Permit Application


Application Name _________________________________ Date______________
Project Address ______________________________________________________
Total Project Cost_________________ Electrical Cost________________________
Subdivision ____________________ Block No. ___________ Lot No.___________

Developer_______________________________ Telephone No.________________
Property Owner___________________________ Telephone No.________________
Address _________________________________ City________________________ State______Zip _________

Project Contact Person _____________________ Telephone No.________________
Address _____________________________ City____________________________
State__________ Zip _________

Description of Proposed Work____________________________________________ 
Type of Building ____New ____ Existing ____ Addition _____ N/A
Type of Construction _ ___ I ____II ____ III ____IV ____V
Occupancy ___ A-1 ___ A-2___ A-3 ___ A-4 ___ A-5 ____B ____E ____F-1 ___ F-2 ____H-1 ____ H-2 ____ H-3 ____H-4 ____ H-5
____ I-1 _____I-2 ____ I-3 ____I-4 _____M
____R-1 _____R-2 ____R-3 ____R-4 ____S-1 ____S-2 _____U ______ Mixed

Equipment: ____ New ____Existing ____ Addition ____ N/A
Property Use: ______ Single Family _____ Two Family
______ Apartment ______ Condominium
_______ Townhouse ______ Other ( Library, Office, Etc.)

Building Area: Total Area sq. ft. _________ Area per floor sq. ft._______
Building Height: ________ Feet No. Of Stories_________


State Agency Approvals:
NC Department of Insurance Yes____ No______ N.A. ______
Plan Approval ________ #of Sheets _______ Date _________
Specifications __________ # of Sheets ______ Date _________
NC Department of Labor Yes______ No______ N.A. _____
Elevators Date _________ Boilers______ Date_____



Utilites:
Water: ______Public ______ Private ______ Private Health Dept. Permit # ________
Sewer _______ Public _______ Private _______ Private Health Dept. Permit # _______

Place X and complete additional Information for each permit type needed

__ General Construction Permit
Contractor Name _______________________________ Telephone ______________
Address_______________________ City _______________ State______ Zip______
License #________________ Classification_________________
Design Professional_________________________ Telephone #_________________
________ Architect ________ Engineer NC Reg. #___________
_______ Owner ________ Other
Address_______________________City__________________State______ Zip_____

__ Electrical Permit 
Contractor Name _______________________________Telephone #______________
Address_______________________ City _______________ State______ Zip______
License #________________ Classification_________________
Design Professional_________________________ Telephone #_________________
________ Architect ________ Engineer NC Reg. #___________
_______ Owner ________ Other
Address_______________________City__________________State______ Zip_____

__ Mechanical Permit
Contractor Name _______________________________Telephone #______________
Address_______________________ City _______________ State______ Zip______
License #________________ Classification_________________
Design Professional_________________________ Telephone #_________________
________ Architect ________ Engineer NC Reg. #___________
_______ Owner ________ Other
Address_______________________City__________________State______ Zip_____


__Plumbing Permit
Contractor Name _______________________________Telephone #______________
Address_______________________ City _______________ State______ Zip______
License #________________ Classification_________________
Design Professional_________________________ Telephone #_________________
________ Architect ________ Engineer NC Reg. #___________
_______ Owner ________ Other
Address_______________________City__________________State______ Zip_____




__Sprinkler Protection Permit
Contractor Name _______________________________Telephone #______________
Address_______________________ City _______________ State______ Zip______
License #________________ Classification_________________
Design Professional_________________________ Telephone #_________________
________ Architect ________ Engineer NC Reg. #___________
_______ Owner ________ Other
Address_______________________City__________________State______ Zip_____

__Fire Alarm System Permit
Contractor Name _______________________________Telephone #______________
Address_______________________ City _______________ State______ Zip______
License #________________ Classification_________________
Design Professional_________________________ Telephone #_________________
________ Architect ________ Engineer NC Reg. #___________
_______ Owner ________ Other
Address_______________________City__________________State______ Zip_____

__Sign Permit
Location of Sign__________________ Address_______________________________
___ Off Premises Sign ____ Wall Sign ____ Ground Sign _____ Awing Sign 
___ Projection Sign ____ Special Event Sign ____ Other \
Sign/Business Owner__________________________ Telephone #_______________
Address ______________________ City _________________ State_______ Zip____
Contractor Name _____________________________ Telephone # _______________
Address_______________________ City_________________ State_____ Zip_____

__Accessory Structures Permit 
____ Accessory Building Size__________ sq. ft.
_____ Solid Fence _____ Dish Antenna _______ Swimming Pool _____ Other

I hereby certify that all information in this application is correct and all work will comply with state Building Code and all other applicable State and local laws and ordinances and regulations. The Inspection Department will be notified of any changes in the approved plans and specifications for the project permitted herein




Owner/ Agent Signature________________________________________