JANUARY 22 2018 BUILD APPS2oru-Q$ll-NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TY PEi RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROIECT
"Proiect Responslbility''
CITY:
Number
(office use)
APPLICANT,S NAME:Date l-22- lP,"-Aii.9-PROJECT ADDRESS:
SUBDIVISION:oT#
PROPERTY OWNER,S NAME:PHONE #
zlP
BL LICENSE
ztP "YltuPHON E 252-LzL - ?a97
PHONE:zra-Lzz- 1c?9
OWNER,S ADDRESS:Pa br 5//CITY
CONTRACTOR
ADDRESS:fu xo -'t Ett
EMAIL AODRESS:
CITY
PROIECT CONTACT PERSON
EXISTING CONSTRUCTION; E Alteration ! Renovation D General Repairs
/NEw CONSTRUCTION: E/Erect New Residence D Additionto Existing Residence D Relocation
*'}'TPTEASE CHECK AND ANSWER BELOW AI.I. THAT APPLY TO YOUR PROJECT**'}
BZDet Garage (sF)
-
D Att Garage (SF)-
n Sunroom (SF)
Owner/Contractor:
"Licensed QuoIilier"
D Pool (SF)
State Building Code and all other applicable State and local
approved plans and specifications or chanSe in contractor
D Porch (sF)
E Storage Shed (SF)_
D Other {5F)
to 5500.00'*+
"l*"--
Ll breennouse [5r) _! Deck (sF)
ls the proposed work changin8 the existing footprint? fl Yes dNo
Property Use/ O€cupan leF ilv n Duplex E Townh se
Description of Work:
DISCLAIMER: I hereby certify that allthe information in thisapplication is correctand all work will comply with the
lawsand ordinancesand reeulations.The NHC Development Servlces Center will be notified ofanvchanges in the
information. *'"NOTE: Any work performed without the appropriate permits will be in violation of the NC State Bl
Signature:
ts the property located in a floodplain? E/"". tr t'lo 7r"/'a't^''7 nf 2/}tn
Existing lmpervious Area:
-
Sq Ft Total Acres Disturbed:
New lmpervious Area:Sq Ft Existing Land Disturbing Permit: E Yes n No
waTER: U/CFPUA f] community System El Private well E central well E Aqua
SEWER: U/CFPUA D Community system n Private Septic ! central septic ! Aqua
zone:
-
Officer:
-
setbacks (F)
-
(tH)
-
(RH)
-
(B)
-Approval:
-
City:
-
Date:
-
Flood: (A)
-
(v)
-
(N)
-
BFE+2ft=
-
Comment:Permit Fee: S
il ]!:".:.' i 'i,1.
,fih*Hltr
<E''
ToTAL sq FT UNDER RooF lfot proposed wotkl Heatedt I t zft) unheatedt // ,O?
ToTAL PROTECT cosT (Less Lot): S &4 OO
ls the proposed work changing the number of bedrooms? ! Yes B4{o
ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure dYes E No
lf the project is a Relocation, istherea Natural Gas Line on the current site? tl Yes E/No
ls there Electrical Power on this Building? /ves tr Itto
g LlSgre'( -
aol\J
NEW HANOVER COUNTY BUILDING PERMIT
APPLTCAfiON rrPE, RESITENTIAL
pLEAsE Al{sl{ER ar.r- gJEsrrots orptrcod,t ro youR pRolEcr
?roject Responiibility-
APPLICMTT'S M',IE:G-,-- *, ' a..,'+{..
ffi
a/u
DEVELOPER: -.i a-t-L. ( crLis DATE:
PRO]ECT ADORESS:2o
SUBDIVISION:
PROPERTY OO'NER,5 IAIqE :
or{{ER,s ADDIEsS: /2 ql7 uru
CONTRACTOR:Jrt ?"&
AOORESS:
EMIL ADORESS:G,
PROJECT COI{TACT pgx5qy, &nd.g...:K-o-"cll
PTONE I:
BLOCK *: LoT $:
ttcetst *t 6 B// L
PHOI{E *i
5T
-b 76-Btod
zI.P:Z7l,iV
crw:le, q t-
zrPt Z8 4lL*5?-
fitt)<-znZ76i*
*, ?-rr.4z7--6dt;a
crw:
'fr. u
CITY:
EXTsTTNG CO{STRUCTTOII: I ar_re nlrroru ! netwarron I cereul neecns ! ner-ocrrrorl
t{tH coNsrRucrror: ffirnrcr EH RESTOENCE o. ! oorrron ro Exrsrrl{G RESTDEitcE
..PLEASE CHEC( AND AiISIEN BELOW ALL THAT APPLY TO YOI'R PTO]ECTI
flfarr camce 522 sF !
[surunoou
-sF
tr
OET GARAGE (E
PoOL <E
I roncr 323 srfl sroucr SHED _ sF
P}ONE
SF
llo
I I .rflH tg ?:50Pt'l
! cneelxous r _ sr ! oecx _ sr OTHE R:
rorAl HEATED sQ Fr. Zc,tts rorAr sa";Ttfi**r,
TOTAL PROIECT C05T 1r,ess rorl t g / ?X? zfx-t # OF STORIES:
INCY:tr SINGLE TAMILY
b*5 TorAL AREA sQ FT:ze7
rs Any ELECTRTCAL, p,nBr G or ,n'crAflrcal ,,o,.k Belng Done to the Accessory structur.e] [ ves fi Horf the project is a Relocation, is there a r,raturar. 6as Line on the cu*ent srtil trv* EIs there Electrical powen on this Building? [lV"s Ito
EPROPERTY USE / OCCI,,P
DESCRIPTIOI{ OF }'l0R(:
DUPLEXeo€Hru,:Si
OISCLAIMER: lhel.by certit halal lnbmatjon h hls sppticrrion b cor€d.nd allworkwl! complywih he Stat6 Su dhg Coi,e aod alloherspp[cabte Srats and tocal tawsand ordinances and mgulatlons. Th6 NHC De v€topmen t SeNices C€nter wi{ be notli€d ofsny changes io the appoved ptans aM specifications orchange in contracbr orconrracb, inbnnarion. '_!{OTE:Any Work podormBd WO he Apprcpriale Pemltswillbe h Vblarion of th6 NC Sr.b Bldg Codc and Subject b Fin€s Up To i5000f"
Oh,I{ER/CONTRACTOR:
* ** * ++:| * r* * *+++ +* ** ** * ** ** *9i'Il Jit'J * *
IS THE PROPERW LOCATED I1{ A FTOODPI.AIN?
