EX #02-24 Ex - Nash, Ken and Diane

Post Office Box 549
101 Veterans Memorial Drive
Kitty' Hawk, NC 27949
1112/2024
Ken & Diane Nash
9297 Neptune Or
Mechanicsville VA 23116
RECEIVED
Phone [phone] BAN 1 2 2024
Fax [phone]
,Aww.toumofkitt46awkucr
Exemption Number— 02.24 Ex
RE: EXEMPTED PROJECT (Statutory Exclusion) - MAINTENANCE AND REPAIR OF EXISTING
STRUCTURES - [G.S.113.103(5)(B)(5) and [15A NCAC 7K.0103(a)]
PROJECT ADDRESS — 3725 N Virginia Dare Trl
AREA OF ENVIRONMENTAL CONCERN - Ocean
Dear Mr. & Mrs. Nash:
I have reviewed the information submitted to this office in your inquiry concerning the necessary filing of an
application for a minor development permit under the Coastal Area Management Act. After making a site inspection
on 1/12124, 1 have determined that the activity you propose is exempt from needing a minor development permit as
long as it remains consistent with your site drawing and materials list submitted on 1/12/24, and meets the conditions
specified below. If your plans should change and your project will no longer meet these conditions, please contact
me before proceeding.
MAINTENANCE AND REPAIR — [G.S.113.103(5)(8)(5) and 15A NCAC 7K.0103(a)] - Maintenance and repairs
(excluding replacement) necessary to repair damage to structures caused by the elements are specifically excluded
from the definition of development under the conditions and in the circumstances set out in G.S.113A-103(5)(b)(5).
Individuals required to take such measures within an AEC shall contact the local CAMA representative for
consultation and advice before beginning work.
Structures may be repaired in a similar manner, size and location as the original structure. No expansions or
additions are permissible. The repairs are limited to 50% of the market value of the existing structure and the
following specific conditions.
1. The project consists of the repair/replacement of kitchen & bathroom including plumbing and electrical, as
shown on the attached drawing and materials list.
2. The proposed repairs shall be consistent with all other applicable local ordinances and North Carolina
Building Code standards.
3. Value of house $387,400; 50%cost of house $193,700; Cost of work $41,000; Value work left
in 12 months $162,700
This exemption to CAMA permit requirements does not alleviate the necessity of your obtaining any other State,
Fed�es!tean,
au orization and N.C. Building Permits. This exemption expires 90 days from the date of the letter.
Rob LP�0� Issued:111212024
P.O. Box 549
Kitty Hawk, NC 27949 Expires: 4/11124
CC: Lisa Doepker, NC DEQ

Town of Kitty Hawk
Planning & Inspections Department
101 Veterans Memorial Drive, PO Box 549
Kitty Hawk, NC 27949
Phone: [phone] Fax: [phone]
JAN 1 2 20N
RESIDENTIAL BUILDING PERMIT APPLICATION CWEC
Property Address S -&i ' 7)�� . ?Knit ki Ny Jlxf ypiN # `�1 i A 88 D 4
Property Owner
Mailing Address: L
t21n1 31
Phone: ( 9 D — `i I ;Z Fax.
Email: k r l 15ZN w w tJ A-;4A
I ien Agent Details yLbmi tom.- IN Yes 0 No
r „.
r52_=tc:
O Owner O guilder (I Contractor - License #
Name:-.0BGR
Mailing Address:
(zin} 27 9 Y s cr,
Phone: j22 �} 2 U1 —_. Y D) Fax: (_alCell
tJ5A)_�.D_�_-
Email: RC- p_MC C ✓nA i I C o may}
Snb-coptrfRctQt Information- An affidavit will need to be signed by each subcontractor prior to beginning work.
Contractor
Electric $ IKS—,�-j t c YR i C_
Plumbing 1Qj5 MORTON
HVAC_
Fuel Piping
irrigation f JJ A
NC License No.
21a
Phone #
—53314
No work shall be covered or concealed until approved by the Kitty Hawk Building Inspector
Page 2

General Description of Work: C, k-, a e c~ U Q !� ct
RECEN
LzUZzX5MMK= !
Claw of Work:
X Single Family C] Two Family 171 Accessory Bldg
0 pool 17.1 Other
Type of Occupation:
�R Rental/Spec 10 Permanent/ 2- Home
Type of Action:
0 New 0 Addition 1`1 Pernodel IN Repair/Replace
0 Moving 0 Demo 0 Other
Estimated Cost of Construction
(includes value of all labor and all materials):
Building- $,j_!9 �OO Electrical - $__560 0
Plumbing- Mechanical - $ A
Gas - $ Other -
Total Cost of Construction - $
No. Stories: -1, Bldg
Height
No. of Bedrooms: Existing y Proposed_
No. of Baths: Full 'I Half
Foundation Type:
Roofing Material:
Exterior Finish: -V
A I oA
Fireplace: 0 Y L"4,N
If Yes: 0 Wood 0 Gas 'I Quier
Main {pi Circle One{'
Water: (6a­reCo:Y well DCM-E
Electric: Underground/ Overhead
Z=
I
Voltage
EjQQd-ZQM. --
Base Flood Elevation
- I
ft"MEQMM.
Heated Living Space:
Unheated Space: N It
Porch: A
ft
Deck:
TOTAL: ki
Staff to QQfflPLQjA FIRM Dar
Map Panel #: Base Flom Elevation (BFE):
Effective Date: Regulatory Flood Protection Elevation:
STAFF USE ONLY:
Date;-- Complete Application: 0 Y ON Workers Comp Form:
Received By: Daft of Complete Application: Lien Agent No Submitted

