RESIDENTIAL/COMMERCIAL Permit #
Town of Burgaw Inspections Department
Building Permit Application
109 N. Walker St. · Burgaw · NC · 28425 · 910-663-3452
PROJECT ADDRESS (Physical Job Location):
Owner’s Name:
Phone:
Address:
Mobile:
City/State/Zip:
Email:
CONTRACTOR INFORMATION: (If Home Owner is performing work, write “self”)
NAME OF BUSINESS:
Office #:
Contractor License#
Mobile #:
Project Contact Name:
Email :
Building:
Total Sq. Ft. _, # of Stories , Stories Below Ground , Above Ground ; Sq. Ft. per Floor / / _;
Description :
ELECTRICAL Contractor:
Office #:
Email address:
Mobile #:
Service Amp _________ No. of outlets ________
Description
MECHANICAL Contractor:
Office #:
Email address:
Mobile #:
License #:
No. of units ____ Walk in cooler____ Commercial Hood _____
Change out with duct work _____ Change out without duct work_____
Description
PLUMBING Contractor:
Office #:
Email address:
Mobile #:
License #:
Number of fixtures___________
Description
Gas Contractor:
Phone #:
Email address:
Phone #:
License #:
__Nat Gas __LP Gas (drawing may be required) System Pressure ______
Pipe type _________ Pipe length total ______ Total BTU on system
Description
Owner/Agent: Date
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