Manufactured Hme Permit Applicatin Review Prcess Cntact Infrmatin Currituck Cunty Planning and Cmmunity Develpment Central Permitting Divisin Mainland Office 153 Curthuse Rad, Suite G107 Mainland : 252.232.3378 Currituck, NC 27929 Mainland Fax: 252.232.3470 Crlla Office 1123 Ocean Trail Crlla : 252.453.8555 PO Bx 73 Crlla Fax: 252.453.8300 Crlla, NC 27927 Website: https://www.c.currituck.nc.us/permits-inspectins Step 1 Applicatin Submittal The applicant must submit a cmplete applicatin packet. A cmplete applicatin packet cnsists f the fllwing: Cmpleted Currituck Cunty Manufactured Hme Permit Applicatin Permit Fee(s) (paid at permit issuance) Cnstructin Plans fr mdulars, decks, prches, r rm additins Site Plan, if required (replacement mbile hmes in a mbile hme park d nt require a site plan) Minr Strmwater Plan and Frm SW-001, if required Septic/Sewer Apprval (wastewater imprvements permit, existing septic system inspectin, r wastewater reservatin) Well Permit, if required CAMA Permit, if required V Fld Zne certificate, if required Appintment f Lien Agent, if required Submittal Checklist The cnstructin f 2 3 x3 landings with stairs are included in the manufactured hme permit. Decks, prches, r rm additins require plans and specificatins. Step 2 Permit Review The cunty staff will review the applicatin fr cmpleteness and cde cmpliance. Once all requirements are met and permit fees are paid the permit will be issued. Apprved permits must be signed by the wner r applicant. Step 3 Psting f Permit and Plans Building permits must be psted at the cnstructin site and clearly visible frm the rad. One set f apprved plans (mdulars, decks, prches, additins) and set-up manual (mbile hmes) must be n the jbsite fr all inspectins. Step 4 Inspectins Inspectins must be scheduled by 4:00 pm ne business day befre the requested inspectin. Inspectins are perfrmed between 8:00 am and 5:00 pm, Mnday thrugh Friday. The required inspectins will vary fr each prject; please review the Inspectin Handbk fr inspectin types. Page 1 f 7
Manufactured Hme Permit Applicatin Applicatin Frm Cntact Infrmatin APPLICANT: PROPERTY OWNER: Telephne: Telephne: Mbile: _ Mbile: E-Mail : _ E-Mail : Prject Infrmatin ESTIMATED PROJECT COST: $ Physical Street : Parcel Identificatin Number(s): Subdivisin: Year Size Make Mdel Serial Number # f Bedrms # f Bathrms Wind Zne Permit Classificatin Singlewide Dublewide Triplewide Mdular, n frame Mdular, ff frame Other Additinal Prject Infrmatin Pl Pier/Bulkhead Elevatr Ht Tub Other Des this prject include installatin f a gas line, appliance, r equipment? Will this hme replace an existing hme n the prperty? Yes N Is this prject within 75 feet f a waterway? Yes N Are yu building a deck r prch? Yes N Yes N Will the natural cntur f the prperty be mdified by grading r filling higher than adjacent grades? Yes N (If yes, strmwater plan required fr develpment). Wh will set-up the MODULAR hme? Owner Licensed General Cntractr Square Ftage Heated Living Prch Deck Misc. TOTAL Other, prvide an riginal $5,000 surety bnd in accrdance with NCGS 143-139.1 The permit is null and vid if wrk r cnstructin authrized under this permit is nt cmmenced within 6 mnths, after cmmencement f wrk n required inspectin is requested and apprved within any 12-mnth perid, r fr substantial deviatins frm plans. I hereby certify that I have read and examined this applicatin and knw the same t be true and crrect. All prvisins f laws and rdinances gverning this type f wrk will be cmplied with whether specified herein r nt. The granting f the permit des nt presume t give authrity t vilate r cancel the prvisins f any ther state r lcal law regulatin, cnstructin, r the perfrmance f cnstructin. _ Printed Full Name f Applicant Signature f Applicant Date OFFICIAL USE ONLY: Building Permit Number Type f Water: CAMA Number... Septic Permit Number: Zning f Prperty: Fld Zne: BFE: DFE: Max % Cverage: Min Setbacks: Frnt Side (R) Side (L) Rear _ Page 2 f 7
