62A-19A2
PI0NE #:9L0-679-5221
(Check Alt Ihat Apply)
EXIST CONSTRUCTIO :
lf Relocation, is there a Natural t No
NEr.t coNsTRUCTrOr{: ! rnrcr NEH sTRUcruRE I rasr rmcr I suer-r- ! urrrr I mo ro ExIsT STRUCTURE
ALTERArror,r f] ne uovlrron ! cer,rrur- nrrrrns ! RELocATToN
Gas Line on the cunent site? EYeaENo ls aroc spRtttxleRgoz [-l ves
If UPFIT - The SheII Permit *:
ARCH DESIGN PRoFESSIOIIAL: Goodrich ArchltecLure
McDowelf Consultinq Enqineers
Is Elect Pouer on this Building El Yes E to
PH:
PH:
gto-:q:-roef Nc REG #: ?434
910-2'70-314't NC REG #: 23933
E
-J
<)s7
DESCRIPTION OF WORK:;+ND I
TOTAL PROJECTCOST: $4e, 000. 00 BUILDING HEIGHT, X3 t # OF UNITS: I
TOTAL AREA SQ FT :z{ci SQ FT PER FLR:#OF STORIES: i
TOTAL SQ FTUNDERROOF: ir',zzi # OF STRUCTURES:# OF FLOORS:
- unil I
ls food or bev*ag€s p.Bpded a served h tts *Uaue? flves No ls Tha Property Located ln The Floodflain? ! Yes !No
all other applicable State
olans and aiecif cationsl.lc Srare Bldg Code and
,- OWNER/CONTRACTOR:Prank Lewis SIGNATURE:
cdtain A6b€sto6dnor Yoli aa rBqdtEd to cal tha 6$alal EniBton Standa.& tu Ha2adoll3 lit Hluta.ls (NESfiAP, at (919PO-5950 al1610 daF friGto tE
demditoo oa any lality d boil&lgl Se Ast€st6 W€b slt€x htFr/w*Y.€gi.statanc-t6ret asb€G/rmp.hEnl
Y
I
+ACRES DISTURBED:NA Exsr I.AND DrsrunarNc peRurrz T'l yEs !NO
NEW IMPERVIOUS AREA: NA SQ FT EXSTING IMPERVIOUS AREA: NA
PROPERTY USE: @OrrtCe lnesreunarr lmencarmr-e [eouc nle.r E@NDO OTHER:
WATER: ECFPUA
SEWER: 7l CFPUA
-'SEPARATE PERMITS REQUIRED FOR ELECT, MECH, PLBG, GAS EQUIP, PREFABS A INSERTS "'
pAyr ENr METHoD: [Cn*r floreo< pevea-e ro Hxcl fleuenlcAt{ E@REss El ucrvrse fluscoven
SO FT
f-lcoMMUNlTY SYSTEM flwEtr fIZONING UsE cLASslFlcAnON:
-
fic=rrml semc le-nvnre sEpnc E-coMMUNny sysrEu
aF I e-X€
Comment
ACCESSORY STRUCTURE:
r*r** rs rHrs A cHAircE oF occuparcy user fivrs Elm'-.'-IFYes'Hhatr,asthePrevl.oU5oGcupancyType?-tfiatisthei|doCcupan€yType?-
ENGR DESIGI{ PROFISSIOML:
q
-_))-|..
(FoR oFFICE USE ONLY) nE\,/l{ED DArE 4fl t/12
ZONE:-OFFICER:- SETBACKS: F: LH:- RH:- B:
Appmval:- City:-DATE: FLOOD:
---
BFE+2fr-
AVN
PERMIT FEE: $-
NEhJ HANOVER COUNTY BUILDING PERMIT
HORO23 APPLICATIoi| ryPEr RESIDENTIAL
PLEASE AIISIIER ALL QUE5TIOI{S APPLICAEIE TO YOUR PRO]ECT
"Project Responslblllty"
L6-3320
APPLICATION
Nunben
(Offt(e Use)
APPLICANT'5 NAI'IE:
DEVELOPER:
H6.H CONSTRUMOR I S OF F'AYETTEVILLE LLC
PHONE #:
PROIECT ADDRESS; 1320 Eastbourne Drive CITY: WILMINGIIoN ZIP | 214tl
SUBDIVISION:Sanctuarv at Hanover Reserv BLoCK #: 1320 LOT f: o23
PRoPERTV OWNER'S NAME: H&Il coNsrRUCroRs oF FAYETTEV]r,LE.LLC
oUINERTS ADDRESS: 8209 Market street suite c CITY: wi lminqton ST: J!_ zIP: 2 8411
LICENSE #: ?41s8
CITY; wILMINGToN ST:!g*zIP:28411
EnAIL ADDRESS: iuti.cafferrv@hhhomes iferryBrenainq@hhhomes. com PHONE f: 910-219-148s
PROIECT CONTACT PERSOiI: ,J,r Brenninq PHONE #: 910-219-148s
EXTSTTNG CON5TRUCTTON: I nlrrnnruOt ! AetOVarrON I OeUennu REPATRS I RELOCATTON
NEbl CoNSTRUCTIOU: E] rneCr NEU RESTDENCE o" ! mOrrrOU TO EXISTING nESIDENCE
r*'PLEASE CHECK ANo ANSI,{ER BELotl ALL THAT APPLY TO YoUR pBolECTl
flarr canaoe s2e sF
SUNROOI4 SF
f] oRernxousr
-
sr f] oecx _ sr OTHER:SF
CONTRACTOR: H&H coNsTRUCIoRs oF PAYETTEVIIJIJE, LLC
ADDRESS: 8209 Marker srreer, suite c
TOTAL HEATED SQ TOTAL 5Q FT UNDER RoOF: l!:f_ ToTAL AREA SQ FT: 25a?
T0TAL PR0IECT COSTsessoq l, $ nt,azg # 0F ST0RIES:
Is Any ELECTRICAL, PLUI'iEING or IiIECHANICAL Work Being Done to the Accessory Stnucture? E Yes No
Ff i 32s2
T
If the project is a Relocation, is there a Natunal Gas Line on the Current site? fl Ves No
Is there Electnical Power on this Building?