EXISTIIiIG IIiTPERVIOUS AREA SQ FT
SIGI.IATURE :A httr , 4 .1/u*-,ru;fl'--
***t*+* ****:t+* *,1,r ***:rr
Ero
TOTAL ACRES DISTURIED:
*t**** **++ * ** *+ **+* **n YES
NEti'l I PERVIOUS AREAs SQ FT EXrsT LArrtD DTSTURBTNG prnMrt, l-.1
PRTvATE wELL ! celrul well
YES Ero
wrrenr [l creua I cclr4uNrry svsreN I
sEwER: BCFPUA I c$rrul seerrc I pRrvATE sEprrc I cour.rurtw svsre,r
ZoNE: _ 0F FICE R:
(FoR oFFrcE usE ol!y) x.EvrsEo oarE 04/11/12
SETSACKS: F: LH: RH: E.
*i* SIPAIATE PER}IIIS REQUIREO FOR ELECT, T{ECH, PLBG, GAs EqJIP, PRETASS & JNSERTS **
PAYttErr nErtioo: Ecrsx EIcrecK (payaBLE, nol-tr-r.r;;;;;r''-fr'rl^iio'''Eorr.orr.
* * *'t+'|'tt+++ *+'r'*'t**+ lt'l +**+ **** a**,pt*:| * *r*+,1:t*'*,t**r*** + *:r:t **a*** ** ****+** *** **** **tr**** **
Approval:_ City:_ DATE:_ FLOOD: _ _ BFE+2ft=Av[
rpEliil-rrot
l{ulllber
(offic€ U5.)
Pto E s: 9It-7?.e- 8zi3
, .i.
&,,'
APPLICAITT'S I{AtItE:
DEVELOPER:
NEI^J HANOVER COUNTY BUILDING PERMIT
APPLICATIaN rYPg: RESIDENTIAL
PLEASE ANShER ALL QUESTICNS APPLICAEL€ "TO YOUR PRO]ECI
ttc hfiroject
Responslbilit]/'
CITY:
BLOCK
LTCENSE *:
CITY
2ot8-auo
L€.--90
APPLICATIO
umber
(Offi.ce Use)
DATE:
PROJECT ADDR
SUBDIVISION:
PHOIE *:
PHOt'l €
ST
zrp{4,*U1
LOT *: _
:,
PROPERTY Od ER'S t{AIqE:
Gd{ER,S ADDRESS
CO TRACTOR:
ADORESS:
EI.,IATL ADDRESS:
P
PRO]ECT CSITACT PERSO :
EXTSTI G CO{STRUCTION:
I sur'rnoor,t
-sF
f] eneerurousr
-
sF
TOTAL HEATED SQ FT:
TOTAL PROI ECT COST tr-ess roo I $
PROPERry USE / OCCUPAflCY:
PHG{E *
Pl{ot{E #&9|Hr.'.}:Fl;
ffi
ves E rc n\&
ALTERATION RENOVATION GENERAL REPAIRS RE LOCATION
NEW COT.ISTRUCTION:ERECT NEI RESIOENCE oT ! aoorrror ro Extsrn{G REsrDEircE
**PL E CHECK AND ANSI'ER BELON ALL THAT APPLY TO YOUR PRO]ECT:
5F PORCH \bATT GARAGE e4 5F ! oer ennaee SF
I eoor-SF STORAGE SHED 5F
DECK SF OTHE R:SF
TOTAL SQ Fr uNDER noor:1511 TOTAL AREA SQ FT:
# OF STORIES:
Is Any ELECTRICAL, pLUttBINc o. TIECHA ICAL ltlo.k Belng Done to the Accessory structuret f] Yes
If the pnoject is a Relocation, i.s there a Natunal Gas-Line on the Current sitef I
Is there Electrical Po!,er on this Building ? l-] v"t [l no6,LE FAIVIlLY n DUPL EX TOWNHOUSE
OESCRIPTIOfTI OF WOR(:
and ordinancss and regulatlons. The NHC Development S€Nic6s Csn ter will be notlied of any changes in he ap
contackrinft).meton'"NOTE:AnyWorkP6.fom6dW/OheAppropriaGPermitswillbEinV:oleto.oflhoNC
Od{ER/CONTRACTOR:S I G{AI
*+rr****+r.*+r*r.* *** * ** * **** *(I!11lii."J * *
IS THE PROPERTY LOCATED IN A FLOODPLAIN?
** *****+* **** ******r(+,t +
onr or change an conlract'
fi
YES Eno
EXISTING I''IPERVIOUS AREA:SQ FT TOTAL ACRES DISTURBED:
NEIII IMPERVIOUS AREA:
-SQ
FT EXIST LAND DISTURBING PERI'IIT:flves flrio
h,ATER:c PUA col$luNlw SYsTEl"r PRIVATE [']E L L ! ctnrnal wrll
! co'turrw svsremSEhIER:CFeua I cEr'lrRAL seerrc !PRIVATE SEPTIC
r'''.k 5€P;\RATE PERi{iIi lEr)U:33D iDR EL:(ir rlEcir, )Lg€, 6A5 EtUip, PtiFA05 A llisERiS *ri
pAyMENr r{ErHoD: E crs, E cxecK (pAYABLE ro flrrc; [-] rreucAN ExpREss f] ncTrrsl I orscoven
,a,l* {. t,t* ****,**,r*,**;ti. i.,i* **** * **,r *,1.,t *,k1.* * rr* * *,1. **,&r,r *** )i. *'t* * *** * * * * **** *a,t* *+* ***,a * * *,* ** **,rt
n
ZONE:OFFICER:
Citv:Aooroval:DATE:
(FOR OFFICE USE ONLY) REVISED OATE 04/11/72
sETBACKS: F:_ LH:_ RH:_ B:_
FL@D: BFE+2ft=
Ysqo
I mmm
:i
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATI O N W PEi RESI DENTIAL
PLEASE ANSWER ALL QUESTIONS APPI.ICABLE TO YOI]R PRO]F'T
"Project Responsibility''
2o$-Q(!Z1HO7
Application
Number
(office use)
APPTICANT,S NAME: Porch ConVersion Date: 1-12-18
PROJECT ADDRESS: 4208 Crockette Road CITY: Wilminoton, Nc ztp: 28409
SUBDIVISION: PH2 Sec 5 Masonboro Forest
PROPERTY OWNER'S NAME:Rva n&MarV Taro PHoNE *:910-232-97 44
OwNER'S ADDRESS: 4208 Crockette Road CIIY: Wilminoton. Nc ZtP:28409
CONTRACTOR: Porch Conversion BLDG LTCENSE q.76247
ADDRESS: 6821 Market Street CITY: Wilminoton sT: Nc zrP:28405
[] Att Garage (SF)_
EMAIL ADDRESS: oorchconversion qmail.com
PROJECT CONTACT PERSON: Brian WaIsh PHoNE: 910-777-3363
EXISTING CONSTRUCTION: n Alteration t'Renovation D General Repairs
NEW CONSTRUCTION: [] Erect New Residence I Addition to Existing Residence I Relocation
,T*,TPLEASE CHECK AND ANSWER BELOW ATt THAT APPTY TO YOUR PROJECT'"T'}
D Det Garage (5F)n Porch (5F)
/sunroom (sr)492 D Pool (sF)! Storage Shed (SF)_
n Greenhouse {5F)_n Deck (sF)n Other (SF)
ls the proposed work changing the existing footprint? 5 ves /No
TOTAL SQ fT UNDERROOF Vor proposed work)Heated:492 Unheated:
TOTAI- PROJECT COST (Less Lot):5 10 740
ls the proposed work changing the number of bedrooms? tr ves /No
