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Home My WebLink AboutBLDC-2-12-24820 WFBH Permit-Appls.tif $A C CATAWBA COUNTY PERMIT BUILDING (C) t-t Alteration C� ► �� P. O. Box 389 Phone: 828- 465 -8399 PERMIT NO: BLDC -2 -12 -24820 100A Southwest Blvd Newton FAX: 828 - 465 -8962 APPLIED: 02/03/2012 p r� Newton, North Carolina 28658 Hickory FAX: 828 -322 -6814 ISSUED: 03/09/2012 1 c7 4 !i SM EXPIRES: 09/05/2012 www.catawbacountync.gov Catawba County Internet Citizen Access Portal: energov.catawbacountync.gov /cap/ APPLICANT OWNER CONTRACTOR WAKE FOREST BAPTIST HEALTH TATE BOULEVARD III LLC HEARTLAND CONTRACTING, LLC 1771 TATE Bluff 1781 TATE BOULEVARD SE 1064 BAN BUREN AV STE B WINSTON -SALEM NC HICKORY NC 28601 MATTHEWS NC 28104 P. (336)106 -3551 P. (704)517 -3004 F. (704)882 -3152 EMAIL: jmo ore@heartlandnc.c om PROPERTY ID#: 371206486710 STREET ADDRESS: 1771 TATE BLVD SE, Hickory, NC LOT# TR 2 PROJECT DESCRIPTION: INTERIOR ALTERATIONS/ 5,839 SQ FT * *Hickory Zoning DIRECTIONS: TATE BLVD COMMENTS: TYPE OF USE: Alteration / Interior TOTAL SQ FT # OF STORIES: 1 VALUE: 129,300.00 ZONING: NUMBER OF UNITS: 1 CODE EDITION: IBC 2009 TOTAL # OF ROOMS: FEE DESCRIPTION DATE FEE AMOUNT Temp. Electrical Agreement Fee 03/09/2012 $121.00 Permit Placard Fee 02/03/2012 $5.00 Building Alterations Fee 03/06/2012 $448.00 TOTAL FEES $574.00 Catawba County has an agreement with Garbage Disposal Service, Inc. granting them an exclusive license to transport and dispose of all solid waste, including construction and demolition debris in the unincorporated areas of the County. The approval of your application for a construction/building permit is made specifically contingent upon your agreement not to utilize any other business or company to transport and/or dispose of solid waste from construction site(s). Failure to comply with this provision may result in assessment of fines up to $500 per day. This permit is issued on the express condition that the above work shall conform in all respects to the statements certified to in the application for such permit, and that all work shall be done in accordance with all applicable zoning, building, electrical, plumbing and mechanical ordinances of the County of Catawba and the State of North Carolina. A permit issued for work under this Code shall expire by limitations six months after the date of issuance if the work authorized (FOOTINGS ARE CONSIDERED 1st INSPECTION ON NEW CONSTRUCTION) has not been commenced. If after commencement the work is discontunued for a period of 12 months, the permit therefore shall expire. If a project expires, a minimum fee per the current fee schedule will be charged for each building and trade permit to reactivate the project. * * *AN ADDITIONAL CHARGE PER THE CURRENT FEE SCHEDULE MAY BE ASSESSED FOR EACH UNWARRANTED INSPECTION SCHEDULED. * ** If there are any questions, please contact the office between 8:00a.m. and 5:00p.m. permit 03/09/2011 Page I of 2 �$A CATAWBA COUNTY PERMIT G BUILDING (C) �s 2 BLDC -2 -12 -24820 Alteration AFFIDAVIT OF WORKER'S COMPENSATION COVERAGE AND STATE PRIVILEGE LICENSE REQUIREMENTS N.C.G.S.87 -14 The undersigned applicant for Building Permit # BLDC -2 -12 -24820 being the Unlicensed Contractor Owner 01 Officer /Agent of the Contractor do hereby aver under penalties of perjury that the person(s), firm(s) or corporation(s) performing the work set forth in the permit: has/have three(3) or more employees and have obtained workers compensation insurance to cover them. has/have one or more subcontractor(s) and have obtained worker's compensation insurance covering them. has/have one or more contractor(s) who has/have no employees and has waived and has waived in writing their right to coverage by their contractor or have their own policy or worker's compensation covering themselves has/have not more that two (2) employess and no subcontractors. has renewed Contractor License. has/have applied for permit where the cost is under $30,000 and I am therefore exempt from Licensed General Contractor requirements specified by G.S. 87 -14. has/have applied for permit under owner exception to the licensing requirements mandating occupancy of the premise for 12 months following the completion of the project, while working on the project for which the permit is sought. It is understood that the Inspections Department