Cntractr f Recrd Cntractr f Recrd MH Set-up Cntractr Name NC License # Mving Cntractr Name NC License # Building Cntractr Name NC License # Electrical Cntractr Name NC License # Mechanical Cntractr Name NC License # Plumbing Cntractr Name NC License # Gas Cntractr Name NC License # Other Cntractr Name NC License # OWNER CONTRACTOR As wner f the prperty, I intend t retain the finished prject exclusively fr my wn use and will ccupy the prperty fr at least ne year fllwing the cmpletin f cnstructin. I understand that it is my respnsibility t btain wrkers cmpensatin insurance, if necessary. I will cntract with a Nrth Carlina licensed electrical, plumbing, mechanical, and gas cntractr fr this prject unless therwise nted. As wner f the prperty, I will cmplete the fllwing: Set-up General/Building Electrical Mechanical Plumbing Gas Signature f Prperty Owner Date Page 3 f 7
Cntractr Affidavit Cntractr Affidavit Please submit the signed affidavit with the permit applicatin. STATE OF NORTH CAROLINA COUNTY OF CURRITUCK CONTRACTOR AFFIDAVIT General Electrical Mechanical Plumbing Gas Cntractr Infrmatin License Hlder: Name f Business: Business : : Email: License Infrmatin NC License Number: License Classificatin: Prject Infrmatin Prject : Building Permit Number: Cst f Trade Wrk: $ Scpe Of Wrk I am licensed and qualified t assume all respnsibility and ability as a cntractr n this prject. If I resign r am n lnger affiliated with this prject, I will ntify the Currituck Cunty Central Permitting Divisin in writing within three wrking days. I understand that it is my respnsibility t btain wrkers cmpensatin insurance, if necessary. Signature f License Hlder Date Cntractr Affidavit Revised 7/18/18
Prperty Owner Affidavit Owner Exemptin Affidavit Pursuant t Nrth Carlina General Statutes 87-14(a)(1) STATE OF NORTH CAROLINA COUNTY OF CURRITUCK OWNER EXEMPTION AFFIDAVIT PURSUANT TO GS 87-14(a)(1) Prperty r PIN: I,, hereby claim an exemptin frm licensure under G.S. 87-1(b)(2) by initialing the relevant prvisins in paragraph 1 and initialing paragraphs 2-4 belw and attesting t the fllwing: 1. I certify that I am the wner f the prperty set frth abve n which this building is t be cnstructed r altered. OR 2. I am legally authrized t act n behalf f the firm r crpratin which is cnstructing r altering this building n the prperty wned by the firm r crpratin as set frth abve (name f firm r crpratin):. 3. I will persnally superintend and manage all aspects f the cnstructin r alteratin f the building and that duty will nt be delegated t any persn nt duly licensed under the terms f Article 1 f Chapter 87 f the General Statutes f Nrth Carlina. 4. I will be persnally present fr all inspectins required by the Nrth Carlina State Building Cde, unless the plans fr the cnstructin r alteratin f the building were drawn and sealed by an architect licensed pursuant t Chapter 83A f the General Statutes f Nrth Carlina. 5. I understand that a cpy f this AFFIDAVIT will be transmitted t the Nrth Carlina Licensing Bard fr General Cntractrs fr verificatin that I am validly entitled t claim an exemptin under G.S.87-1(b)(2) fr the building cnstructin r alteratin specified herein. I further understand that, if the Nrth Carlina Licensing Bard fr General Cntractrs determines that I was nt entitled t claim this exemptin, the building permit issued fr the building cnstructin r alteratin specified herein shall be revked pursuant t G.S. 153A-362 r G.S. 160A- 422. Signature f Affiant Date Swrn t (r affirmed) and subscribed befre me this the day f, 20. Signature f Ntary Public Printed Name f Ntary Public My cmmissin expires: Nte: This affidavit is used fr cnstructin prjects that exceed $30,000. any affidavit taken pursuant t law G.S. 14-209. (Ntary Stamp r Seal) It is a Class F felny t willfully cmmit perjury in Page 5 f 7