ls any Electrical, Plumbing or Mechanicalwork being done to the Accessory Structure /yes fl No
lf the project is a Relocation, is there a Natural Gas Line on the current site? ! yes Ef No
ls there Electrical Power on this Building? pf Ves g1 lto,Property Use/ Occupancy: fr Single family n Duplex n Townhouse
Description of Work:
DISCIAIMEn: I hereby certify that allthe information in this application ir correct and all work will comply with the Stale guilding Code and all other applirable State and local
laws and ordinances and re8ulations. The NHC Developmenr Service5 Ceoter be notified of any changes in the approved plans and spe.ifications or chan8e in contractor
information. r"NOTEr Any work performed without the approp pe e in violation of the NC State Bldg Code and subject to fines up to 55OO.OO*.*
Owner/Contractor:
"Licensed Quolifier"
t Jerem Martin Signature:
ls the property located in a floodplain? n Yes
Existing lmpe rvious Area: 4550 Sq Ft Total Acres Disturbedi 0
New lmpervious Area: 0 Sq Ft Existing land Disturbint permit: ! yes fl No
WATER; [U -CFPUA n Communlty System n Private Well I Central Well ! Aqua
SEWER: M CFPUA tr CommunitySystem n Privateseptic E CentralSeptic ! Aqua
zone: _ Officer: _ Setbacks (r) _ (LHl _ (RH) _ (B) _
Approval: _ City:_ Date:_ Flood: (A) _ (V)_ (N)_ Bf Er2ft= _Comment: Permit Feei S
/*o
LoT #: 21 5
PHONE: 910-777-3363
I,
NEW }IANOVER COLTNTY
DEPARTMENT OF BUILDING SAFETY
230 GOVERNMEN'T CENTER DRIVE - SUITE i70
WILMINGTON, NORTH CAROLINA 28403
Telephone: 910.798.7308 Fax. 910.798.781 I
lnl erne I : wwy,. nhcgov. com
REGULAR RESIDENTIAL BUILDING APPLICATION
STATEMENT OF UNDERSTANDING
am submitting an application for a residential
building permit to New Hanover County. And, as the applicant or person submitting
the application, I check the boxlboxes below to acknowledge that:
A I did not attach an official CFPUA document that acknowledged approval of
the payment made to CFPUA.
A I did not attach an official proof of a Zoning sign-off from the City of
Wilmington, for this work that will be done in the City of Wilmington.
E I did not attach an official proof of an approval granted by the New Hanover
County Environmental Health Department, for this work that requires an approval
from Environmental Health.
And because I did not attach the official proof of approvals along with my
application for permit; New Hanover County cannot guarantee that the building
permit will be issued within 4 (four) to 7 (seven) working days after the official
submittaldate/time (the stamped date/time notation made by the Building Safety
Department on the application or submittal document)
Signed in acknowledgment:
Agent Jeremy Martin
Sign ure Printed Name
4208 Crockette Road
tl g
Address for the proposed residential work:
Date
q
L$tJS
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION TYPE: RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT
"Project Responsibillv'
2or&hroS
Application
Number
(office use)
APPI.ICANT'S NAME:
PRO.'ECT ADDRESS:
QftcJJ.e A. {+rrr TiT
SUBDIVISION:
PRoPERryoWNER'SNAME: r le+t-JutZ A .trtr
OWNER'S ADDRESS:
SCONTRACTOR
ADDRESS:Ao,ov?
CITY (J(.ztPZjSq(L:
LOT f:
PHONE #:qto-?r{-l ooBq
crrY: {^ALJ\4 IUqA)N-t ztt:?
't-ll/Z.-,
Date
CITY
Bt D6 UCENSE #
ST:ZlPl
EMAIADDRESS: F iti ara*-ri^q<e fA rnari I . corrr PHONE:\.,v g
PROJECT CONTACT PERSON 6G)vg,f'PHONE
EXISTING CONSTRUCTIONT ! Alteration n Renovation ! General Repairs
NEW CONSTRUCTION: f] Erect New Residence E/Addition to Existing Residence f) Relocation
**}PLEASE CHECK AND ANSWER BETOW AtT THAT APPTY TO YOUR PROJECT*TT
n Att Garage (SF)_E Det Garage (SF)_! Porch (SF)
E Sunroom (SF)
\o -1q?'814
l:zJfiH l8 3t8l Pl'1
n Greenhouse (SF)tr Deck (SF)
tr Storage Shed (SF) _
tr Other (SF)
ls the proposed work changing the existing footprint? ! Yes ! No
TOTAT Sq FT UNDER ROOF lfor proposed work) Heated:Unheatedi
TOTAL PROJECT COST (Less Lot): S qK
ls the proposed work changing the number of bedrooms? ! Yes €/No
ls any Electdcal, Plumbing or Mechanical work being done to the Accessory Structu re f] Yes gzifo
lfthe projectisa Relocation, istherea Natural Gas Line on the current site? E Yes !,rqo
ls there Electrical Power on this Building? E4es n No
Prop€rty Use/ Occupancyr q,,6(6gle family E Duplex ! Townhouse
Description of Worki
ADord Ol*JE TB LU]Sg *{\P*{
laws and ordinanaes and regulations. The NHC Development Services Center willbe notified of anychanges in the approved plans and speciflcations or change in contractor
inforhation. +"NOTE: Any work perrormed wlthoutthe appropriate permits willbe in violation ofthe NCState 8ld8 Code and subject to fines up to $500.00.+.