PROPERTY USE / OCCUPAT'ICY: [l SrrueLr rmrrrv
DESCRIPTION OF WORK: S]NGLE FAMIIJY DWEI,I,INC
ves f] no
DUP L EX TOWNHOUSE
DISCLAIMER: lherebycedt lhBt all inbrmalion in ihis apdicaljon is co.recl and all wo.k willcomply wih Sle Slele EulEing Oode and ail oher Eppllcable Slale and local laws
and ordinancos and regulatlons. The NHC Developmonl Services C€nEr wii be nolifred olany changes io he apprcved phns afid speclfrcBlioos or change ln conl.acbr or
contracbr lnformadon. "'llOTErAny Work Pelormed W/O he Approprlale PermiBwillbe inVDlatbn ol th6 NC Slab Sldg Clde and SubFcl lo Fines Up To $500.mr"
0WIIIER/C0NTRACTOR: oo erenninq
* *,r* *+ +:I +,.:*:r,i ** *** * *** * *** *(liTl lil"i
I5 THE PROPERTY LOCATED IN A FLOODPLAIN? l--.l YES
EXISTING IMPERVIOUS AREA:
-SQ
FT
NEW IMPERVIOUS AREA: 3130 SQ FT
SIGNATURE : (\&d., t x.--.-
-
ur 6*rt** ** *+ +* +** *++*,*+* )t ***,*** *+**:* ***t +,**+,lr **,**** * ++ jl +:t
I NO
TOTAL ACRES DISTURBED: .22
EXIST LAND DISTURBING PERMIT:I vEs U rvo
I^JATER:CF PUA COI'{'IUNITY SYSTEM PRIVATE WELL CENIRAL HELL AQUA
COMMUNITY SYSTEM AQUASENER: E] CFPUA E CENTRAT 5EPTIC PRIVATE SEPTIC
*'* SEPARATE PERI1ITS REqJIREO FOR ELECT, I4EC}I, PIBG, CAS EQIJIP, PREFAES & II{SERTs
pAyr,rENr HErHoDr fl cnsx D or.cr( (pAvABLE ro Hc) f] alrERrcal ExpREss E nc/vrsl E o.t.orr*
*'t +'*t***d<*,t,t*)ht,**)t***:f 1i ,1. {r,* xx*)* *t*t,t*t***t +)**+ +it*,t*t,t*x* t***)t**{.r*** *,1+1.*,ix +****)*+*,*t)t***
(ro8 oFFrcr usE oitLY) SEVrSED DArE 04111/12
SETBACKS: F: LH: RH: B:ZONE:OFFICER:
Approval:- City:- DATE:- FL00D:
-
BFE+2ft=
-
avt{
r
I
comment :
(
DATE | ]]12]J2!JS_
PHoNE #: 910 219-148s
I orr canacr sF ZI PoRcH 2i2 sF
I eoor- _ sr I sronace sHED _ sF
PERMIT FEE: $-
NEW HANOVER COUNTY BUILDING PERI{IT
tlsW
APPLIcarIott rvpr; CO{IERCIAL
PIEAS! ar,Br,tR Au, QUESTTO$ Appl:c 3LE rO yOUr ptOlECt
-projGct R.sponsibillq/
tb_3tq7
AP P L ICATIO'{
ilunb.r
(offlc. Ur.)
APPLICAII'S Nrtt'lt:L'e 0teqn tlrt&'it
PHONE i:
P}E'{E ':
OATEDEVELOPER T
PRO]ECT ADDRESS:
ocoJPAnT/BUSIiIESS MritE i
PTOPEiTY ol{'{Ei'S ilANE :
OU'IER'S ADDRESS:
CO'JTiACIOR
ADDiESS:
E'IAIL ADDiESS:
ACCESSORY STRUCIUNE:
aJ-
CITY?
e-J
CITY:
LICETISC I:
CITY:/e
ue :Lf ///
PeolECT COI{TACT PtnSOJ3 P|0 E ':P}ONE ':((hr.r At th.t &9ry)
EXIST CO STRUCTIOJ:tr A!IERATION tr R E }TOVATIOt{GEIIERAI Rtrf Relocltion, h therc E Nstural GBs Line on th€ Cunent Sit€?tr Yes ElNo rs
rrlrns f; nErocarroil
BLDG SPQlNKLspgpz I ves flwo
EB cOilSTRUCTtOl: El EiECT ilElrl STRUCTUIE tr T IBACX E SHErr uPrll fl ADD ro Exrsr srnucruiEtr
st?\LztP.2tv!3
fir/1./-zptZEV)
I ves Ero
I
F
If UPFIT - The Shcll Pemit {: Is Elect pord.r on this Building..... ls tuts a ou cr oF ocofl cy usrt ftws @!.ro.,...tF yrs, rA.t ras thr PraYiour occup.ncy TID! I - ftI tr ttFfG, gccup.ncy TypG
Ator DEsIo'l PrcrEssrollAt:
EX6T DISIGN PTOFESSIOI{AL:
P+t:___ c REG 1:
PH:
-___
]tc REG 8:
DESCRIPTION OI }OR( :q 4u -/n Co o/et
b tood or Ocveogcc pcpar€d or sc,rad h Urt rrUur? @/Ves I Ho t nc Ropcny Loctd h nc Foodptlh? E yes El6
" SEPARA]E PERMTTS REOUIRED FOR ELECT, MECX, PL!
pAyMErfi METHoD: flcsx ficxecx pavreu ro xncl
(FOR OFFICE t 8E OMnZONE:-OFFICER:
Ell .thr sgp,tcsue Sbb
triB#EffiT#Ji
G, GAS EOUIP. PREFABS a tt,SERr .-
Eldr,renrcu ocREss EMc/vtsA I orscoven
L
AcREs DlsruRBEDi- E srry?-?':]U,lgtNcrrRMrnEtyEs EiloNEW IMPERVIOUS AREA / 1-O SOF1 D(F1NG tMpERVtOUS A&i!,; -
sO FTpRopERTyusE: EpFFpE ffitnesrauurr flnencannu leorc Eerr fhrroo orxm
ut^r*R: gbF:v^ Elpll!ryryg'lEgElq+ _g'il"o r.-=o^rJ,-l-*I*J-
SETBACKS: F:_LH:_RH: B:
--
BFE+2n=t
REVIgED DAiE a/1l/lt
,4.^
r"\{
Appro\ra
Code compliance
, Comment
b D
FLOOD:
PERMTT FEE: $
(q.rri
h
/J2./b , a/D.{ /rr.'1rr/! -
r7"*/,7/{ -
's -a// -
r..7--'yr{ /"r_.'r/r*//
(Pr/ 5 / f"'f7
' s,r)& l",f l^A
v" lA +,d -
".-a 2 ,l ,,0
otl,*ft Qclq
/-a----a'.'NEhl HAI'|0VER COUNTY BUILDIilG pERf,tIT
Applrcrfiort rnr: C{I{iERCtAt
Pl.tlst rrsrtt Atr Qtrfsllol! A?ptr( !t: to yotl ?to]tcr
"prorGct t.rDo lbiuty-
tb-31q'.|
arPtlc^fiot
XsrDar
(Offt<. Ur. )e €-6nL,an , ' i"P}}O E tl
Pto{E r:
DATEDEYrlOPfn i
Pro)tCT aDDtE tr
OCO'PAT'T/BU9IXT5S MIIT :
PtOPttTY Ol'tlEl'S lur{t :
otfft's aDoiEss;
c
e-
crTY:
eJ
CIW3
LrcEt6f r:
crrY:
ztPt Ll///
COI'TRACIOi
ADOiESS:
EirArL ADOiEss:
Pi0lECr co.lrAcT tttgox:
xtx c0 srrucllo{: [f
ACC:5SoAY SlttclutE:
(
--
sr.fulztPt zl{43
sr:r*ut.ZEl9
Exrsr coirsrRucroil: I lltrurror tr rEJiXiHj
ll Rrlocdbn, E thcrc s Nslural Gls Line on the Curenr Sife? ft
Pr{}lE T:
Tto t t:
Ilttt aF]yl
#fr r" ; g,x,RH[:ffjrfi
"* tr *
I** E sxrr.r f] wrl g roo ro trrsr srrucrur
Ir Elcst Pol,tr on thts Buitdin8 E yQs E xo
ERTCT
'{EI{
SIiUCTUi[E]r T
rf UPrIT - Tte ShGlI Pemit *:
r..r. lI THIS I (tlArr6I 0r ocorpAticy t,sE?E*s @fm .....