Town of Kitty Hawk
Planning & Inspections Department
L!1 Veterans Memofial Drive, PO Box 549, Kitty ti -11 1`!V f ELJ
Phone (M) 26t-3S52 Fax [phone] t__ s
GENERAL CONTRACTOR SIGN OFF FORM )AN 12 2024
GENERAL CONTRACTOR INFORMATION
Qualifier's Name:
Business Name: Q.(3 C ft t _ i,__(r o /rL4_zR . __V L •__. N G,_
Business Address: 3 )1 O $/{Y iyF� ka,,l_, A/G .2 xjy8
Business Phone (Includes Area Code): ��_- -Z U_Z_
NC General Contractor License #:
General Contractor License Limit: RTi
General Contractor's Email Address: �'tlbGL 3!�_31-tLl �%�Q! dL , (Tdm
Surety Bond (Project Over $30,000): _
PROJECT INFORMATION
Property Owner:.. -"j t. N A $..
Property Address of Job: ,3 ?y5 N._Y_,q a�R� T'rWL kjr-r 6)Awk�VC_
.a -7,7
I the undersigned have read and understand the General Statutes pertaining to General
Contracting in North Carolina. I hereby affirm or swear I am licensed and qualified to
assume all responsibility and liability of a General Contractor upon this project. If I
resign or am no longer affiliated with this project, I will notify the local authority (Town of
Kitty Hawk Building Inspections) immediately by phone or in person and in writing within
threA(3,olking days. S Date
Xevr era Apr-d .202z

Town of Kitty Hawk
Planning & Inspections Department
101 Veterans Memorial Drive, PO Box 549, Kitty Hawk, NC 2 R 0
Phone t252) 261-3552 Fax [phone]
]AN 12 2024
HOMEOWNER AUTHORIZATION FORM
Property Owner(s): _ __I.< 'r- u W A 5 N_
Property Owner(s) Mailing Address: 9,2 9,7 NE('?ur%g b k
I hereby give authorization to:
(Contractor's Name)
to apply and obtain all permits on my behalf.
(Property Owners Signature)
(Property Owner's Signature)
(Date)
(Date)
Physical address of property where work is to be conducted:
3?�S.N.VA.T)RR:_TkRlt f<iT7Yfls4t.ik�1JG a'79L1aj
DCM-E C
Re ised dpril2fi22

1•1MP& an&i7.rum 1
Details: Appointment of Lien Agent
Entry #: 2069471
Designated Lien Agent
North American TINe Insurance Company
pnllnatwwwllen3nc< m m..u.,..o..
Address: 223 S. west St2et, Svne gap /
Raleigh NC 21603
Phone: B69-6W384
Faa: 913AM5231
Email:
Owner Information
Hobert Gomez
3110 Bay Dr
KIII Devil Hills. NC 27948
United States
Email: rgomez)r311f1(rygmall.cem
Phone: [phone]L
View Comments (0)
Project Property
3725 N Va. We hail
' Kitty Hawk NC 27949
Dare County
Filed on: 01/12/2024
Initially filed by: Rgomezjr
Print & Post
2 0
�hr
Gyve
RECEIVED
Contractors:
Property Type Please post this notice on thejob Site.
Suppliers and Subcontractors:
1.2 Family Dwelling Stan this image with your smart
phone to view this filing. You can then
file a Notice to Uen Agent for this
project.
.Date of First Furnishing -'
01/22/2024
Technical Support Hotline: (886i 690-7384
)AN 1 7 2024

Town of Kitty Hawk
Planning & Inspections Department
t iJ? Vtrterwns Memorial (give, PO Brix 549, Kitty Hawk, NC 27949
Phonc (252) 261-3S52 Fax [phone]
RE.'x:D
AFFIDAVIT OF WORKERS'COMPENSATION COVERAGEN' 2 2024
N,C..G�S, § 87-14 DC(y;_II=C
The w: digned applicant for Building Permit being the:
_ ✓er�Contractor
_ Owner
Officer/Agent of the Contractor
do hereby aver under penalties of perjury that the person(s), firm(s) or corporation(s)
performing the work set forth in the permit:
has/have three (3) or more employees and have obtained workers'
compensation insurance to cover them,
has/have one or more subcontractor(s) and have obtained workers'
compensation covering them,
has/have one or more subcontractor(s) who has/have their own policy of
workmen's compensation covering themselves,
has/have not more than two (2) employees and no subcontractors,
while working on the project for which this permit is sought, It is understood that the
Inspection Department issuing the permit may require certificates of coverage of worker's
compensation insurance prior to issuance of the permit and at any time during the
permitted work from any person, firm, or corporation carrying out the work.
Firm Name: 01>-e r L JNt z J p_
Signature: --f�
Title:
Date: / 1 r r-
Re+7.ted A/zr-rl �Ft