HomeMy WebLinkAboutELE2005-02868.tif Nov 22 05 03:53p Renee Lawrence 704335 -1017 p.3
(828) 465 - 8;399 Dllice Number County FAX 9 CALL Q WITH ISSUED PERMIT
(8 28) 465 -8962 Newton F,ax Number Applicrtion ±: Permit TO THIS NUMBER (7cx/)
(828) 322 -6814 Aickory Fax Number
ww w.catawt racountyrlc -gov
(Please print or type) P.O Box 389 Newton, NC 28658
Type of Permit el Electrical ❑ Plumbing ❑ Mechanical ❑ Fire Cate
Active Building 1 Mobile Herne Permit # zl –,E4 Property !D # (if known)
Use of structure- Q Mobile Houle PI Single family ❑ Multi family ❑ Commercial ❑ Industrial/Factory ❑ Church Ow
C] Gov't owned ❑ Accessary
Physical 911 Address of Project -5 l�atoott`� �� r` AI
Owner or Business A Telephone
Addre S
Subcontractor ou.. r - ence , P c ►�'r'G Gan 1rt r T e l e p honr: �- 1 2 0)-� - f701
Address 1�7 c License It
General Contractor _ _ �. Telephone
Design Professional Telephone
Address NC Reg #
ELECTRICAL Panel # 1 Amps Panel # 2 Amps Panel It 3 Amps Panel 9 4 Amps
❑ New Panel ❑ Pole Service ❑ Vice Mechanical unit only f No Svc Chg) Total#
Q Sub Panel ❑ Service Change Amps C1 Interior Wring (No Service Changej —
❑ Saw Service ❑ Load Control ❑ Modular Home
❑ Sign Service ❑ Mobile Home ❑ Other jList)
'List each panel installed separately' fl RV Service Total Electrical Cost
PLUMBING
❑ Full or Partial Bath/Toilet Rooms.(Includes future.) Q Fire Sprinkler System ( ❑ New p Addition }
-otal number being installed ❑ Gas line/Pressure Test only
❑ Mobile frame (new set -up only) ❑ Modular Horne
❑ Water Heater 10ectric, Gas) ❑ Other (List)
MECHANICAL (Check flue) ❑ New installation ❑ Ghange out exiting system
❑ Heat Pump or Furnace with A/C Total 11 ❑ Gas Linel Pressure Test
❑ Furnace (Oil, Gas, or Electric) Total I ❑ Gas Logs Total #
❑ Air Conditioner Total it _ ❑ Unit Neater Total #
❑ Water Heater (Electric /Gas) Total # ❑ Modular home
❑ Other (List)
FIRE (Check permit type applicable)`
D Fire Extinguishing System ❑ Compressed Gases ❑ Spraying & Dipping
Fire AlarmlDetection System p Hazardous Materials ❑ Standpipe Systems
Fire Pumps & Related Equipment ❑ Industrial Ovens ❑ Temp. Membrane Structures
� j Flammable & Combustible Liquids ❑ PVT Fire Hydrants ❑ Other
., Ali tees entered by Permit Center, DOUBLE FEE charged for wont started prior to obtaining permit; - The undersigned makes application for
permits and inspeclian of work deser d and agrees to comply witty all applicable State. County codes aod4aws7mulalinq the work.
PRINT NAME e �1►�/� �' SIGNATURE
tSubco gractur] license Hol oflwner