ol,vner/Contractor:Signature:
"Licensed Quolifier" Print Ndfie
ls the property located in a floodplain? n Yes fl No
Existint lmpervious Area: _ Sq Ft TotalAcres Disturbed:
New lmpervious Area: _Sq Ft Existing Land Disturbing Permit: E Yes D No
WATER: \ CFPUA ! Community System E Private Well E Central Well ! Aqua
SEWER: CFPUA tr Communiw System ! Private Septic l Centralseptic D Aqua-1
Zone: _ Officer: _ Setbacks (F) _ (l-H) _ (RH) _ (Bl _
Approval: _ Crty: _ Date: _ Flood: (A) _ (Vl _ (N) _ BFE+2ft= _
Comment:Permit Fee: S
Y\
tr Pool (SF)_
APPUCANTS AME:
PROJECTADDRESS:
NEW HANOVER COUNTY BUILDING PERMIT
AP PUAfl O N TY P E : RESI DEI{T|,AL
PI..EASE ANSWER AI.I qUESTIONS APPUCABI.E TO YOUR PROJECT
'Prolect RsspooslbllM
Co L
L_C-'f-lL (J Date:i-r '^J
sotS"ABa
18-10 9
Appllcetlon
Number
(office use)
t - lc-t{
zt?t '73lWf
suBDtvtsloN:
pRoprRrr orvtEtrs nrrr, Cul*4- t t t
OW ER'S ADDRESS:
CONTRACTOR:tr}A
ADDRESS:
EMAIL ADDRESS:
PROJECT CONTACT PERSO :
tr Sunroom (SF)
-
E Greenhouse (SFl _
tu
LOT[: I I
1t 0 .- 2q1- z5taL2-PHO ES:
CITY: r. I I Llr.r r o'f zre, ZZYOT
BtD6 UCENSE #;1Z c{e4
sr:MCzp
PHOITE:
PHO E:4lo z 1"1 - zqcru
+"-6
n *orage Shed (SF) _
tr Other (SF) _
E(|STll{6 COJ{STRUCnO :tr ltseration E Renovation E General Repairs
SW CON_SrRUCnOI: E/Aec ruew nesidence E Addhion to Existing Resldence t] Relocation
,/ .r.pLEAsE o{Eo( A D attswER BEr.ow Alr rHAT Apply ro youR pRoJEcrr*
E att Garage lsr) I +1. trn
tr Pool(SF)
tr Deck (SF)
ls the proposed work changing the existint footprint? fl yes No
TOTAL SQ FT UNDER nOOF (for prcposed work) Heated;"Ja?-1_..',-........_
TOTAL PROJECT COST (tess Lot):o &A
*{
ls any Electrlcal, Plumblng or Mochanlcal work betng done to the Accessory Structure E yes
lf the project is a Reloratlon, ls there a NaturalGas Liry)dn the cunent site? D yes El4q6
ls there Electrical Power on this Euilding? E Yec pf o
6ls the proposed work changlrE the number of bedrooms? E y.a
"Licensed Quolifref Nome
Prcp€.ty Use/ Occupancy: gdnge family Ll Duptex tr Townhous€Ne,u lpBQof work:
DlsOelilER. I hereby aenlfy that all the loiormation in thls appliotlon b conect and alt wort wtl, comply with the State EuiHing Code end all other applicable SBte and tocallav6 and ordinanc€s and r€gula0ons. The NHC 06reloFrent Serylcea Center wll be nodfied of erry dlanges ln the approvd phns and spedffaadons or dEnte ln coitractorinformation....NOTEl will be ln NC State
TTIV\
Blds @den^J and sut ect to fine! up to
\
ls the property located tn a floodplain? {ro , no
b&tln8 lmp.rylou. Arca, 4 SC Ft Totat A.res Dtsturbsd , , &C J ty
I{ew lmpervlorE Area:+1c 9 Sq Ft Existlng tsnd Dlsturbing Permit:IYerENo
WATER: E CFPUA n Community System fl private We n Centrat We dG-
SEtirER: a CFPUA E Community System fl priyate Septlc a C.ntolS.pti. gfi
zone: _ Ofrc.n _ S€rbacb (F, _ (Utl _ (RH) _ (B) _
Appoyel: _ Ctty: _ Date: _ Ftood: tAl _ (Vf _ (Xl _ BFE+2ft='_
IComment:Permit Fe€:
t
t-
L/r--.(./\--r\
unheated: l4qJ q......!|....rd}--
NEW IIANOVER COT]NTY
DEPARTMENT OF BULDING SAI'ETY
230 GOVERNMENT CENTERDNVE - STJITE I7O
WLMINGTON,NORTH CAROLINA 2MO3
Telephone: 910.798.7308 Fa: 910.798.781 I
Interrre t : www.nhcgov. com
REGUI-AR RESIDENTTAL BUILDING APPLICATION
STATEMENT OF UNDERSTANDING
I,am submitting an appli€tion for a residential
. And, as the applicant or petton submittlng
s below to acknowledge that:building permit to New Hanover Coun$
the app!on, I check the box/boxe
I did not attach an official CFPUA document that acknowledged approval of
the payment made to CFPUA'
{O I dld not attach an official proof of a Zoning sign-offfrom the City ofdI
\Mlnlington, for this work that will be done in the City of \Mlmington'
d I aio not attactr an official proof of an approval granted by the New Hanover
county gnrironmental Health Department, for this work that requires an approval
from Environmental Health.
And because I dld not attach the official proof of approvals along with my
appll"ation folpermit; New Hanover county cannot guarantee that the bulldlng
p"*lt *il1 be Issued withln 4 (four) to 7 (seven) working days after the off,clal
Lubmlttal date/time (the stamped dateftime notation made by the Building Safety
tlepartnent on the appllcation or submittal document)
Signed ln acknovledgmont:
Signature Prinbd Name Date
r,7ld a tffln
LILAddress for the proposed residential work:
NEW HANOVER COUNTY BUILDING PERMIT
APPLI CATION TYP6., RESIDENTIAL
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT
"Proiect ResponsibilitY'
Application
Number
(office ure)
APPLICANT,S NAME:
PRO.IECT ADDRESS:/ l/2 Canopu b)a-a
rdo-*-LL(*Oate: / -/b l6
CITY: LU aP: ZB+oq
SUBDIVISION:-TL- "n I o ).>a.[q-J toT #3f
PROPERTY OWNER'S NAME:O-,r^*-' c-c.+ +x,rs .,t J'l-L LLC
owNER's ADDRESsT lZ9(1 Drr* a '-l- e&
CONTRACTOR ).knRqctr-
ADDRESS: (Z't[1 D.^v-A-.v.*-
EMA|L ADDRE5S; J2oP K- Cl,A*-tr' c,--tn kowo f*-i(L, e or.n-
A^J.e.: 2o--.i..