tF Yrs, rirt Ya3 tltt Prtvlost Oacuptncy T14el Itrrt it ttc *ai otcuprncy fygcf
af,or DClrAn PE lsJlo{ 1.:
-n{
-
tc RfG 'rcil6r De5t€tl Ptof lsslotlAL :_ P+t;
-
llc Rt6 t.
DESCRIPTION OF IOR( :dU -/n tu a/s/
b bod o, D.rt(t06 FF t{, d..nEd h tt{r dn.Et .? @'vo I xo k Ih. Progrry tqd h nr mo4nhrE vas El6
.ll 0orr Brfldh Sbrtrf#;EHt
H:Hffi.'ffiffif H,.gg;.,i*'Oirr&o ol rry ldy o, hef . G- ^rD.*.Ir$ 8t: lllp:hi*rrl.r!.JslJ.tdiaala'l!.alf
(o-nd
BUlt.D|l{G HEGHT: _
SQ FT PER FLR:
-
TOTAT AREA SQ FI:-
TOIAL SO FT UNDER ROOF:
-
' Of STRUCTURES:
ACRES DISTURBED
WAIER:
SEWER:
oGrt D DlsTURBttlGrgpslpfty66 !x9
EXISThIG IMPERVIOUS AftluNEW IMPERVIOUS trc* 1Lo soFT SO FT
pRopEBryusE: EpFrE-E ffilnrsnunerr $encarnre flerxr Eerr Eoroo ornen
dQF"uA flCOMut t{rY S}:STEM EWEr EZoNr\lG usE qrssFrcAmN:
@fcrrul Ec€rfrRAL EEFflC E Pf,rvATE SEFrlC f]Coruru{rTY SYsrEs
- STPAMTE PERUTS REOI IFED rOR aECT, rrECX. PLAG. GAS EOUP, PREFABS a ,{SEFB *
ifrffi ...ih*..fr
(FOROFfTCE lr8€ Olrln iBrSED DATE (r 1A,
ZONE:OFFICER:SEIBACKS:F:-LH:-RH:, Bi
Appo,ral:-CIy:-DATE: FLOOD:
--BFE+zft -
AVT
Commcnt PERMI FEE: $
I
a?Pllclrr's tllrf:
TorAr PRoJEcr costl o, c N
I
, cF uluT8:
,0f SToRES:
{ q FLOORS:
-.
pAwE|IIr{ErHoo: lcesx ffo,recxPevrguroNHc} EHMEE}CaT{E(PRES$EtMcrvrsa floscorcn
\
g( 5rea.rn:ralul.- tlusrlt"--B'' E cy? H;'*l
i pr.*,- ,2.?,,,* a 'fiu =-,.,selr 6S sGrarurcl.- -
* .fi,\,r+-- k,*|J, L'l- *tt g(tc'*- [o' '!tt fi'---s
L)/Y(lo
NEw HANoHRo.Jkfru,r, NG PERM rr
Emall
u *
&
APPLTCATTON TYPE: RESIDENTIAL
PITASI ANSWER ALL QUEST|ONs APPLICABT' iO YOUR PNO]ECT
"Proie.r ierponrlbllity"
ApplcANT,s NAM€: DISASTER ONE INC g6qg. 12105/2016
Pnnl
pROrrgr ADDRESST 648 CHO\ lNlNG PLACE s1n WILMINGTON 2;p 28409
SUBD1V1SION: THE COMI\rON$;61 x 73 SECTION 5
pRopERTy owNER,s Nag6. SALVATION ARMY PHONE T, 704-526-5554
OWNER'S AADRISS g1n. CHARLOTTE 71p 28211
coNrRAcToR: DISASTER ONE. INC 9166 Ug6p56 e 24249
EMATL ADoif ss: TWATSON@DISASTERONE.COM px6xp. 910'332-3572
pnOjECI CONTACT pERSON DON KIBLIN p1161s 910-604-8424
EIISTING CONSTRUCTION: - Alteratron I Renovatroo -:i General Repars
NIW CONSlRUCIlOili : Erect New Residence ,- Addition to Exisline Residence *-l Relocatron
I"PLEASE CHECX AND AI{sWER EELOW AL[ THAT APPLY TO YOUR PiO-'ECT"I
2 Art Garage {5f)1!:-- : DetGarage{St)- : Porch(sF)18
I )Unroom l)lJ : Pool (SF)_:: Storage shed {5$)-
: other {sFi
, ELECTRICAL, INSULATION. ORYWALL. PAINTING
C Greenhouse (SF)_-. Deck (5F)168
ls the proposrd \rork .hinging the exiltrng iootprlnl? : Yes I : No
TOTAL SQ FT UNDER nOOF Uat p@t oted watk)3.21p31 2206 Unheated:1627
TOTAL PRO,ECT COST iIe's toI]960.000
lstheprogosedworkchlnSingthenumberotbedrooms? 0 Yet E No
ls any Eledriaal, Plumbln8 or Mechanital work berng done to the Ac.essory Stru.lure O Yer E No
ll the protecl i5 r Relo.atlon, is there a Nat!,ral Gas Line on the (urrent srte? E Yes E ,tg
lslhere Electrical Power on this gu ilding? E Y€s El tlo
Property Use,/ occupan.y: E singh ramily 3 Duplexn Townho.rse
Descriptlod ot work:FIRE DAMAGE RESTORATION. REPLACE HVAC
REPLACE DAMAGED FRAMING. CABINlERY. AND FLOORING
Owner/Contraato r. DONALD KIBLIN Signature
"Licetlted Quoliliet' Ptiht Nohe
Ir the properly located in ! floodplrin? n Yes G No
I.rirting lmperviolj' Atear
-
Sq Ft
New tmperviour Ar.ar
-
5q Ft Exlsting Land Distl]rbint Perrnit: E Yer O fto
WATER: € CFPUA D commun,ty system n Privale well E cent'alwell D Aqua
SEWIR: G ctPUA E Communitv System E privat€ septr. E central Septic E Aq!3
Zone: *- Officer:
-
Setba.kr {r}
-
{tH)
-
(iH}
-
{8}
-Approval: -- CitY:
-
Date:
--
Flood: {Al
-
P)
-
(N)
-
BfE+2ft=
-
TotalA.res Dirturbed
Comment -Permit Fee: 5
4p9js55. 3232-1 KITTY HAWK RD ctry WILMINGTON sTr p zle: ?8405_
