www.meckpermit.com
Please Choose one:
OnSchedule
or
Revised 11-1-07 page 1/4
Fax: 704-602-6968
Express Review
Please choose all that apply:
[
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Upfit
Renovation
Addition
Professional Certification
Rehab
Change of Use
Daycare
Char/Meck School Project
CMC Project
[ ] New Construction (Full)
[ ] New Construction (Footing/Foundation)
[ ] New Construction (Shell w/F/F)***
[ ] New Construction (Shell w/F/F previously approved)***
[ ] New Construction (Shell/Core w/F/F)
[ ] New Construction (Shell/Core w/F/F previously approved)
[ ] Revision to approved plan, original project # ___________**
[ ] Pre-Engineered Metal Buildings Option A or Option B
***Limited Conditional Power Application must be submitted
**If this project is Revisions to Approved Plan, please name the reviewers who did the original review:
Please include a scope letter specifically outlining the changes made and the trades affected
______________________________________________________________________________________
Phased Construction: For projects that will have phases, it is required this information be provided at this point. The
construction drawings must clearly reflect the different areas in each phase, whether different areas will be occupied during
construction, and a permit application must be completed for each phase in the construction. The permit applications must be
submitted at time of plan submittal.
Does this project include phases? Yes No
If Yes, will any phase be occupied during the construction of another phase? Yes No
[ ] Preliminary Review – Circle Requested Trade(s): Bldg Elec M/P Zoning Fire Health Backflow
If you have selected Preliminary Review, please circle:
Schedule Preliminary Review Only
or
Schedule Preliminary Review & Schedule Plan Review
In order to best utilize meeting time, an agenda for the preliminary review must be submitted with this application.
The meeting will not be scheduled until an agenda is received.
Have you had a preliminary review on this project? YES NO If so, please name the reviewers:
_____________________________________________________________________________________________
If a preliminary review has been completed or requested, please make the following choice:
First Available Date
or
Same Review Team
A signed Address Verification form must accompany this application in order for an appointment to be scheduled.
To obtain an address verification form, go to www.meckpermit.com, Commercial Plan Review Services, Address
Verification(on left side) or fax a request to 704-336-7333. Request can be the first page of this application. Please
call Addressing at 704-336-6175 with questions.
Date construction drawings will be ready for review: __________________________________
Project Information:
Confirmation Preference (circle one):
Phone
Email*(Must provide below)
Project: ______________________________________________ Date: __________________________
Address: _____________________________________________ Suite#/Floor:_____________________
Tax Parcel #: ___________________________
Contact Person MUST be the Architect of Record.
If an Architect is not part of the project, it must be the Designer of Record.
If the project is not required to be sealed or is not sealed, it must be the Project Manager.
Contact Person Name: __________________________________
Phone # _____________________ Fax # _________________
Company:________________________
E-Mail:__________________________*
Page 2 of 4
Code to Reviewed Under:
2006 NC Bldg Code
2006 NC Rehabilitation Code
2006 NC Bldg Code Chapter 34 Original code building built under: _____________
Type of Construction: (circle one) I-A
I-B
II-A
II-B
III-A
III-B
IV
V-A
V-B
Building Height: _______Feet _______ Number of Stories [ ] Unlimited per __________________
Mezzanine: (circle one) NO YES
High Rise: (circle one) NO
YES
Are Special Inspections required for this project? YES NO
Project Designers of Record:
Person
Firm
Email
Owner
Architectural
Structural
Electrical
Mechanical
Plumbing
Fire Protection
Site Work
Building Occupancy: (New) (circle all that apply)
Primary Occupancy:
Assembly
A-1
Business
Educational
High-Hazard: H-1
Institutional: I-1
Residential:
R-1
Storage:
S-1
Utility and Miscellaneous
A-2
A-3
Mercantile
H-2
H-3
I-2
I-3
R-2
R-3
S-2 High Piled
Parking Garage:
A-4
A-5
Factory/Industrial
F-1
F-2
H-4
H-5
I-4
I-3 Use Condition 1 2 3 4 5
R-4
(Identify what is being stored)____________________