PHoNEs: 1t q-61G_gtoc)
CITY IZot,ztP: Z7L I Y
BLDG LlcENsE f: 6 8, /t,
CITY:Sf: z\)C-ztP: zlc I
PHONE ?tt -422-L qEo
PHONE:1t1 -1qi- bz | 3PROJECT CONTACT PERSON:
EXISTING CONSTRUCTION: E Alteration E Renovation ! General Repairs
NEW CONSTRUCTION: EL Erect New Residence E Additionto Existing Residence E Relocation
''IPLEASE CHECK AND ANSWER BELOW ATT THAT APPI.Y TO YOUR PROJECT***
m Att Garage (sF)q71 E Det Garage (sF)_
! Sunroom (sF)! Pool (sF)
E Deck (SF)D Greenhouse (sF)
ls the proposed work changing the existing footprint? [ Yes El No
TOTAL PROJECT COST (Less Lot): S lfo aoc-t
ls the proposed work changing the number of bedrooms? D Ves E t{o
ls any Electrical, Plumbing or Mechanical work being done to the Accessory Structure E Yes EI No
lf the project is a Relocation, is there a Natural Gas Line on the iurrent site? fl Yes .E[ No
ls there Electrical Power on this Building? EI Yes E No
Propertv Use/ Occupancy: [l Single Fa ily E Dupl Townhou
Descrip tion of Work; S,
E- Porch (sF)3Zc:
D storage shed (sF) _
S. Ottrer 1Sr;5W-
I i JflN t8 2r5?P[
JL €
owner/Contractor A**eraeL.-1-r.-Signature:
:Liceti:9f :q!oti|ie+ -, - .: ...---PrinTNome
us Area: _ Sq Ft
ls the
Existi
operty located in a floodplaln? D yes EL trto
ng pervious Area: _ Sq Ft Total Acres Disturbed:
New lmpe
walrn, H CFPUA E Community System E Private Well E Central Well D aqua
SEWER: ll CFPUA El CommunitySystem E Private Septic D Central Septic E Aqua
Zone:officer: _ setbacks (F) _ (tH) _ (RH) _ (B) _
Approval: _ City: _ Date: _ Flood: (Al _ (Vl _ (N) _ BFE+2ft= _
Comment:Permit Fee: S
r lY ao$tpg4u
ToTAL sQ FT UND ER RooE (for proposed workl xeated: 39(sb unh.l^r"d, /3L6
DISCLAIMIR: I hereby certify that all the information in this application is corred and all work will comply with the State Building Code and allother applicable State and local
laws and ordinances and regulations. The NHC Development Services Center will be notified of any changes in the approved plans and specifications or change in contractor
ExistinB l-and Disturbing Permit: E Yes n No
Clear Form
APPLICANT'S NAME: SEAN MCDONOUGH
Print eMail
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATION ryPEi RESIDENTIAI
PLEASE ANSWER ALL QUESTIONS APPLICABLE TO YOUR PROJECT
"Prorect Responsibiliq/'
2o l€- (!q2-
r}g
Application
Number
(office use)
oate:'1211112017
PROJECT ADDRESS: 205 MARSHFIELD DRIVE clTY: WILMINGTON ZIP:28411
SUBDIVISION: SCOTTS HILL BLUFF LOT f: 28
PROPERTY OWNER'S NAME: NCA BUILDER lNC.
OWNER'S ADDRESST 827 BAYSHORE DRIVE
PHON€ #: 910-443-'1667
clTY: WILMINGTON ZIP: 284'11
coNTRACToR: NCA BUILDERS lNC.BLDG LICENSE #
ADDRESS: 827 BAYSHORE DRIVL clw: WILMNGTON sTr NC-ZIP 28411
EMAIL ADDRESS: ncabuilders@ec.ff-com
PROJECT CONTACT PERSON : SFAN fi,lCDONOllGH PHoNE:910-443-1667
EXISTING CONSTRUCTIOT{: ! Alteration ! Renovation ! General Repairs
-
NEW CONSTRUCTION: g Erect New Residence n Addition to Existing Residence n Relocation
*.*PLEASE CHECK AND ANSWER BETOW AIt THAT APPTY TO YOUR PROJECTIIT
D Att Garage (SF) _E Det GaraBe (SF)_
D Pool (SF)
tr Deck (SF)
! Porch (5F)
n Stora8e Shed (SF)_
! Other (SF)
n Sunroom (SF)
X Greenhouse (SF)
ls the proposed work changing the existing footprint? tr Yes E No
TOTAL Sq FT UNDERROOF Aor proposed workl Healedt 3207 Unheated: 1822
TOTAT PROJECT COST (tess Lot)s200.000
ls the proposed work changing the number of bedrooms? a Yes {No
lsanyElectrical,PlumbingorMechanicalworkbeingdonetotheAccessoryStructurenYesENo
lf the project is a Relocation, is there a Natural Gas Line on the current site? D Yes Ezf{o
ls there Electrical Power on this Euilding? n Yes gNo
Property Us€/ Occupancy: V/Single Famiry n Duplex a Townhouse
Description of Work:
I2DEC l7 19!34ffi
BUILD SINGLE ILY HOIV1E
laws and ordinances and regulations. The Oevelopment Services centerwillbe notafied ofany changes in the approved plans and specifications or change in contrector
information. *"NOIE ut the appropriate permits willbe in violation ofthe C State BldS Code and subject to fines up to S5OO.m...