RECEIVE? tiii .! ;'.3S
ffi,
NEI^J HANOVER COUNTY BUILDING PERMIT
APPLI:AII0N IyPf I RESIDENTIAL
PLTASE ANSI,I€R ALL qJESTIONS APPI,ICASLE TO YOUR PRO]ECT
"Project Responsibility"
r^<u^, <r^"r--!(.,"^',.|i c oarc: ,/O-2O -ti-
PHONE fl: ?/o /2' -3/-F
z**€?/3-7/<
PHoNE fi >>>-JJJsrrAl(ZtP:2
9rl ACCOUNT [:*,$< r.'-ri@6 1e
eLrlKA
tbabe"
APPLICATION
Number
(0ffi( e Use)
APPLICANT'S NA,''1E :
DEVEI.OPER:
PRO]ECT ADD
CONTRACTOR:
ADDRESS:
F-'-<./-E
tlf ClrY | 2
SUBDIVIS ION:
RESS:
E
ST
BLOCK f:
7fi
LOT f:
PROPERTY OWNER ' S
OWNER'S ADDRESS:
€*'.<r Ha.^e I
o
g l.\
cITY: t^J
LICENS E T:
CITY: LT
c-. €^
()
()
EHATL ADORESS:
SUNROOM
GRE E NHOUSE
6 . a or4,7 PHONE fi:
PRO]ECT CONTACT PERSON:
EXISTING CONSTRUCTION :ALTERATION RENOVATION GENERAL RE PAIRS RE LOCAT ION
-\o,*-^/Lo,Ls<)^(z-c L
NE!., coNsrRucrroru: l7l rnecr NEt.t REsTDENcE o" ! noottrol To ExrsrrNG REsTDENcE
,i.PLEAsE CHECK AND ANSWER BELOW ALL THAT APPLY TO YOUR PRO]ECTIp arr canacr 6 /( sF fi eoncl 2 VO sr
OTHER:
DUPLEX TOI,^]NHOUSE
PHONE f:t2\-3 ^.,:OJ
SF
5F
Ilo
Yes Ero
2
DET 6ARA6E
-
SF
P00L _ 5F
DECK SF
STORAGE SHED
SF
roTAr HEATED se w: 2S7t rorAL sQ Fr UNDER RoaF:.?Zz4 ToTAL AREA se Frt 3{oO
ToTAL PROIECT CoSTrressror) : $ /70. OOO S OF STORIEs:7Is Any ELECTRICAL, PLUI'I8ING or IiIECHANICAL Work Being Done to the Accessory 5tr.ucture? [ yes
If the project is a Relocation, is there a Natunal Gas Line on the Current Site? [Is there El.ectrj.cal Power on this Buildingl
PROPERTY UsE / OCCUPANCY, [l SrHCle rlmrrv
Iv.r [l r,ro
DESCRIPTION OF WORK:/)Eds /4 ca-
conractor inbrmstion. "'NOTE: Any
oISCLAIMER: lhereby certily hal all inhrmatron in 0ris applEatoo is cotrecr and allworl willcomply wilh rhe Srere Euruhq Code and al ober applrable Srars and bcat laws
and ordinances 3od requlations. The NliC Developmert Services CenEr willbe nolilied ol Eny changes in he approved plans and specalicarions or change iI conrracror or
lbe irr vblarion olrhe NC Srare Bld I b Fines Up To $500 00"'
OWNE R/CONTRACTOR:SIGNATURE:
(p.r,'r Name)*'I***t****,t,t**l++*+t'|*+**lll++++4++++++++++t**r+iir*+t*++t+*+*r+*****t*it**+,1*+++++++r,i*
I5 THE PROPERTY LOCATED IN A FLOOOPLAIN?YEs E ro
TOTAL ACRES DISTURBED: ,/Z
NEIJ IMPERVIoUS AREA: /72 r EXIST LAND OISTURBIN6 PE RI,IIT:YES lFl ruo
CENTRAL WELL
COMI'IUNITY SYSTEM
wyllslJo/ne
Jun tu,,
EXISTING II.IP ERVIOUs AREA:
ZONE OF FICER
{oo SQ FT
SQ FT
warER: ! creur El coMMUNrrY svsrrm f] PRTVATE ,JELL
sEwERr E[cFpuA ! cerurnau seerrc I PRTVATE sEPrrc
}T} SEPARA'T€ PERI'IITS REQUIRED FON ELECT, i!ECH, PL8G, GAs EQUIP, PRETABS & INSERTS :'t
pAyMENT 6ETH6D: Ecasn f] c"ecx (pAyAsLE ro tHcl !BrLL AccotrNT E ;,rclursn Iorscovrn
t*1**t]tl,l**,t*+*+,1*t,l*+t*rtx*,1'ii****.')tti*****li*,1+*ii++,i**i**i(lt(+++,t*r***+**ilt*+tl*,**ir**.
(fo8 ofFICt usE oalLY) Rtvlt'o 0AT' 04l11/r2
SETBACKS: F:- LH:- RH:- B:-
Approval :- CitY:- DATE :- FLOOD
N
Comment:
/cul€L
Q<-, Cc e\)h
PERMIT FEE: $
BFE+ 2ft= _
.1 "-,i.:
',&='
NEW HANOVER COUNTY BUILDING O'*',P rb - rl83(-*#t#
Application
Number
(offi.e use)
A PP Ll CATI ON fypE: REStDENTIAT
PLEASE ANSWER ALI QUESTIONS APPLICABLE TO YOUR PROJ€CT
"Project Responsibilit/,
AppucANT,s NAME. Ashley Hague oate. 11.04.16
PROJECT AODRESS: 125 Hollis Lane CtTy. Wlmington zrP. 28409
SUBDIVISION: Masonboro Township
pROpERTY OWNER,S NAME. Nick Nixon PHONE #. 843.457.1974
OWNER,S ADoRESS. 1'11 Brookhaven Trt 66y. Leland zIP.28451
conrmcrof,lJB <-
ADDRESS:Prn o lcl,v *-,, Tfll l-CITY C
BI"DG LICENSE #:
sT:N(- ztpEMAII. ADDRESS;
Property Use/
Description of
PHONE
pRoJEcr coNTAcr ,r^ron. leley++agl* Nl ida dix,-
EXlSTlt{G CONSTRUCTTON: E Alteration D Renovation E General Repairs
NEW CONSTRUCTTON: D Erect New Residence i Addition to ExistinS Residence D Rerocation