Open Enclosed Repair
Secondary Occupancy: ____________________________________________________________________
Special Occupancy: Yes No 508.2 508.3 508.4 508.5 508.6 508.7
Mixed Occupancy:
No Yes Separation: ___________ Hr. Exception: _______________________
If Mixed Occupancy is Yes, please choose one: Non Separated Mixed Occupancy Separated Mixed Occupancy
Square ft. of overall building: ____________________ Square ft. to be reviewed: ____________________
Is this an increase of usable square footage? YES
NO Amount of Increase:______________________
Number of Buildings to be reviewed: ________________________________
Number of stories of overall building: ____________ Does Building have a Basement? _____________
Estimated Project Cost: ________________________
Gross Building Area:
Floor
Existing (SQ FT) Renovation (SQ FT)
New (SQ FT)
Sub-Total (SQ FT)
6th Floor ______________________________________________________________________________
5th Floor ______________________________________________________________________________
4th Floor ______________________________________________________________________________
3rd Floor ______________________________________________________________________________
2nd Floor ______________________________________________________________________________
Mezzanine ____________________________________________________________________________
1st Floor ______________________________________________________________________________
Basement _____________________________________________________________________________
TOTAL
Plumbing Fixture Requirements
Occupancy
Waterclosets
Male
Female
Urinals
Lavatories
Male
Female
Showers/Tubs
Drinking Fountains
Regular
Accessible
Page 3 of 4
Fire Information:
Does this submittal include fire alarm and or sprinkler shop drawings? YES NO
Is the building sprinklered? (circle one) YES
NO
Type of System: NFPA 13
13R
13D
Does the building have a standpipe? (circle one) YES
NO Class of system: I II III WET DRY
Does the building have a fire pump? (circle one) YES
NO if Yes, new or existing? ___________
Does the building have an elevator? (circle one)
YES
NO
Does the building have a smoke detection system? (circle one) YES
NO
Does the building have a fire alarm system? (circle one) YES NO
Backflow Information:
Circle type of outdoor underground piping work proposed in project: none /new/replacement/extension / alteration
Circle type of fire sprinkler piping work proposed in project: none / new / replacement / extension / alteration
Are you installing a CMUD required Backflow Preventer? Yes No
Zoning Information
Type of Business (Be Specific. ie: office, clinic, retail – clothing store, restaurant, etc)
(Previous Type of Business)_______________________(Proposed Type of Business) ______________________
Zoning of the Site*:___________*(For Zoning information: http://maps2.co.mecklenburg.nc.us or 704-3363569)
Health Department: (circle all that apply)
Facility Type: [ ] Restaurant
[ ] Lodging/Hotel
[ ] Bar Service w/o food
[ ] Seafood/Deli
[ ] Adult Day Care
[ ] Meat Market
[ ] Water Recreational/Pool
[ ] Child Daycare _______# of Children
[ ] Other ___________________________
Seating Capacity: _______________ Utensil type for customer :[ ] disposable [ ] reusable
Health Department Checklist must accompany plans when submitted to the gatekeeper (attached)
Water/Sewer: (Must answer)
Do you have an existing septic tank system? [ ] Yes [ ] No
Are you installing a new septic tank system? [ ] Yes[ ] No
Do you have an existing well? [ ] Yes
Are you installing a new well? [ ] Yes
[ ] No
[ ] No
City of Charlotte Applicants, Only
Yes
No
□
□
Is this zoned Urban (UMUD, MUDD, PED, TOD, TS)? If yes, please provide
the City of Charlotte’s tracking number.______________________________
□
□
Is this Planned Multi-Family? If yes, please provide the City of Charlotte’s tracking
number.______________________
□
□
Does this site adjoin a new Public Street? If yes, please provide the City of Charlotte’s tracking
number.________________________
□
□
Does this site require detention, grading, landscaping or work in the City’s right of way? If yes,
please provide the City of Charlotte’s tracking number.____________________
*If you answered YES to any of the above questions and have not begun the City of Charlotte’s review process for
this project, please call the City of Charlotte’s Land Development office (704-336-6692) for instructions on how to
proceed.