Owner/Contra Signature:
"Licensed
ls the property located in a floodplain? ! Yes n No
Existing lmpervious Area: NA Se Ft Total Acres Disturbed:
New lmperv ious Area: 3850 Sq Ft Existing Land Disturbing Permit: L.l Yes D No
WATER; n CFPUA {Community System n Private Well D Centratwe n Aqua
SEWER: tr CFPUA [] CommunitySystem E/Private Septic n Centralseptic n Aqua
Zone: _ Officer: _ Setbacks (f) _ (tH) _ (RHl _ (B) _
Approval; _ city: _ Date: _ Flood: (A! _ (V) _ (N) _ BFE+2ft= _
Permit Fee: SComment:
ioHc zo'Q-,ltn\jico
ffi
PHONE:910-443-1667
APPLICANT'S NAME:
\$-, b 0ot8'(sq4
Number
(of{ice use),l
NEW HANOVER COUNW BUILDING PERMIT
APPLTCATION TYPE: RESIDENTIAL
PLEASE ANSWER ATT QUESTIONS APPLIC}BLE TO YOUR PROJECT
"Proiect Responsibiliv,
CITY
Date 6./ {)
PROJECT ADDRESS:
suBDtvtstoN:
Zl?t,2YYoJ'
LOT #:
PROPERTY OWNER'S NAME:
OWNER'S ADDRESS:
PHONE 8:16-
crw:
7 -t (,
)ZIP:2tYu )
BLOG LICENSE #:J-?OYC
5f:
^tL
zlP: )k t/ ?0
PHONL 9/o'6"20 - /9J;-
PHONET 9/O 6d-O -/?JJ-
CONTRACTOR
ADDRESST
o
ctw
EMAIL ADDRESS:
EXISTING CONSTRUCTION: ! Alteration E/henovation E General Repairs
NEW CONSTRUCTION: C Erect New Re sidence F{dditbn to Existing Residence E Relocation
.T{."PLEASE CHECK AND ANSWER BELOW AI-t THAT APPTY TO YOUR PROJECT'*'
,Z/att Garage (Sr) 7 t 1
! Sunroom (SF)_
E Greenhouse (SF)
PROJECT CONTACT PERSON: t'ar x ,(-A r,-, ,a+
E Det Garage (5F)_
! Pool (SF)
tr Deck (SF)
ls the proposed work cha n8inB the existing footprint? Ezles E No
TOTAT Sq FT UNDERROOF llor proposed work) Heated:'7aO Unheated: 1 / \/
TOTAL PROJECT COST (Less Lot):5 /Ao, cao
! Storage Shed (SF)_
tr Other (SF)
ls the proposed work changing the number of bedrooms? A Yes {no
ls any Electrical, Plumblng or Mechanical work being done to the Accessory Structure,[/Yes ! No
lf the project is a Relocatlon, is there a Natural Gas Line on the current site? ,Bifes n No
ls there Electrical Power on this Building?)Z/Ves a no
Property Use/ occu pancy: Gngle tamily n Duplex ! Townhouse
Description oI Work:
7*.^ d ^r
, allother applicable State and local
laws and ordinances and regulations. The NHC Development Services Cente. will be notified ofany changes in the approved plans and specifications or change in.ontractor
information. "'NOTE: any work performed without the appropriate permits will be in violation of the NC State Eldg Code and subied to fin€s up to S50O.m"'
I
owner/contractor: >-*l-n ""X <")t'-,,ll sitnature: 2.-.-L ).L"- -d-l-
"Licensed Quolitet" P nt Nome
ls the property located in a floodplain? ! Yes_D-{ifo
Existing lmpervious Area:_ Sq Ft TotalAcres Disturbed:
New lmpervious Area:Sq Ft Existing Land Disturbing Permit: n Yes E No
WATER: Z'CFPUA E Community System ! Private Well ! Central Well E Aqua
SEWER: Z"-CFPUA f] Community System ! Private Septic f] Central Septic n Aqua
Zone: _ Officer: _ Setbacks (Fl _ (tH) _ (RH) _ (B) _
Approval: _ Crty: _ Datei _ Flood: (A) _ {V} _ (N} _ BFE+2fb _
Comment: Permit Fee: S
leJflH r8 9r808ll
cqr c e.t<c- , ^/n 7 c,<c <arcre .-,-,/\ ,,.t"rh - + rau.'r, aScv
ffi
tr Porch (SF) _
Tetg - bu(
FLOOD ZONE
]{EU' HAIIOVER COT'I{TY BUIT"DITIG PENil]t
APfl rcAIr,I l:t,PE: mJEEt{ITAttu l* AllIx,u AllqrEfil,lEttftrc alrrr,llmtrorrrtlll.Ci.?lrry
aa
T/A Fh.lhrp!
ffi
rarmhc. (oafc.,Dl*'lthiAPT'LICA'iTT! UUIE:S@el!
PftUECT AI'OIESI'I
suaolvlsl(xt Thc cl€.k dtfiorlct C[IY:!P:
lor*
I !)cvr'
:iJll@itm,I
.i0rr
AE
@ITIITACT :$avEns Butdhg arDe ucaEtft 31626
ADDiDIC:6110 Oeander &nr $nc ZXt OIY:WillhCDrr tt: ltC apr
EMAIL ADDGSS3 snidrdlor@hwrdhCloma.cun PIII E 910"794{@S
PROJECT COI{TACTPTNSO :$ad Nddron {'0imlr{!a{616
![!rf ClIrcrl*tr rhn tr fI*r tr crlrdHr
w oo6tltru, d ml*r*,. tr raftbnb ffi r.{ia tr i*.di
d e*a.rrpa {06 tr Dr-r.g*t- /r*,an I
tr Pml6Fl
O D.d6fl
tr sbrl.: sh.d €n_--
tr odt.r (sn
b dr rropcarut dlrrrhrdndlt*firt? tr vrr d no
TOTAT SQ FIIFe'g} W pr@ Il!,t<l t*10r4 I
lr th t lrad nft drrtllt tl. r!tirg.. ot f*osnr? tr Vr d fIt.rytt .nh0 'l*3o.H wt l-tldrl!.toth.f .y*n6rl tr yr d f.Fttx pl!.dbr E.lLILf lhflt X.fr{ G.3 l4. on th orrr* rltr? O f. d .rdr.rt ELcdalnorJfm$aaulf|? tr Vt dfr
ri€rq t rroEF* f! lf Ur = Itr = r*.r
orrcr@m ofwo*lLw Conltncton
lI'O]lS: IltrSycr y dt.. ddt.bfltGtr hda.rradcl f csEt.d.l Et r,l coip.yfrr dr 5&lrd.tCon -d d dtr.Blath ltt rdto(.tbu. rtd q{hrE rd nfrAforr'.Ih. lolcDcdqn-rttrltaa Crlrr b.mi$dot Jr, da.ra.. h tha gbll.atd agaaficadoia adirhcdrffi
$(D.o.r Iffi rnrtbr. "'X0lEr Aay rcrt S.E.ht EtdErl b. h t ld&. ddr tr
SEmtun:
in rllb
1t3
YJlwtlafloY\ B16o-urr-<_***14'fii
P.rmft La: S
Otfltll/Cmmn
'Udrnt,it qnlv
B th. proFrty locrtd ln r tfoapmrf JVI I lo
ffiia lmr]Ilolr^il: ZrLl 4ft
,cfunad tirtt.
slrr.n3
klfr rlorn \l{ r\r
mrY14 \L FLOOD ZONEfl*tr
Tottl A.rrt
tLtrhp.rtulrr: Lrbl q?t Uratd hrlr;rr*r tr vr /ro
Wer* E! CFPU O Cdrtttr*y Sfrn tr prtva ur.l tr c.rt lwd g t{l|.
n, sEwrr. d crpue Ot,w-,L15_o,*CoflrnnnltY Sy't m tr prlY tt S.pdc tr Cstrr.ls.p& tr A$r.