** T.PLEASE CHECK AND ANSW€R Et ow AtL THAT APPTY TO YOuR PROIECT**.
n Att Gara8e (SF) _
i Sunroom (SF)_
D Greenhouse (SF) _
D Det Garage (sF)2304
pHoNE. oTo.T6isos$ fu 3' rr r -/Fr
tr Pool (5F)
D Deck (sF)
E Porch (SF)
n Storage Shed {Sr)_
n other (sF)
ls the proposed work changing the existing footprint? X yes I No
TOfAt SQ FT UNDERROAF lfor proposed workl Heate6:1152 unheated. 1 152
TOTAL PRO.|ECI COST (Less Lot):,000
ls the proposed work changing the number of bedrooms? 0yesE o
ls any Electrical, Plumbing or Mechanicar work being done to the Accessory structure E yes ll Nolftheprojectisa Relocation, istherea Naturar Gas Line on the current site? c yes E wo
ls there Electrical Power on this Building? E yes E No
Ocrupancy; E Sintle Fam
Work. Detached 2 car ga
ily D Duplex D Townhouse
ra ge witlfi fvnrgF€Bace€beve
DISCIAIMER: I hereby certify that all the info
la*s and ordinances and regulations. The Nrl
information. '..NOTE: Any worl performed
all other applicable State and local
ifications or change in contractor
Owner/Contractor,*@IJg
without the appropriate permlts will be in violatioh of the Nc state gldSCode and subject to finer Bg*"'
o1"rF l,),.b^@-
Signature:
"Licensed Quolifier'
New lmpervious Area: I 152 Sq Ft Existing Land Distuting Permit: fl Yes E tgo
WATER: E CFPUA D Community System E private we EI Central Well E Aqua
S€WER: E CFPUA El Community System E private Septic n Centralseptic E Aqua
Zone: _ Officer: _ Setbacks (F) _ (LH) _ (RH) _ (B) _
Approval: _ City: _ Date: _ Flood: (A)
--
(Vl _ {N) _ BFE+2ft= _
rmation in this application is cofiect and allwo.kwill comp,y with the State Building Codeand
C Oevelopment Setuices Centerwtll be notified ofany chaflges in the approved plans and spec
Comment:Permit Fee: $
I,a t7 -
toT #:
lsthe property located in a floodplain? EI yes Cl No
Existing lmpervious Area: 0 Sq Ft fotal Acres Disturbed:
/ :. , ,:.itri
u,,ffi;
NEW HANOVER COUNTY BUITDING PERMIT
AP PLICATIO N rYPE: RESIDENTIAt
PIEA5E ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT
"Project Responsibility"
)01\r- lDqlu
t.6ra3Q"O
Application
Number
(offi.e use)
AppUCANT,S NAME. Ashley Hague p"1". 10.05.'16
pRolEcT ADDRESS: 1729 Country Club Rd 6gry. Wilminglon ztP.28403
SUBDtvtstOfl: Country Club Terrace LOT #:20
pRopERTy owNER,5 1141y6. Mark & Kelly Tinsley
owNER,s ADDRESS. 1729 Country Club Rd
PHONE #l
611y. Wilmington ztP: NC
CoNTRACTOR. TBD
AoDRESS: 11
EMAIL ADDRESS:
/.BIDG UCENSE f: 7? ?7o
ctfl: Lt/.-/*: l,LztP
PHONE: QN JZA-!6A-
EXISTING CONSTRUCTION: I Alteration f] Renovation I General Repairs
NEW CONSTRUCTION: E Erect New Residence n Addition to Existing Residence I Relocation
***PLEASE CHECK AND ANSWER BEI-OW Att THAT APPLY TO YOUR PROJECT'*T'
Property Use/ Occupancy:Single Family E Duplex E Townhouse
Description of work. Conslrucl a single family residence
laws and ordinances and regulattons. The NHC Oevelopment SeNices Cente. will be notified of any changes in the approved plans and spe€lficatioo! or chanSe in contractor
information. +*iNOTEr Any work performed withour the approp.iate pe.mits will be in violation of the NC State Eldg Code and subject to fioes up to S500.0O'*'
olrrner/contractor. Ashley Hague iS""t,. Th/,n Signature:
"Licensed Quolf,et" Print Nome
ls the property located in a floodplain? E Yes E No
Existint lmpervious Area:
-
Sq Ft Total Acres Disturbed: '
Nerr lmpervious Area:
-
sq Ft Existing land Disturbing Permh: f] Yes [3 No
wAl€R: E CFPUA B community svstem E Privatewell E cenlralwell E Aqua
SEWER: E CFPUA D Community System E Private Septic E Centralseptic Cl Aqua
zone:
-
officer:
-
setback (Fl
-
(tH)
-
(RH)
-
(B)
-Approval:
-
Crty:
-_
Oate:- Flood: (A)
-
(V)
-
(Nl
-
BFE+2ft=
-
$ztlzt -
Comment:Permit Fee: S
pRoJEcT coNTAcT pERsoN. Ashley Hague pHoNE. 910.763.6053
n Att Garage (sF) _ n oet Garage (5F) ! Porch (sF)-
sunroom {sF) _ n Pool {sF)- fl Stolage shed (sF)-
I Greenhouse (SF)
-
E Deck (sF) 707 n other (sF)
ls the proposed work changing the existing footprint? yes G wo
ToTAt sQ FT uNDE RRooF (for proposed work) Heated:3'975 unheated' 1505
TOrAt PROTECT COST (Less tot;: 9900,000
ls the proposed work changing the number of bedrooms? EI Yes E No
lsanyElectrical,PlumbingorMechanicalworkbeingdonetotheAccessorystructurenYesBNo
lftheproiectisa Relocation, istherea Natural Gas Line on the current site? t] Yes El No
ls there Electrical Poweronthis Building? E Yes E No
20lL-ttBl')
NEId HANOVER COUNTY BUILDING PERMIT
AP P L IC AT ION ?YP€ : COlttlitERCIAL
PLEAsE AX5IiIER ALL QUEsTIONS APPLICASLE IO Y(I.JR PRO]ECT
"ProJe(t Responsibili.ty''
lu-315?
ffi APPLICATION
ll!mber
(0+fice u!.)
APPLICANT'S AflE: OATE /t
DEVELoPER: J'n: :.i-,Lrrn,j Li ,j
CITY: iii ii:r3E..r'ZIP i ). : .PRoIECT ADDIESS: .:) ; ,,.:t. i,.: .:......, ::r-::c .rl
OCCUPANI/EUSIT,ITSS NAJ'!E :
PROPERTY O TER'S NAI4E:
0M{ER'5 AoDRESS: r rr'i ,l
CO{TRACTOR : t:'(.!!..i1)! Errlcrnq ;o:po r:i. r o
AOORESS: .l8 ir r !.ir.:irr.:-i: i;.-'su!te;lilll
LICEftSE *: ic! e.
