Fillable Residential Permit Application (City of Raleigh NC)

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Residential Permit Application (City of Raleigh NC)

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BROWSE CITY OF RALEIGH NC (NC) FORMS

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Residential Permit Application
Development Services Customer Service Center • One Exchange Plaza, Suite 400 | Raleigh, NC 27601 | 919-996-2495
Litchford Satellite Office • 8320 Litchford Road | Suite 130 | Raleigh, NC 27605 | 919-996-4200
Page 1 of 4
REVISION 02.12.19
raleighnc.gov
GENERAL INFORMATION
OFFICE USE ONLY
2018 NC Building Code
Transaction #
Group #
Technician
Applicant:
Date:
Project Address:
Subdivision:
Lot #:
Property Owner:
Property Owner Phone:
Property Owner Email:
Project Contact:
Project Contact Phone:
Project Contact Email:
PROJECT INFORMATION
Choose Work Type(s)
Demolition
Manufactured Home
Stand Alone
Single Family
Dwelling/Duplex
Tree Conservation
Townhome
Water/Sewer Service
Other
Provide a detailed project description:
Site Information
Building Information
Zoning District: _________________________
Overlay District: _________________________
Existing Use: ___________________________
Proposed Use: _________________________
Will impervious surface change? Yes No
Existing impervious (sq. ft.): _______________
Proposed change in impervious (sq. ft.): _______
Proposed total impervious (sq. ft.): ___________
Existing bldg (sq. ft.): ___________
Heated Unheated
Proposed new bldg (sq. ft.): ___________
Heated Unheated
Total bldg size (sq. ft.): ______________
Heated Unheated
Existing height (ft.): _______________
Proposed height (ft.): ______________
Number of stories: ________________
Total construction cost:
Applicant Signature:
2018 Existing NC Building Code
Page 2 of 4
REVISION 02.12.19
raleighnc.gov
MECHANICAL EQUIPMENT QUESTIONS
If the scope of the proposed work consists of replacement of existing mechanical equipment only, and the
answer to ANY of the below questions is “No” then a plot plan is required. See the Residential Plot Plan
Checklist for submission requirements. If the answer to ALL the below questions is “Yes” a permit could be
obtained using the E-Permit process.
1. Is (are) the A/C unit(s) for which the permit is being applied for at the same
location of the old/existing unit?
YES
NO
2. Is (are) the A/C unit(s) for which the permit is being applied for the same size or
smaller (BTU or Tonnage) than the old/existing unit(s)?
YES
NO
3. Is (are) the A/C unit(s) for which the permit is being applied for the same type
(split or package) unit?
YES
NO
LIEN AGENT INFORMATION | www.liensnc.com
NC law requires appointment of a lien agent. Contractors/subcontractors can give notice when they are
working on the project. Lien Agent appointments are not required for improvements under $30,000, or to
the owner’s existing residence, or for public building projects.
PLANS HOLDING POLICY
It is the responsibility of the Applicant to pick up plans after each review cycle. If plans are not picked up
180 days from the last review cycle, they will be considered abandoned and will be destroyed.
RESIDENTIAL INFILL COMPATIBILITY (UDO 2.2.7)
If your project is subject to residential infill compatibility (UDO Section 2.2.7) a foundation survey may be
required with this project. The foundation survey must be available at the time of zoning site inspection.
You are also required to notify property owners within 100 feet on all side of the subject property.
Please select the response that applies to your application:
Yes, this property does qualify as residential infill development
No, this property does not qualify as residential infill development
NOTE:
• If you select yes, you will need to provide unsealed, stamped, addressed envelopes with your
application. For more information about this requirement, visit the Residential Infill webpage.
• If you select no and your application is found to qualify as residential infill, staff will be unable to
complete the review because the application will be deemed incomplete.