Description of proposed work: Note: Failure to accurately describe work may lead to expulsion from
review:_____________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Revised 4-14-04
OnSchedule
4 of 4
Electrical Data Sheet
Project Name:
Check All That Apply, Fill in the Appropriate Blanks
New Service(s)
#
Amps (Rating)
Volts
New Panels**
#
Amps (Rating)
Volts
Existing Affected Panels
#
Amps (Rating)
Volts
Existing Affected Circuits
#
Amps (Rating)
Volts
New UPS
#
KVA (Rating)
Volts
New Transformers
#
KVA (Rating)
Volts
New Generators
#
KVA (Rating)
Volts
Volts
New Motors
#
H.P. (Rating)
New Appliances
#
(Approx) KVA
New Heat/AC Units
#
(Approx) KVA
New Lights
#
(Approx)
Pools/Spas/Hot Tubs
#
(Approx)
Welders
#
(Approx)
Elevators
#
(Approx)
Cranes
#
(Approx)
Fire Alarm Devices
#
(Approx)
New Receptacles (Computer)
#
(Approx)
New Receptacles (Dedicated)
#
(Approx)
New Receptacles (Gen Use)
#
(Approx)
Classified Areas: Describe in detail (Attach Sheets if Needed)
General Description: (Attach Sheets if Needed)
Designer Signature/Electrical Firm
Date/Phone
** If you have multiple panels and/or circuits, please use the space provided below.
New Panels
Existing Panels
#
Amps (Rating)
Volts
New Panels
Existing Panels
#
Amps (Rating)
Volts
New Panels
Existing Panels
#
Amps (Rating)
Volts
New Circuits
Existing Circuits
#
Amps (Rating)
Volts
New Circuits
Existing Circuits
#
Amps (Rating)
Volts
New Circuits
Existing Circuits
#
Amps (Rating)
Volts
NOTE: Failure to accurately describe proposed work will result in expulsion from review.
Mecklenburg County
Health Department
E. Winters Mabry, MD
Director
(704) 336-4700
Mecklenburg County Environmental Health / Food Service Plan Review Checklist
The following information shall be submitted along with any plan being received by LUESA:
Commercial Plan Review for purposes of obtaining food service review approval.
___ Food & Beverage Menu
Water/Sewer Equipment
___ ¼” to 1’.0” Equipment Floor Plan
___ Interior & Exterior Seating Diagram
__Define Smoking and Non-Smoking Zones
___ Food Establishment Plan Review
Application*
___ Dry and Refrigeration Storage
Calculation Sheet*
___ Food Equipment Specification Sheets or
Equipment Schedule Listing Make and
Models
___ Site Plan Showing: __Dumpster,
__Recycling, __Grease Waste Containers
___ Location of Private or Municipal
___ Interior Finish Schedule; Including
Material Composition
Plumbing Needs;
__Supply & Waste Lines
__Hot Water Generator Make and Model
__Drain Receptor Type and Location
__Grease Interceptor Calculations
__36” x 36” Floor Mounted Can Wash
__Employee Hand Wash Every Work Area
Important: Trade (i.e. B/E/M/P) coordination with submitted Kitchen Equipment drawings is very
important and will be evaluated by this Department for accuracy during each review.
*PDF available on-line under “Plan Review Section”
(Pathway) www.charmeck.org/Departments/Health+Department/Environmental+Health/Home/
Food Service Plan Review Submittal questions should be directed to Jody Throckmorton, RS at
(704) 336-5505 or by email jody.throckmorton@MecklenburgCountyNC.gov
I certify all the items above necessary to this project are in this submittal
package.
