Fillable Residential Permit Application

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Residential Permit Application

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Residential Permit Application
Planning and Development Customer Service Center • One Exchange Plaza, Suite 400 | Raleigh, NC 27601 | 919-996-2500
Page 1 of 5
REVISION 12.31.20
raleighnc.gov
GENERAL INFORMATION OFFICE USE ONLY
NC Building Code 2018
NC Existing Building Code 2018
Case #:
Technician:
Applicant (print name): 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)
Accessory Dwelling Unit
Accessory Structure
Addition
Alteration/Repair
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: _________________________
Required parking: _______________________
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:
This form is required when seeking a Residential Building Permit and/or Zoning Permit approval for development
activity associated with a single-family or two-family dwelling unit. See the Residential Tier One Site Plan Checklist
for submission requirements.
Page 2 of 5
REVISION 12.31.20
raleighnc.gov
MECHANICAL EQUIPMENT QUESTIONS
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
ACCESSORY DWELLING UNIT (ADU) INFORMATION
An Accessory Dwelling Unit (ADU) is a self-contained dwelling unit that is located on the same lot as a principal
dwelling that meets the regulations identified in UDO Section 2.6.3.D. An ADU may be located above a
garage. ADUs may be detached, attached, or internal to the principal dwelling and accessed separately from
the principal dwelling. Only residential uses are permitted in ADUs.
If the scope of the proposed work includes an ADU select the option that best describes the type of
ADU proposed and include a floor plan with the submission:
Detached: Construction of an ADU separate from the principal use
Attached: Construction of an ADU as an add-on to the principal use
Change of use: Conversion of an existing accessory structure into an ADU
Alteration: Conversion of an area within the existing principal use into an ADU
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 must comply with residential infill compatibility (UDO Section 2.2.7) it will be subject to
more restrictive setback and height requirements. A foundation survey may be required for this
project. For more information about residential infill compatibility visit the Residential Infill web page.
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 are not sure if your property meets the infill standards, you may submit an Infill
Verification request form via the Permit and Development Portal.
• There is a $45 fee for this request.
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 Tier One Site Plan is required. See the Residential Tier
One Site 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.
Page 3 of 5
REVISION 12.31.20
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):
Contractor:
Address:
Phone:
Total Project Sq. Ft:
Total Building Cost:
Wake Co. Well/Septic Permit #:
Utilities
Water: 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
Page 4 of 5
REVISION 12.31.20
raleighnc.gov
ZONING
Contractor:
Phone:
Email:
Address:
City/State/Zip:
TYPE OF WORK
Accessory Dwelling Unit
Accessory Structure
Fence/Wall/Retaining Wall
Landscaping
Parking Lot
Solid Waste/Recycling
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)
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:
Page 5 of 5
REVISION 12.31.20
raleighnc.gov
UTILITY CONNECTION PERMIT
This permit is for establishing new water or sewer service at a parcel that has not previously been served.
Water
Sewer
Irrigation
1. Is new service being established?
For irrigation, indicate if service is a split service.
Yes
No
Yes
No
Yes
No
Split
2. Do new taps need to be constructed from the main to the
property line? If no new taps are to be constructed, skip #3.
Yes
No
Yes
No
Yes
No
Split
3. Who will install the taps? (enter city or contractor)
4. What size are the new water and sewer services?
(Most common water size = ¾” / Most common sewer size = 4”)
NOTE: The City will not install services where the roadway width is greater than 48’ or for new construction.
Contractor installed permits require stub permits below and may also require right-of-way permits.
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):
STUB PERMIT
This permit is for construction for a new connection to a water or sewer main.
Water Size
Sewer Size
Irrigation Size
Contractor name:
Phone:
Email:
Address:
City/State/Zip:
Performance bond on file:
NC License #/Classification:
General Liability on file:
Is Sewer connection in Easement or Right of Way? Easement Right-of-Way None
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Residential Permit Application

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Completed 5 January 2021

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