• If you are not sure if your property meeting the infill standards, you may complete the
Infill Verification Request form. Please note there is a $45 fee for this request.
Page 3 of 4
REVISION 02.12.19
raleighnc.gov
UNDER PENALTY OF LAW, THE UNDERSIGNED DOES HEREBY CERTIFY, THAT THE SIGNATURE SHOWN
IS THE SIGNATURE OF THE LICENSE HOLDER. THE UNDERSIGNED FURTHER INDEMNFIES THE
CITY OF RALEIGH AND ITS EMPLOYEES AGAINST DAMAGES THAT MAY ARISE DURING THE
CONSTRUCTION PROCESS.
BUILDING
License Holder Name (PRINT):
License Holder Signature:
Contractor:
NC License #/Class:
Address:
City/State/Zip:
Phone:
Email:
Total Project Sq. Ft:
Total Building Cost:
Wake Co. Well/Septic Permit #:
Utilities
Water: Public Private
Sewer: Public Private
ELECTRICAL
License Holder Name (PRINT):
License Holder Signature:
Contractor:
NC License #/Class:
Address:
City/State/Zip:
Phone:
Email:
Voltage
50 or less 600 or less over 600
Total Electrical Cost:
PLUMBING
License Holder Name (PRINT):
License Holder Signature:
Contractor:
NC License #/Class:
Address:
City/State/Zip:
Phone:
Email:
PLUMBING (NFPA 13D Res Sprinklers)
License Holder Name (PRINT):
License Holder Signature:
Contractor:
NC License #/Class:
Address:
City/State/Zip:
Phone:
Email:
MECHANICAL
License Holder Name (PRINT):
License Holder Signature:
Contractor (HVAC):
NC License #/Class:
Address:
City/State/Zip:
Phone:
Email:
Type of
Heating
Electrical Gas Hot Water Oil
Air Condition Size in Tons:
Work
Includes
Appliances Appliance/Duct Ventilation Refrigeration Fuel Piping
ZONING
Contractor:
Phone:
Email:
Address:
City/State/Zip:
Type of
Work
Accessory Structure
Solid Waste/Recycling
Fence/Wall/Retaining
wall
Landscaping
Parking Lot
Site Plan
Swimming Pools
Other
URBAN FORESTRY
Contractor:
Phone:
Email:
Address:
City/State/Zip:
Type of
Work
Tree Conservation Area
Tree Buffer Protection
Tree Pruning (TCA)
Tree Removal (TCA)
Tree Impact (Right-of Way)
Prop. Street Trees (Right-of-Way)
Page 4 of 4
REVISION 02.12.19
raleighnc.gov
LAND DISTURBING/FLOOD
Contractor:
Phone:
Email:
Address:
City/State/Zip:
Total Disturbed Area (sq. ft.):
Construction Cost:
Flood Contractor:
Phone:
Email:
Address:
City/State/Zip:
RIGHT-OF-WAY
Contractor:
Phone:
Email:
Address:
City/State/Zip:
Performance Bond and General Liability on file with City? Yes No
NOTE: Permits for work within the right-of-way cannot be issued without bond.
Type of Work
Driveway new/mod
Number of Driveways:
Sidewalk/Curb and
Gutter new
Linear feet:
Utility Service Installation
Number of cuts:
Sidewalk Obstruction
Start Date (m/d/yy):
Duration (Days):
Lane Obstruction
Start Date (m/d/yy):
Duration (Days):
Street Obstruction (Full
Closure)
Start Date (m/d/yy):
Duration (Days):
UTILITY CONNECTION (Plumbing Utility, Stub, and Right-of-Way Permit may be required)
Contact Person:
Phone:
Email:
Address:
City/State/Zip:
Tap will be installed by
: City
Contractor
Property:
Residential Commercial
Type of Service
Water
Sewer
Irrigation
New Meter
Split Meter
Size of Meter
UTILITY SERVICE (Water and Sewer service in Right-of-Way or Easement for Single Parcel)
Contractor:
Phone:
Email:
Address:
City/State/Zip:
Performance Bond and General Liability on file with City?
Yes No
NC License #/Class:
Water Size
Type
Sewer Size
Proposed Stub Location
Easement or Right-of-Way (req. Right-of-Way Permits)
Easement or Right-of-Way (req. Right-of-Way Permits)
Easement or Right-of-Way (req. Right-of-Way Permits)
Easement or Right-of-Way (req. Right-of-Way Permits)
If utility services for multiple parcels are needed please use the Water & Sewer Service Addendum
Plumbing Utility (Water and Sewer line from Right-of-Way to Foundation)
Contractor
Phone
Email
Address
City/State/Zip
Water Service (From Meter to five feet of
foundation):
Sewer Service (From property line to ten feet of
foundation):
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Residential Permit Application (City of Raleigh NC)

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Completed 14 July 2020

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