issuing the permit may require certificates of coverage and/or waivers of worker compensation insurance coverage prior to issuance of the permit and at any time during the permitted work for any person, firm or corporation carrying out the work. SIGNATURES ARE TO BE WITNESSED BY INSPECTIONS PERSONNEL OR NOTARIZED. FIRM NAME: BY (PRINT): Pa (1 ra L--Yt TITLE: su .w—ri n —(-fin den - SIGNATURE: DATE: SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF , 20 SIGNATURE OF NOTARY: MY COMMISSION EXPIRES 20 OFFIC1,4L SE.4L permh 03/09/2012 09:50 Page 2 of 2 � c -z 2- 2y�Z& .,C r Newton Office (828) 465 -8399 CATAWBA ' a COUNTY -�-'CR - 2-1 `C - P.O. Box 389 Newton Fax (828) 465 -8962 h10 P ' + Newton, NC 28658 Hickory Fax (828) 322 -6814 APPLICATION FOR PLAN REVIEW www ,catawbacountvnc.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:' cz P rcel ID ' ? l - 06 -- 4-8• Ce `7 /(U A p .cant: Phone #: Fax: 2 6 0 al 5f4 Address ofApplicant: Email: Owner: Phone #: Fax: 2 . 3�, Address of Owner: Email: Gen ral Contractor: Phone#: Fax: " n ' Z C' - 70'4 -f8l -Jodi{ � ear- �-��ihd Cc,►� ro.0 - - - 7oy- 5 /7 -80zl 7oS�88z -3�sz State Licensee: License Classification: Federal ID M 5 2 Z Z i.e., H1, P1, Limited aA Ilrn ( a� Z.0 .- d'7 08 93 6 Address of Contractor: Email- 106 n Bwr Avg Ski 4 �,' YI[><Ict n lau 2607 i(Vl o r c,Nd ,gar Architect/ Designer: Phone #: F : v ti. _ 3_,L .- Address ofArch /Designer: 1.1 t o\ Email: Contact Person for Project: Phone#: I Fax: �yl Address of Contact 2 - 7 IL Email: Does the Project have a Fire Alarm System? [ees [ ] No Does the Project have a Sprinkler / Standpipe System? * es [ ] 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 No • * 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? * [ Yes [ ] 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? * es No * 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? * [ ] Yes [ o • *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 required. 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 [tJ o 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 [j :]'No *If yes, please check which phase? [ ]Footing / Foundation [ ] Shell 1 Hull -in [ ] Up -Fit Continue to Next Page 1 Updated 04/15/2011 T _ 47 Newton Office (828) 465 -8399 CATAWBA � COUNTY P.O. Box 389 Newton Fax (828) 465 -8962 Newton, NC 28658 Hickory Fax (828) 322 -6814 APPLICATION FOR PLAN REVIEW www.catawbacountyn AND /OR BUILDING PERMIT Describe work to be done under this Permit: L-) P t 1 - _� _� t C -; iii j <,i�AL -- N�cx r►_� TYPE OF WORK ❑New Building ❑ Addition ❑ Alteration ❑ Mixed Add /Alter ❑ Demolition ❑ Accessory Structure ❑ Deck / Porch ❑ Re -Roof ❑ Pier ❑ Repairs ❑ 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 II `' III IV V Etected:(A Unprotected (B) building is designed with specific fire rated construction methods. PROJECT DATA Total Sq F t - 'S Heated Sq Ft Unheated Sq Ft (basement, garage, covered porches, etc) Garage Sq Ft Bonus Rm Sq Ft (finished /unfinished) Basement Sq Ft (finished /unfinished) 1S' Floor Sq Ft 2 nd Floor Sq Ft Exterior Finish Material Total # Rms # of Units # of Stories # Full Bathrooms # Half Bathrooms (Toilet & Sink only) # Bedrooms Building Height Fireplace openings (masonry, prefab /gas, prefab /wood) Type of Heat Type of Foundation �Jt 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 ❑ No 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) Owner / Agent Signature Date Est. Project cost (For Permit) Contractor /Agent Signatur Date 2 Updated 04/15/2011 Fire Only Bldg/Fire— Hickory [ ] H ICKORY County [' O W;. COMMERCIAL ZONING APPLICATION j ~ (A City of Hickory application becomes a permit upon C r Hickory Office (828) 323-7410 approval by a City of Hickory Zoning Administrator) Hickory Fax (828) 323 -7474 County Zoning Office (828) 465 -8380 Parcel Identification No. County Zoning Fax (828) 465 -8484 �7�•�- fllo �$ -G /O Project 911 Address: Date 7,��•2C1Z A`j"�\ '7�; -Tr Jn \{ �� C �L The Proposed Use For This Building Or Land Is (Specific). The Building Or Land Was Previously Used For (Specific): List Physical Changes To Building Or Land: X11, /�\ ► 1. _�y� Is Proposed Land Disturbance Under One (1) Acre? (If applicable) [ ] Yes, Please complete the City of Hickory Application for Grading Permit J- f No, Approval for Erosion & Sedimentation Control Plan from NC Department of Environment