HomeMy WebLinkAboutCBPR-3-12-14942 3rd Surgical Wall Demo Appl.tif c��� -3 -i2
Newton Office (828) 465 -8399 CATAWBA � a COUNTY P.O. Box 389
Newton Fax (828) 465 -8962 Newton, NC 28658
Hickory Fax (828) 322 -6814 APPLICATION FOR PLAN REVIEW www .catawbacountync.gov
AND /OR BUILDING PERMIT
All submittals /re- submittals of commercial Plan review must be accompanied by a 10.00 plan processing fee
Name of Project: Date of Application:
Address of Project: Parcel ID #:
Applicant: �� �C Phone #- o ��; Fax:
Address of Applicant.
SG v� Email: L
Owner: I
\ CA �> Phone#: Fax:
o �- �c� � 8
Address of Owner: &tli� - - -3TC Email:
General Contractor: Pho a #; Fax:
S c, ,,,,_ � 83t - 3 & _) $
State License #: License Classification: Federal ID M
i.e., H1, P1, Limited
Address of Contractor: Email: — 7 1
ArchitectlDesigner: Phone #: Fax:
Address of Arch /Designer: Email:
Contact Person for Project: Phone #: Fax:
Address of Contact Email:
Does the Project have a Fire Alarm System?
[ es [ ] No
Does the Project have a Sprinkler/ Standpipe System?
[W-Yes [ ] No
* Sprinkler Plan Submission to the County, City of Hickory, Conover or Newton Fire Bureaus' is the responsibility of the
customer. Plan Approval must be forwarded to the Permit Center when completed and approved.
Will this Project require Environmental Health Review? * [ ]Yes [ta - Pt6
• * If yes, submit one set of plans to Environmental Health with appropriate fee (Page 4 of this application Provides
explanation as to when these are required and the fee amounts.).
Type of Sewage Disposal: Is Public Sewage available on or adjacent to this project? * [ q1es [ ] No
* If No, a Septic Permit must be applied for prior to project review approval, if not already approved.
Type of Water Service: Is Public Water available on or adjacent to this project? * [i ]�'es AfMtWo *If No, a Well Permit must be applied for prior to project review approval,
if not already approved.
Are you disturbing more than 1 acre of soil? [ ]Ye
* If yes, 5 sets of erosion control plans and one set of calculations must be submitted. A fee of $200 for the first acre and
$150 for each additional acre of disturbed soil will be collected at the time of plan submittal. Additional applications will be
re uired. Forms are at permit centers, or can be obtained from our website See above for website address
Is this a New Building or Addition that is owned by a Government/Municipal Agency AND 20,000 sq ft [ ] Yes [qNo
or more? NCDOI Approval Letter MUST be submitted to this office before Permits will be issued!
Is this Project being submitted for Phased Construction? * [ ] Yes [0-No
*If yes, please check which phase? oon / Foundation [ ] Shell / Hull -in
[ F ti
J g [ J Up -Fit
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1 Updated 04/15/2011
Newton Office (828) 465 -8399 CATAWBA 4 COUNTY P.O. Box 389
Newton Fax (828) 465 -8962 Newton, NC 28658
Hickory Fax (828) 322 -6814 APPLICATION FOR PLAN REVIEW www.catawbacountync.gov
AND /OR BUILDING; PERMIT
Describe work to be done under this Permit:
lS 75�
TYPE OF WORK
❑New Building ❑ Addition A ❑Mixed Add /Alter Demolition
❑ Accessory Structure
❑ Deck / Porch ❑ Re -Roof ❑ Pier ❑ Repairs p ❑Swimming Pool
❑ Footing /Found ❑ Shell -In ❑ NC Rehab ❑ Up -fit
❑ Retaining Wall
❑ Relocate Dwelling (Prior Address of Dwelling)
STRUCTURE USE /OCCUPANCY (check all that apply)
Occupancy Classification (See Classification list on sheet 5, enter multiple if mixed occupancy)
❑ Condominium ❑ Modular Office ❑ Retaining Walls (Sealed Plans)
❑ Addition ❑ Covered Deck ❑ Modular Dwelling ❑Single Family (site built)
❑ Agricultural ❑ Deck only ❑ Multi- Residential
❑ Townhouse
❑ Alteration / Exterior ❑ Mixed Occupancy ❑ Modular Garage
❑ Alteration / Interior ❑ Hanger, Mixed Use ❑ Pier (Sealed Plans)
Other
TYPE OF CONSTRUCTION Protected or Unprotected construction refers to whether the
(Circle) I 11 111 IV V Protected (A) Unprotected (B) building is designed with specific fire rated construction methods.
PROJECT DATA
Total Sq Ft 3CxQ Heated Sq Ft 3 ° Unheated Sq Ft (basement, garage, covered porches, etc)
Garage Sq Ft Bonus Rm Sq Ft (finished /unfinished) Basement Sq Ft (finished /unfinished)
11 Floor Sq Ft 211 Floor Sq Ft Exterior Finish Material
Total # Rms # of Units # of Stories # Full Bathrooms
# Half Bathrooms (Toilet & Sink only) # Bedrooms B uilding Height
Fireplace openings (masonry, prefab /gas, prefab /wood) Type of Heat t-
Type of Foundation
SUBCONTRACTORS NEEDED FOR PROJECT [electrical ❑ Plumbing ❑ Heating/ A/C ❑ NONE
POWER/UTILITY COMPANY Servicing the Location: Type of Gas Service (Nat. or Propane)
Is a Temporary Saw Pole Needed for this project? ❑ Yes k2
Will there be more than one electrical Meter for this building? ❑ Yes ❑ No (If Yes, provide Number of Meters )
I hereby certify that all information in this application is correct and all work will comply with the State Building Codes and all other
applicable State and local laws and ordinances and regulations. I understand that a Certificate of Occupancy is required prior to
occupying the premises and the Building Services Department will be notified of any changes in the approved plans and specifications for
the project permitted herein.
(For Plan Review Ow er /Agent Signature Date
( d 0D
3��/ t I
Est. Project cost (For Permit) Contractor /Agent Signature Date
2 Updated 04/15/2011