El,lAIl ADORESS:, - :.i::.::i:ir.Ii
pROIECT CoNTACT PERSfi: ir.a1d i. i-rsE
{(h..k All lr.t ArDly)
RE}'OVATION
NEtJ CoNSTRUCTtrOI,l:ERECT NEH STRUCTURE FAST IRACK
ACCESSORY STNUCTURE:
PHONE s: tl:-r!'r-.:, :'
PHONE #: -ll. - t'-. ):,.
EXIST COi|STRUCTTON: f] ALTERATToN
lf RMoo. is there a Natural Gas Line on the Cl,rrenl Srte?il l-l errrnrr nEplrns I-l RELocArroN.I-Eruo rs si Dc spd xrenpe, f]ves fiuo
SHELL uerrr I AoD ro Exrsr srRUcruRE
If UPFIT The Shell Permit f: at--:r,il Is Efect Polrer on this Euilding Eruo
ENGR D€SIGN PROFESSIOIIAL: lt:ll I r,ai:,,:F:;PH: al:lklg!!_ Nc Rr6 {
DESCR]PTION OI lnORK
ts food or b€\,ssgBs trBp€rEd d q'r.d in tlis smrcarEZ I vu" [ ruo b Tho Property Locded fa fU ffooa6rf I ves I lto
DISCLAIMER: rher€Sy ced{y r-at ;x ,nlormatlon rn lh's applEarion's co,re(l.nd 3[ w(tl dllcomCy wlh lhe
a.d locat laE ,nd ordlnancei lnd reoJ8ions. The NHC Ocvcloo.nent Ssrvrces C€orer wdlb€ notjfied or anv
o. dtaooe h @.rr'.rc!o. or corlrado, ritormabor "'NOTE Aay Wol( Pc',ormeo W,O lho
^rp{oprratc
Permits
s!bJ€crio Fmc. up To S50n.00"'
cheMes,n lhe aoor6,€d olans andsrrb-e,. v,ora(r'aqliha IIC Srare
Slate Aui dr.g Codo and allolher iopli.;ble Stale
OWNERYCONTRACTOR 3, an lo. L,rsk SIGNATURE:
(qE ir) (Pirn !ar)
ibb: Domo[lon rtilic.lbB t 36!€eG .tro'rEl FrmX appltauo.ls .c io b. 6!&rlE lEln{ dl€ stpli.don tom (OHHS-376E)tsdlry or hJdrE *d tlund !o
dlbill AstEb d io! Ya r! lE$!!d b cdl dE tlriril EnBe sr6 ..* 6r F&,lb'.r. An Po{r.tb.G $EstlAP) at (919P07-5S50 d L€6l 10 daF Fior b th.
d€rm{1b. dry A.rry o. tofl(le. sa A6!6b6 rrcb Sn6: }rrltu rrt.d"r!e!..rc.rd.pabb!st!6/dlnp.hl' l
TOTAL PRO,TECT COST: ..:BUILDING HEIGHT: :i. :# OF UNTTS: rr' 'f OF STORIES
TOTAL SQ FT UNDER ROOFI
-
# oF STRUCTURES # OF FLOORS
ACRES DISTUR BED: I., i Exsr LANo DrsruRBruc eraurr Ives f, lo
NEW IMPERVIOUS AREA: i,SO FT EXISTING IMPERVIOUS AREA:SA FI
pFlopERfi usE florrrcr f]nrsreumtrr f]usncarnr-e n rouc [lrr f]coNoo orHER:
WAIER: EICFPUA
SEWER: EI CFPUA
pAyMENT MEfttoo: flCnSn fiCxecx PAYABLE TO NHc) filUen1gA|\| aonesS I uCnrtsl otsCOvrn
coMMUNfrY SYSTEM E WELL DZONING USE CIASSIFICATION:
---
GENTMI SEPnC E PRIVATE SEMC f]COMMUNTTY SYSTEM
CITY : ji.jl==l:,_ SI: li ZlP : ?:j
CITY| r,r r r$rni::,r 5I: ra ZIP: l84.il
/<-:
P|o{E S: iI!-?!: - r :J
PHO',IE #i '
*:*. rs rgrs a cHAllGr oF occlJpAN(y use l flves E * r,*'
IF Yes, rrlat ua5 the Previols oc(upan(y Typel _ uhat is the {ew o((upancy rype?
-
ARCH DESIGiI PROF€SSIO|IAL: !1.1:i irii.: -.j(:'.. Pli: ll': -;- :r-r- N( REG t: ri:-
TOTAL AREA Se FT : ' , ..:)t:. Se FT PER FLR: --
ZONE:
PERMIT FEE; $_-__.-
r\2dL-llgt?
lu-:15?
APPLICATION
Number
(office Use)
NE[^I HANOVER COUNTY BUILDING PERMIT
APPLICATION TyPE.' COMMERCIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE IO YOUR PRO]ECT
"Project Responsj.bility"
DEVELOPER: one li -1,-m, -
CITY: ilitmi:1qron
PHONE #:910 r92 12:11
ZlPi284a3
PHONE #: 910-395-5035
PHONE #:910-395-5036
PROIECT ADDRESS: 3806 pea.hrree A.,,e.sulre 210
OCCUPANT/BUSINESS NAME:
PROPERTY OI^,NER,S NAME: .Ic:]CS I{iI]i3n1:j LIC
ot{NER'S ADDRESS: 1414 S. 39th streer
ADDRESS: 380? Peachtree Ave., Suite 200
EIIAIL ADDRESS: bLisk0mckinl e bu 1I din
pROIECT CONTACT PERSON: tsra.do. Llsk
CITY: !,li lmington
PHONE #: 910-192-i231
ST: NC ZIP:28403
LICENSE #: :10896
CITY:',,ii1mlnqton
(check AII That Appty)
EXIST CONSTRUCTION:
PRIN
RE LOCATION
xLeneor flves !Nolf Relocation, is there a Natural
NEW CONSTRUCTTON: ! eneCr NEr{ STRUCTURE ! rasr rnlCX ! SXer-r-uerrr ! aDD To Exrsr srRUcruRE
ACCESSORY STRUCTURE:
ALTERATToN fl nrrovarroru [-l ceruenar neparns
Gas Line on the Curent Srre? LlYes LlNo ISBLDGS
If UPFIT - The shell Permit #: 08-s061
fF Yes, what was the Previous Occupancy Typ€?
r!**** rs rHJs A CHANGE oF occupANcy user fivrs I NO *r.***
Is Elect Power on this Building Yes Ero
what is the Neu Occupancy Type?
