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(828) 465 -8399 Office Number atawba Coon y WITH ISSUED PERMIT #
(826) 465 -8962 Newton Fax Number Application for Permit HIS NUMBER
(828) 322 -6814 Hickory Fax Number �/
www.catawbacountync.gov
(Please prfnt or type) P.0 Box 389 Newton, NC 28656
Type of Permit -E Electrical ❑ Plumbing 19<chanlcal ❑ Fire Date
Active Building / Mobile Home Permit # Property ID # (if known)
Use of structure: ❑ Mobile Home ingle family ❑ Multi family 0 Commercial ❑ Industrial /Factory ❑ Church Owned
❑ Godt Owned ❑ Accessoj� A �j p
Physical 911 Address of Project _ q _I S.J��J l_Uc e , ` y ✓ L°, ` l�� C 0 0 0
Owner r Business __T �r° � M �t ��.. _ Telephone __21 • (P�5 1.
Address �lU L7 �ll1 Q �VZ. • r �E�I ((e !Sic a$ l 1 5_
Subconlractor V - D+4 - N ffik : bj Telephone _7jpy ; '9 a (q _W
Address p� �G .(Y11C1 S�-. tx,l� i1�,5C. _ 1 �ip nse t M15q%9 E ao4 0 u
General Contractor Telephone
Design Professional Telephone
Address NC Reg #
ELECTRICAL Panel u 1 Amps Panel # 2 Amps Phpel # 3 Amps Panel # a Amps
❑ New Panel ❑ Pole Service [Wire Mechanical unit only (No Svc Chg) Total#
❑ Sub Panel C7 Service Change Amps_ ❑ Interior Wiring (No Service Change)
❑ Saw Service ❑ Load Control ❑ Modular Home
❑ Sign Service ❑ Mobile Home El Other (List) . p _ __
'List each panel installed separately* ❑ RV Service Total Electrical Cost S
PLUMBING
❑ Full or Partial Bath/Toilet, Rooms.(Includes future.) ❑ Fire Sprinkler System ( ❑ New ❑ Addition )
Total number being installed ❑ Gas Line/Pressure Test only
❑ Mobile home (new set-up only) Cl Modular Home
❑ Water Heater (Electric, Gas) [l Other (List)
MECHANICAL (Check One) ❑ New Installation VChange out exiting system
❑ Heat Pump or Furnace with A/C Total #_ ❑ Gas Line/ Pressure Test
❑ Furnace (Oil, Gas, or Electric) Total #_ El Gas Logs Total #_
❑ Air Conditioner Total # ❑ Unit Heater Total #
❑ water Heater (Electric/Gas) Total # ❑ Nom t l
L!d" Olher (List) _ t Pcv— J
FIRE (Check permit type applicable)
❑ Fire Extinguishing System ❑ Compressed Gases ❑ Spraying & Dipping
❑ Fire Alarm/Detection System ❑ Hazardous Materials ❑ Standpipe Systems
❑ Fire Pumps & Related Equipment ❑ Industrial Ovens ❑ Temp. Membrane Structures
❑ Flammable & Combustible Liquids ❑ PVT Fire Hydrants ❑ Other
"Alt fees entered by Permit Center, pg ffi f FEE charged for work started prior to obtaining permit."The undersigned makes application for
permits and Inspection of work described and agrees to comply with all applicable State, Coun codes andlaws regulatin Work.
PRINT NAME _ , • SIGNAT URE
(5ubcuntrecir License Holdedowner