Apflld:
Coltn.t
c parl ct-
Clty:
tr Sunroom 6fl
-
tr crrrnhour ffi-
rorar imtt GGT (rt., r4: tl20p0__'ffi qbq
tr.i'. i: i:,I
2 o /U- { /O
NEW HANOVER COUNTY BUILDING PERMIT
APPLICATIN IYPE: RESIDENTIAL
PLEASE ANSIJTR ALL QUESTIONS APPLICABLE TO Y&N PRO]ECT
"Project Responslbility"
18-s9
APPLICATION
Number
(Offi(e use)
DEVELOPER: Robuck Homes Trianqle, IJLC PHoNE S: 9r9- a76- e2oo
PROJECT ADDRESS: s149 Laurenbridqe Lane CITY: fiilminqton ZIP | 28409
LoT #: 012
CoNTRACTOR: Robuck Hones Tiiang1e, Llc LICENSE #: 57083
AIDRESS3 6131 Falls of Neuse Rd. ste 200 CITY: Raleiqh 5T: Ig- ZrP: @a
EI4AIL AODRESS: i norbech@robuckhomes. com PHONE #: gls-a't6-s2oo
PROIECT CoNTACT PERSoN: ,ral Norbech - i norbech@r:obuckhomeE. com PHONE #: 9L9-2"1't -ta2a
EXISIING CONSTRUCTION :ALTERATION I nenovrrroru [GENERAL REPAIRS RELOCATION
NEUI CONSTRUCTION:m ERECT NEW RESIDENCE oT ADDITION TO EXISTING RESIDENCE
'*PIEASE CHECK AND ANSWER BELOlil ALL THAT APPI"Y TO Y0rR PROIECTI
V ATT GARAGE 504 SF ! orr elnncr
-
sF
SF P00L _ sF
GRE ENHOUSE SF f| orcr _ sF
Eponcr L-sF
I sronaer SHED
-
sF
OTHER: SF
TOTAL HEATED SQ FT: 255s TOTAL SQ FT UNDER ROOF: :zoe TOTAL AREA SQ FTi 32oB
TOTAL PROIECT COST t,ess r-ou : $224560.O0 # OF STORIES: 2
Is Any ELECTRICAL, PLUiIBII'|G or T4ECHA ICAL Wonk Belng Done to the Accessory Structure?Yes I No
If the pnoject is a Relocatlon, ls there a Natunal Gas Line on the current site? f] ves fr ruo
Is there Electrical Powen on this Bulldlng?I ves flruo
PROPERTY usE / occupANcyt ffisrNele FAilTLY f]DUpLEx f]T0hrNrousE
DESCRIPTION OF ORK! new home
DISCLAIMER lheBby certit [|at all inbrmatlon ln hls appllcaton ls corecl and allworkgrll comp{ywih he Slate BuildlnO Codo and dloher eplicabb Stals and local laws
and ordin6ncrs ond rogulalilns. Th6 NHC D€vgbpmsnt S€rvlcss Canl€r *lll b€ mlifbd otanychang€s in he appmved plans dld speclncadons or chsrge ln conlracb. ot
conlac@r lobmdton. '_NOTE: Any Work tlerfoflned WD hg App{ofiab Pemlls \r,ill ba ln Vlo,afon ot lhe NC St€ts Bldg Cod6 and Subroct b Fhes Up To 3500.0cl"
OITNER/CONTRACToR: charlea ,r. Bishop rv SIGNATURE:
+:ir,i:i** * +:*+ *r,r )r ** * * ** * ** * * *(I i'll Jll"],(+**,t*r*t)*)r)r*r*,*'ix*+*****+**t*t****i*{.**,}*i:***+,tt)hr**)r*
rs rHE pRopERry LoCATED rN A FLod)pLArNl I VeS [E] r,ro
EXI5TING II{PERVIOUS AREA: O SQ FT TOTAL ACRES DISTURBED: 31.2*
NEI,J IMPERVIoUS AREA: 2 024 SQ FT ExrsT LAND DrsTURBrirG pERr4rr: Ef yES fI NO
I.,ATER :cFpuA E co|r,ruNrry sysrEm fl pRrvATE wELL fl crrurul wrll /=.2_L_i z7 Z6
SEWER: EI cFpuA E CENTRAL sEprrc ! nnrvarr sEprrc I coMMUNrTy sysrEM
+** SEPARATE PERIi.IITS REQIJIRED FOR ELECT, I,IECH, PLBG,, GAs EqJIP, PREFABS & IIISERTS *'I'I
pAyr4ENr i.rErHoD: E cnsr E cxec( (pAyaBrE To NHc) E ar'rERrcAt{ ExpREss E rclvrsn l]l orscovEn
t* 't* ** * * *** *** t **** ** * * *** * tt*+*)i +*** **at t *t* * ** !t * * * * t* * *** *** **t** ***l *(+ * ** ** f*+ * **** *t
ZONE:OFFICER:
(FoR oFFICE USE OtrY) REVISED DATE 04111/12
SETBACKS: F:_ LH:_ RH:_ B:_
N
Approval:_ City:_ DATE:_ FLooD: _BFE+2ft=
APPLICANT's NAltlE: Robuck Homes rrianqle, LLC OATET 1/9/1,8
SUBDMSIoN: Laurenbrldqe BLOCK S:
PROPERTY olrlNER'S l,lAritE: Robuck Homee Trianqle, LLc PHO0IE *: 9a9-a75-9200
ohlNER's ADDRESS: 5131 Fa11s of Neuse Rd. Sbe 29q CrTYr Raleiqh ST: NC ZIP:27609
I surunooN
,ot I -bs6
1fr" t t7
TIEU' IIATI(,I'EN O(x.lilW BUTIIXTG PERMITA,?trl,tf,t( ,:fpE: iESDEI{I|AInlA$$6tAlllqf,$rx6l,'lrA]lmrcui r rr:cr?i.l.Citotrfff Aiadqr[aaa.(.norf
toAPPUCAJ{TI xAyg Stevar
PROJECT d0O[Et5:
suaDlvlsloil:Th. Cf3qk Ctrwlod*
T/ &vilt Fh. Horl6 *l t5
loTf:
p1166169 91G70,1-€@9
i ctw:&t
PROPERTY OWITEPS TME S'brrB Af(tr!