ARCH DESIGN PROFESSIOTIAL: % PH
ENGR DESIGN PRoFESSIONAL: CBiIE Engineers PH
9lA-T62-2621 NC REG #: 6431
:910-791-4000 NC REG #: 023311
DESCRIPTION OF I,ORK: J.:iI ';ortion of 2nd Floor that is currently in a "She1f" condition
I
ls food or bovorages prepar€d o. sorvod in lfils strrlrre? [ Yes I No ls Th6 Prop€rty Located ln The Floodflaln? ! Yes I No
DISCLAIMER: I hereby certfy lhar all rnrormation in lhis applicalion is correct and all work willcomdy with the Sta
an.t local taws an.j ordlnances and reoulalions. The NHC Develoomenl Services Cenler will be nolified ol anv cha
or cranoe n cont,aclor or conn aclor r"nformalion. "'NOTF: Any Wort Perfor med WO the Appropnale Permits w ll
Subied lo F nes Up To $500.00"'
noes
b;e in
olans and'NC State
le Building Code and allother applicable Slatenlhea
the Code andV
SIGNATURE:
SQFT D(STING IMPERVIOUS AREA:
OWNER/CONTRACTOR : Brandon Lisk
(at€fib.) {Pnit tlam)
Nota: Demolilion notificaihats & asb6toc Isnoval p6mlt appllcadons ar6 to b6 subml!6d rrslne th6 applicatjon form (OHHS376a)tudllty or bulldhg was found to
contain Asbesb6 or nol You are Gquircd to callthe Naiioml Embslon Sbndads ior Hazedous Air PollutsnE (NESHAP) at (919)m7-59m 3t bast 10 day6 Flor b tho
donblitho of arry fadllty or building. S€e Asb€stos Wob Slte: httsJA,rfi,.opl.sbb.nc.tdepyasb€6tos/ahmp.ht nl
TOTAL PROJECT COST: 1ro, oil0 BUILDING HEIGHT: N,/I # OF UNITS: lr, A
TOTAL AREA SQ FT :.':f[- SO FT PER FLR # OF STORIES:
TOTAL SQ FT UNDER ROOF:
-
# OF STRIJCTURES: ]# OF FLOORS
EXST LAND DISTURBING PERMIT?I ves l-l ruoN/A
NEW IMPERVIOUS AREA: N/A
pRoPERTY uSE: florrrce Enesrnunru'n lueRcet{rtle fleouc Eapr ECONDO OTHER:
WATER: ECFPUA
SBit/ER: @ICFPUA
ACRES DISTURBED
PAYVENT METHOD:
N /.A,SQ FT
T-1COMMUNITY SYSTEM - WELL IZONING UsE ctAsslFlCATloN:
-
ficeurnel seertc flP-RlvATE sEPnc E coMMUNlrY sYsrEM
flcesn flcxecK (PAYABIE To Nxcl flxrlenrcelr EXPRESs I uovtse E otscoven
SEPARATE PERMITS REQUIRED FOR ELECT. MECH, PLBG. GAS EQUIP, PREFABS S INSERTS "'
N
(FOR OFFICE USE ONLY)REMSED DATE {11/I2
ZONE: OFFICER:SETBACKS: F:-LH: RH:- B:
Approval:- CitY:- DATE:- FLOOD:
---
BFE+m=-
Comment PERMIT FEE:q/o,('(,
APPLICANT,S NAME: McK-nlev Buildins Corporation DAI E | _JlJ2!1]j_
CONTRACTOR: McKi nlev Buildins Corporation
ST: r.t ZIP: :3.ra:
)\
NEt^, HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: RESIDENTIAL
PLEASE ANSIIER ALI- QIJISTIONS APPLICABLE TO YOUR PRO]ECT
"Project Responsibility"
/.atu- ll$,5C
l@
APPLICATION
Number
(office use)
APPLICANT' S NA'4E :
DEVELOPER:
CONTRACTOR:
ADDRESS:
PRO]ECT ADDREsS;
SUBDIVISION:
PROPERTY OWNER'S t.IAIilE :
Z/ ? crrY:
BLOCK *:
ST:
RAGE SHED
-
SF
SF
DATE :-Jo6
PHONE #i
ZIP I
LOT *: /3
PHO',IE #:65tr'O.//3?/tsrrQne, H//4
,&up, /fu15
s/2 630 747
e
6r.
CITY:
LICE
CITY:
C<NSE f:
! orr eanacr sr ! eon
fl poor
-
sr ! sro
PHONE $:
PHONE f:q//5//55?2EMAIL ADDRESS:
PRO]ECT CONTACT PERSON:
Exrsrr,rc coNsrRucrroNr ! arrtnarrotl ! ntrcvrrroN ! errrnlr Rrearns RELOCATION
NEw CONSTRUCTTOT: [t rnecr NEu RESTDENCE o" f] eOOrrrolr ro ExrsrrNc RESTDENCE
|*PLEASE CHECI( AND ANSHER BELO!'J ALL THAT APPLY T0 YOUR PROIECT
cH 3P sFSFATT GARAGE
suN Roorvl SF
! enreruousr
-
sr I orcx i sa)SF OTHER:
TOTAL HEATED 5Q FT:?197 rorAt sQ FT uNDER aoorr gtTl/ rorAL AREA sQ rr' SSd
TOTAL PROIECT COST 1re* r.r1 : $S20.rs0c # OF STORIES: L
willbe in Violalon o,lhe NC Slac
SIGNATURE:
Is Any ELECTRICAL, pLut{BIN6 or }.IESHANI6AL ttork Being Done to the Accessory Structure? [ V"t I Ho
If the pnoject is a Relocation, is there a Natural Gas Line on the Current Site? [V"s I Ho
rs there Electrical Power on this Building?!v"t l-l'1 ruo
pRopERTy usE / occuPANcYr E srlerr ramrlv f] oullrx f] ToIJNHOUSE
pplicable SlaE and bcal laws
or change in conltacloror
Fines Llp To 1500 00"
DISCLAIMER lhereby cerlit thal all inlormaljon h 0'is applicaton is conecl and all wori willcomplywih he Slate Burldng Code and all oher a
and odinances and regulalions The NHC Dev€bpment S€ruhes C€nEr willbe no!fied olany cnanges n tle aPpro!€d plans and sPecifc€tions
SLr bcont6cror inbrmaton "'NOTE:Any Work Perlomed W
O[^INER/CONTRAcTOR:
* i*,i * * ** l,r,r * * *,i,i *,i * * * + * r* * * a *, t I * * + t + * + r'
FLOODPLAIN? EI YES I UO
** * * **,f *** * *,r ** *,* ** 'i 'f****,***,Irt * * * *** * * +it ** * * ,i,t
I5 THE PROPERTY LOCATED IN A
EXISTI]'IG II4PERVIOTS AREA:
-SQ
FT
NEt^t II4PERVIOUS AREA:
-SQ
FT
TOTAL ACRES DISTURBED:
EXIST LAND DISTURBING PERMIT: E YES
NArER: El creun f]COI',IMUNITY SYSTE14 PRIVATE WEL L CENTRAL I^JE L L
NO
BFE+2ft=
-
sEwER: K creua ! cENTRAL sEPTrc I enrvarr sEPTrc D cotlMuNrrY sYsrEM
*** STPATRATE PERI4ITS REQUIRED FOR ELECT, hECH, PL8G, GAs EQUIP, PREFAB5 8 INSIR]S *"
oo1,rr* ,rrr,oo, E aorr, E arraK (PAYABLE ro tulc; I mrarcat{ ExPREss E nc/'rsl ! orscovr*
** * *,| * r * * +* ** *,*,t,t** * * * +,r,t ,l ** *** ** ** * *,*,*** * * ***,t* * * ** * ** i( i(** **,* ** + * '* *'I *'t * * * **** * * * * * ** * **
(TOR OFTICE UsE ONLY) RFVISEO, DATE 94111/12
SETBACKS: F:- LH:- RH:- B:-ZONE ;OFFICER:
approval:- CitY:- DATE:- FLOOD:
-
A
comment l
NilC air"U i
l
\CL.Q(
PERMIT FEE:t\?