and Natural Resources must be forwarded to City of Hickory Engineering Department for plan approval. Applicant: �i� -" � f� Pic Applicant's Telephone No.: 15L �9 Applicant's Address: �� Z \ Y� q Fr�z"lEl �-'� .JL Z"71 b1 Applicant's Fax: _gCX> ` 1 y ` Z c l( Z Applicant's E-mail �l= - (k Property Owner: ii --�� p rtY k �� C PT }��ker's Telephone No.: Owner's Address: Business Name If Different From Above: f' (ALL BUSINESSES OPE G IN THE HICKORY CITY LIMITS MUST HAVE A PRIVILEGE LICENSE) Applicant's Signature Date FOR DEVELOPMENT ASSISTANCE CENTER USE ONLY Change In Use Remodeling Change in Accessory Structure New Construction Home Occupation Manufactured Housing Temp. Const. Office ✓ New Renovations Other: Parkin g/Loading OR ZONING ADMINISTRATOR USE ONLY REFERENCE NUMBER 43 ZONE _PZ— QUADRANT L OVERLAY DISTRIC Front Setback ,Approved PD Rear Setback Size of Lot Approved Minor PD �/ Use Permitted _ Side Setback �� Flood Plain Side Street Setback Elevation Certificate Required 77F Trees Required Airport Ordinance Maximum Height Watershed 1 2 3 4 Protected Other Describe): — — — — Critical Zoning Approve _4oninj Date: � m Conditions of Approval: *No building, structure or zoning lot for which a zoning compliance permit has been issued shall be used or occupied until the Planning Director has, after final inspection, issued a certificate of zoning compliance.* Zoning Disapproved: Zoning Administrator Date: Reasons for Disapproval: CommercialZoni ngAppli cati on04261-1 Donna Ketchersid From: Keith Pace [keith @t2pm.com] Sent: Tuesday, March 06, 2012 11:04 AM To: Donna Ketchersid Subject: Re: WFBH - Hickory MOB Yes, it was a plastic surgeon's office. Sent from my iPhone On Mar 6, 2012, at 9:54 AM, "Donna Ketchersid" < DKetchersid @CatawbaCountyNC.gov wrote: Keith, Was there another business in this space before or is it a brand new space you are going into? Thanks, Donna Donna Wetchersid Catawba County Permit Center TOckory Office 76 ?f Center St., t6ickory, ?fC 28601 'Je ky fWne: 828-4 65 - 7957 Tax: 828 - 322 -6814 dketchersid@cataw6acounr ync 1 Page 1 of 1 North Carolina Licensing Board 1 t Contractors License Detail NUMBER 55222 STATUS Active Name Heartland Contracting, LLC Address 1064 Van Buren Ave. Suite 8 Indian Trail, NC 28079 -5569 County Union Telephone (704) 882 -3004 Renewal Date * January 1, 2012 Limitations Unlimited Classifications Building View Qualifiers * Date of most recent license renewal on record http:// www. nclbec. org /lbecWeb /servlet/LicenseeSearch 03/09/2012 Page I of I North Carolina Licensing Board for General Contractors Qualifier List Heartland Contracting, LLC Moore, W. Don http://www.nclbgc.org/lbgcWeb/servlet/LicenseeSearch 03/09/2012 Sean Greene From: Keith Pace [keith @t2pm.com] Sent: Thursday, March 08, 2012 11:37 AM To: Sean Greene Subject: FW: Catawba County Fee Schedule Attachments: BS Fee Schedule 11 -12 Rev 7- 1- 11_.pdf Here you go. Thanks, Keith Pace Senior Project Manager 5X% 842 West Fourth Street Winston - Salem, NC 27101 keith @t2pm.com p: 336- 793 -8484 x108 c: 336 - 757 -6972 f: 800- 795 -3043 facilitating project success From: Donna Ketchersid < ; e tc` - 1 @CatawbaCountyNC.gov Date: Thu, 8 Mar 2012 11:34:31 -0500 To: Keith Pace < ithnt7nm f- > Subject: Catawba County Fee Schedule Keith, The permit fee is based on the total construction cost, which I have as $129,300. If the cost is any different than this let me know. (See Schedule F on the attached fee schedule). The computer calculated the fee as $574.00. That would include the permit fee of $448.00, a $5.00 placard fee and $121.00 fee for temporary electric. If they do a check, it needs to be made out to Catawba County. If they have not worked in the City of Hickory Jurisdiction, the general contractor and sub - contractors will need to get a privilege license from the City of Hickory. They can call 828 -2- 323 -7424 for an application and cost. Any checks would be for the City of Hickory. The GC can get that when he comes in to get the permit. They are just upstairs on the 2 nd floor. The subcontractor permit fees will be paid separately depending on specific work they will be doing. You can check the fee schedule for each trade. Thanks, Donna Donna Ketchersid Catawba County Permit Center Hickory Office 76 N. Center St., Hickory, NC 28601 Telephone: 828 - 465 -7957 Fax: 828 - 322 -6814 i