____________________________
Print Name (Architect of Record)
______________________________
Project Name
____________________________ ___________ __________________
Signature (Architect of Record)
Date
Phone Number
PEOPLE • PRIDE • PROGRESS • PARTNERSHIPS
Seal
Environmental Health Division • 700 N. Tryon Street, Suite 208 • Charlotte, NC 28202
MECKLENBURG COUNTY
Land Use and Environmental Service Agency
Code Enforcement
Limited Conditional Power Connect Request Form
Limited Conditional Power (LCP) is used primarily, but not exclusively, to maintain environmental conditions
on buildings where a CO or TCO have not been issued, i.e. a building not approved for occupancy.
LCP use in connection with mechanical permits is limited by Department policy on shell buildings (i.e. heating
to 40 degrees and no cooling). Please contact the Mechanical Code Administrator in this instance.
The electric permit must be finaled before the utility company of record will be notified. If the permit is part
of an “active” building, the owner, owner’s representative (with written authorization from the owner) will be
required to submit this application for the power connection.
Electrical Permit Number: E ____________________________________________________________
Project Address: _______________________________________________________________________
Limited Conditional Power Connect (please initial each space)
a) I acknowledge responsibility for any outstanding holds.
b) I acknowledge that LCP does NOT grant occupancy.
c) I acknowledge that LCP shall be terminated if:
- there is an illegal occupancy.
- there is misuse of the LCP agreement.
- there is a hazardous condition imposing safety conditions.
d) I acknowledge that a placard will be posted conspicuously on site,
with a note “not to remove” stating the conditions of the LCP.
YES _____
YES _____
YES _____
YES _____
The LCP fee charge is determined by the number of square feet on the building. These fees will be charged to
the General (Building) Contractor. The fee schedule for LCP is as follows:
• Less than 3,000 sq. ft. = $90
• From 3,000 sq. ft. to 10,000 sq. ft. = $100
• Greater than 10,000 sq. ft. = $150
Submitted By (please print name): _________________________________________________________
Signature: _____________________________________Date ___/____/________
Representative of (Company or owner’s name) _______________________________________________
MECKLENBURG COUNTY
Land Use and Environmental Service Agency
Code Enforcement
Limited Conditional Power (LCP) Application Form
Limited Conditional Power (LCP) is used primarily, but not exclusively, to maintain environmental
conditions on buildings where a CO or TCO have not been issued, i.e. a building not approved for
occupancy. LCP may only be used for construction power with prior departmental approval. The
customer must submit a Conditional Utility Plan during the plan review or permit application.
Electrical Permit #:
E ________________________ or Project #: _______________________
Building Address: _______________________________________________________________
Conditional Utility Plan (to be filled out by customer)
a) Why LCP is needed: ___________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
b) Branch circuit or feeder isolation details: ___________________________________________
_________________________________________________________________________________
___________________________________________________________________________
c) How will this plan guard against unauthorized extension of LCP power?: _________________
______________________________________________________________________________
______________________________________________________________________________
d) Submitted By: ____________________________________________ Date ___/___/_______
NOTE: LCP Power Connect Application will be accepted only after Electric permit is finaled. LCP
fees will be charged to the General (Building) Contractor when the LCP connect is requested by the
owner, or owner’s representative (with written authorization).
The LCP fee is determined by the square feet of the building:
< than 3,000 sq. ft. = $90; > 3,000 sq. ft. to 10,000 sq. ft. = $100; > than 10,000 sq. ft. = $150.
Electrical sign-off: _____________________ Accept? Yes__ / No__
___/___/_______
Date
[Your Name]
[Street Address]
[City, ST ZIP Code]
[DATE]
Mecklenburg County
LUESA - Code Enforcement
700 North Tryon Street
Charlotte, NC 28202
RE: Authorization to execute the LCP Connect Request Form on behalf of [Your Name]
Dear Mecklenburg County Code Enforcement:
I am writing to authorize [Attorney Name or Advocate Name] to execute the Limited Conditional Power Connect
Request Form on my behalf.
If you have any questions, please call me at [your phone number] or [Attorney Name or Advocate Name] at
[Attorney or Advocate phone number].
Sincerely,
[Your Name], Project Owner
Sworn to and subscribed before me this:
_____day of ________ 2007
______________, Notary Public
[COUNTY, STATE]
My Commission Expires___________