,'
&
OWNER,S ADDRESS:
lso ,0lb'ttloY
APPLICATIOI{
unber
(offlce Ur.)
o tE,lZb/tL
z,lil --fu4-/1.?/
NEI{ HAM)VER COI'NTY BUILDIT{G PERI'IIT
aPPLIcarIOtt TYPE; C0{iIERCIAL
PLEASE A}ISXER ALL QUESTIOXS APPLICAALE TO YO{JR PROJECT
"ProJect Re3ponslbility"
<=?APr /4rrtE
DEVEL@ER: 4 {tt r*,A*2e, A1ES
APPLICAT{T, S ttAI,IE :
rD*Lco rRAcroR: AZft*r)A a, fi&anuE\ tt/<-'{:'iuoness, zv*t Dern es ftcc-t A
PRO]ECT AIDRESSI /i,/Z I /)/a De-
OCCUPAI'|T/BI SII{ESS t{^ttE: ADnAN(n -A o-r <)
O,flER'S ADDRESS:
PHol{E S
CIW: tituq,a,t artt,r/ . tVX zLP.'L?-fio3-
Prg{E f : ?a -6rts -/r',//
CIW | "tt dh //e d 7'o,r'sf : ^,L ztP I Z?.+4r5
ctrtt AfiA pfk 5T:ztP: 3d31935s-. EIAIL ADORESS: b
PROIECT COITITACT PERSOT:
rl. co P}l(' E *:
PTIONE *:
EXrSr Cq{STRUCEOi: ffiUremrrOr
tf Rslocatlon. is there a Na{ural Gas Line on the
N/lJ€N
(ch€ck All Ihat Apply)
REI{oVATIOI{tr CENERAL REPAIRS RELOCATIO
.to+-372- L 3
D vesftoCurGnt Site?Yes No lS BLOG SPRINKLERED?
NEH COT{STRUCTIOI|:ERECT STRUCTURE
ACCESSORY STRUCTURE:
If UPFIT - The shell Permit *:
IF Yes, *rat Es the Prarloug Occupancy T!,pe I
Irasr rmcr f] snsr-r- ! uerrrproo ro Exrsr srRucruRE
Is Elect Porer on thls Building
.t..* rs rHrs A cHllrcE of occupAl{cy r,rst I lvrs lro'....
I ves pro
A,h- raz
,6/4-/3t'o/06. *re o, btzi:1o -lQl -*7o7Nc RE6 *: 03+35 +
t*rat is th€ Ner occupancy Typ€?
ARCH DESIGN PROFESSIO{AL:
ETIGR DESIGN PK'FESSIOTAL :
{-?rI tll i+,D/0,
PH
StstB Building Code and all oth€r ap'plicaus State
and
OWNER/CONTRACTOR:(o.llr)6 SIGNATURE:
Ndar Oa.noldoo noliticr0a.ra t arb-ba .rnovd parmil lplilcado.a rr' b ba aub.n[bd urirB tha appllardoi tbdn hlldit r- hnn b
contlrr Arbffi d lEt Yoo a6 rqoirtd b call lla iLddral E nl.foo Sladaada b, tLzidqa A. Po{um Et (918)"5850 st 16l i0 rrsy. Fi(r b tro
d..mlitbn of dty
'ldtty
ltaD $: htol r.yir.6C..l&.nclrLd/.!5ab./Crig.ltrl
oa BUTLDTNGHETGHT, lb'-Gn roFUNrrs: tTOTAL PROJECT
SOFTPER FLR: '/,5O5
z,{a5 f oF STRUCTURES:f OF FLOORS:
ACRES OISTURBED:Exsr LANo Drsrunanc eenurn f] ves fil No
NEW IMPERVIOUS AREA 2D 529 s SA FT EXISING IMPERVIOUS AREq: 22 '7 SQ FT
E)
DEscRrprror{ oF r{oRK: *eotttoil AuD AtJ@tnn 7, [./Gr/r/6 Bo/t-t>r,/6.
h fEod or botrssg65 F€ps€d arw€d h uri rtruanr flvesftNo b lho Propo.ty Loc#d ln The Floodflah? [ vesplro
DlSCtAltlER: I trqeby cartly lh€t all rnto,rm8tion in this sIrp ic€tbn i6 corr€ct and 8ll wort will comdy wrtr tho
ard local l8rs and ordinancos and reodalions. Th€ NHC Doveloomorfl Sewic* C€nba wlll b€ nodfi€d ol anv
or d|ango in coolracbr or cont'aclor iitonnotion. '_NOTE: Any Wo* Peabrmod w/O h€ Approprial€ Pcrmib
SuDi€cfio Fin€3 Up To t5O0.00-'
soecificationsBldg Cod6 and
Y TOTAL AFIEA SO FT :
TOTAL SQ FT UNDER I I
pRopERryrrsE: EoFFEE nnesrrunerrflr.rERcANnLE [eouc lerr EcoHoo oTHER-
WATER:YICFPIJA T-]@IIIMUNfiS\6TEil NWEU. f]ZONIT{GI,,ISEqT]SSIFICANOTT
sewen: ffitreua fi cenrnru- seenc D iffi/ArE sEpflc g-comuuxrwswren
-. SEPAFiAIE PERMITS REOUIRED FOR ELECT MECH. PLEG GAS EOUIP PREFAES E INSERTS ".
PAyMENTMETHO0: ICASX [CreO<{erVlaUrOXXCl [HlenrcANE(PRESS [r'lCwSa EOTSCOTCn
))"
(FOR OFFICE USE ONLY)REVISEO DATE 4/1lfl2 .t .lZONE:_OFFICER:_SETBACKS: F:-LH:RH:B:
Apgovsl:_Clty: DATE:-FLOOD:BFE+2ft='001,6,
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PERMII FEE:
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pRoPERw ff{ER,s wt: 4/2/ f tEAtvPtP . i4C
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