Appintment f Lien Agent Appintment f Lien Agent Pursuant t Nrth Carlina General Assembly Law 2012-158 Nrth Carlina law requires an wner r cntractr acting n the wner s behalf t appint a lien agent when they first cntract fr imprvements t real prperty. A lien agent is nt required fr the fllwing: a. Imprvements less than $30,000 at the time the riginal building permit is issued; b. Imprvements t an existing single family residential dwelling as defined in GS 87-15.5 (7) that is used by the wner as a residence; c. The first furnishing f labr r materials at the site is prir t April 1, 2013; r, d. Public building r ther public wrk r public imprvements. Lien Agent Infrmatin Name f Lien Agent: Mailing f Agent: Physical f Agent: : Fax: Email: A website was created t facilitate the filings f appintments f lien agents and filing f ntices t lien agents by ptential lien claimants at www.liensnc.cm. When an wner r cntractr acting n the wner s behalf appints a lien agent thrugh the LiensNC system, it will generate an Appintment f Lien Agent dcument r frm fr the prperty and prject. The dcument will include: Designated lien agent and cntact infrmatin Unique entry r identifying number fr the prject Owner and cntact infrmatin Cntractr Instructins fr the wner and/r cntractr t pst at the prperty and prvide t the permitting ffice QR Cde fr easy access t the prperty infrmatin in the LiensNC system NOTICE: A cpy f the Appintment f Lien Agent frm r dcument printed frm the LiensNC website can be included in the building permit applicatin submittal in lieu f this frm and must be psted at the jb site. Page 6 f 7
Submittal Checklist Submittal Checklist Residential Manufactured Hme Permit Submittal Checklist Applicatins/Frms/Permits 1 Residential Manufactured Hme Permit Applicatin Frm 2 Wastewater apprval r permit New Septic: Cnstructin imprvements permit (ARHS) Existing Septic: Existing system inspectin (ARHS) Central Sewer: Sewer reservatin frm (peratr f central system) 3 Well Permit, if required (ARHS) 4 Cntractr f Recrd Frm 5 Cntractr, Trades, and/r wner affidavit(s) 6 CAMA permit, if required 7 V- Zne Certificate (if develpment is lcated in VE fld zne) 8 Fundatin Certificatin (if chassis is 36 inches r mre abve grade) 9 Appintment f Lien Agent, if required (www.liensnc.cm) 10 Minr Strmwater Plan Frm SW-001, if required Plans 11 One cmplete PDF set f detailed mdular plans 12 One cmplete PDF set f detailed building plans (decks, prches, rm additins) Name, address, and signature f plan designer Fundatin Plan (sizes and spacing): Fld vent penings (SFHA nly) Flr plan Building elevatins Typical wall sectins (sizes and spacing) Design pressure rating Wind ratings (130mph wind zne) 13 Site plan (if lt is 20,000 square feet r smaller the site plan must be prepared by a licensed surveyr, engineer, r architect) Lt/parcel dimensins Lcatin f existing physical features (rads, streets, navigable waterways) Lcatin and dimensins f the prpsed cnstructin and existing structures Setback measurements t all prperty lines Septic system, repair area, and well lcatins Prpsed fill r grade changes 14 Minr Strmwater Plan, if required Fld Damage Preventin, if Applicable 15 Bundary f the Special Fld Hazard Area (SFHA), Fldway, Castal Barrier Resurce System (CBRS) Area, water curse relcatin, r a statement that the entire lt is within a specific SFHA. 16 Prpsed elevatin f all structures and utility systems 17 Plans fr nnstructural fill (if being utilized in V zne) Fees 18 Permit fees t be paid at permit issuance Page 7 f 7