OWNCR'S rDilEst: 5/10 oldd..Drnp Sdto 200 gTYr Wlmlnobn *
COflTRACIC Srlna Buldltg
^DOiE35:
5710 Olander tH}r Stt n orv: lvh*rbn
ro6llcaltEt: 31620
4428,1o35I: trcEMAIL ADDIEIS;
PiOjECT cdfl cIPEtO : Srd lddrobon
tsrAxl'IUm W V*t@Ifi,rl tt d& It60 tnharbd:firf L tiOEclO06T (t!rE too:qr20,000
a*rt 01G791-86S0
psq6; 91-3112{6,16
ffiflflO OoXS rCIlOf: O lEndon tr Roovrdon tr {fnrrd i4rtn
ewco 5l ,GI|O , d a.d [rrLdd.,ro. EJ Addtbnb Unairkhm! O i.locr0on
,^
t t'
tll lltornrFo 'l5U O D11er{: Gfl _ d rutpA /01
tr suntoonr (sr,
-
tr todgrl_ O 55n,sro 1g1__tr errrntolr ffi
-
tr D..r6fl_ tr od1., 15n
Itdl. p.opo.d rort.ifi dr..tr albotDrt *? tr yr d ffo
s62
Bth p.o9o..aF,t dngf {rx;arrof b..nooG? tr y. d t.ob.ny b.trlC, rbahor rddro* ldnj&rr brh. f.c.rorytucrr. E Vr. d bf th. proj.d tr H.*r, f drrt. llt*rl Gr t+.on Onqn11 rt *ri tr t.. d-; - "
b tft.'t ELcllctl torrrm tl$ f{t? tr Vrr df
t@gttnl
Orrrhdon oa
o-r.,otdrtr*rrrry tr ordc tr Iol,r{lolr.
Wodc
ifl@iilrliJJJ
g:2IBH
ol.ct l.r* I haayr- ytt t.lllrhida.l h trltdrdoi 3.qrCnd { Etrl c.qtrfth dtirn llfAta C.d.hrr.d ordrt-rlld qda.rr ItaEICHqG-atrtk.C-E b.ndLd o,irdryE h rn ,tlt.r|dtrrrnrdon. ...Xm: f/iy xqtprtnrq, rdgltrli ryE h r-nf,{b. h rtuor dt r tE c&
Oh.r/Contn6cL&'f!.dq&r.r'Crals Sbv!{r8 glrrtm:
hfrr,o.t c
lsth. prop.rtytodto, floodphh? tr Vrr d fo
Edrrtg lmr.rulourrrr t l1\q s4?a
.wtnprlhrrrAr.!: ll{1 sf n
wAfEi: E cFpu EI conmoritysyrtrn tr prlt.t
sara d creur tr
,-,.,1L'16 n*Cfltnl Srptc
cuC ol fl).t
Iotd Acrr. Dlrturtedr lB
l*ft0trldDltrtfrarrnk tr v8 d m
W.{ EJ Crrtrd Wd tr Aqx
Sptam tr tr A4,. /
tWorltz (NL dv Ittvl *h,l-M-frD < r;r+h_
I t1q' ooP.rmlt F..: S
Commant:
Ciiy lnspeciion ,9't0.254.0901 i)/tut , cz.
NEW HANOVER COUNTY BUILDING PERMIT
AP P LI CAT'O N TYPE.. RESIDENTIAL
pttAsE ANswIR ALr QUa:flof.]s APPt rcAEtt ro YoLJR PRolEri
"Proiect RetPonlibilitY'
lot1 - lo L
i1' 2,c17,1
APPLICANT'5 NAME:
PROJECT ADDRESS
SUBDIVISION:
Rct'z CITY - tt:lry-zaP
)
CITY
_,_- -_ PHONE
zrp,7bl51CONTRACIOR:
ADDRESS:
EMAIL ADORESS
PROJECT CONTACT PERSON n'l PHON E 1q3 3 ?c7
t7 - l/b 7DEXISTING CONSIiUCTIONi :l alte,ation : Rrnovation I General nepairs
NEW CONSTRUCTIONT : [rect New Resrdence 7 addition to lxistin8 Re5adence ] Relocation
... PIEAsE CH€CK AND ANSWER BEI.OW AI"L THAT APPLY TO YOUR PRO'ECI"'
E Att Garage {St)
-
i- slnroom {5F)=--..-
!.1 G.€anhouie i5F) --
t-l Det Garaee ist l C Porch {5F}
. l FooliS[)
I Deck {Sr)
Ll storage Shed (Sr)
----7 Other lSF)l, ):ho
15 the gropo5ed work rhantint the existin, {ootpri t? : I Yes :' No
TOIAT SQ FI UNDER ROOI llot ptoposed worli Heated unheated
ToTAt PRo.,EcT COSI {Lesr Lot): 5 fao
lstheproporedwork(hangingthenumberof bedroorng? : Ye9 Z No
15 a,ry Eleclrir3l, Plumbing or Mechanicalwork being done tolhe AcceesorY St.rrct re 7 Yei : No
ti the proje(r is a Relocatlon, is th€re a Nalu.al Gas Lile on lhe (urrent sitel . . Y€a ,j No
ls there Electrical Power on this BuildinS? Z Ye!: No
Prop€rty Use/ Octupan.y: f-l Single family : Ouplex :l Townhouse
-ro
14t)[(] 1; 315&ill
Oes.ription of Worl:
DISCIAIM€n: , het.by rertr,Y thal atithe iof!.m.rion i5lhi! .pp ilrlDn r; io(e.t irnd all worl willcomplyedh the Statr SurldinE Codt and all clh€' .ppl(abl€ SlaIe and lo(rl
laes and ordinaflrerand rept.tion! th€ NhCOelelopment Serrces Cenrerwilt b. ronn.d of any.h.t8lr iulhe approved rlans and ,pe.iliralio.3 o..h;nte in contrndor
,nlorm.tion '".1,{OTt , Any woit perto.med wrhou! I h. appropr ate pe,4n1. ,iir b? jn lrora tion of rle N C Statl] 8ld8 Code r nd subi€(t to fine, trp ro S5oo 00"''
aLhlurr{ ?-_ SiEnatureOwnedcontla.tor:
'Llcensed Qvolilie;
15 the property loc.ted 'n a floodplain? i:l Yet I No
Existing lmpervigu! Alea: __- 5q Ft
New lmpervlout Areal .--Sq Ft
WATEI: : CfPUA [.] communty system ! Private
SEWER: n CfPUA,, CommunitY SYstem fl p.ivate
zone:
-
officer:
-
Serback5 (f)
-
{
Approval: -- GtYt
-
Date: -*- Flood
lotal Acret Disturbed: --
Eristing land Oislurbiri8 Permit: : Yes - No
we ll : C€ntral Well : Aqua
Septic : I CentralSepric :""i Aqua
rH) _ (Rr!) _. (8) _
:tl)-(V)- (N)
-BrE+2ft=.-_'*Permit Fee: 5Comment:
C.Affi
Oale
LOT #r__
PROPrRTY OWNTR'S NAME| - PHONE E
oW'rlER,sADDftEssi---'--clTY]-'.-*-.-zlP:-.-..''
roDt"v -
4' z-?