BUILDING
M
liunett County earl Pcanitung
PO•Box 65 Li11/nglon, NC 27546
Telophonb Numbor 910-393-4759
II di and.Trade Pe m
Owner's Name: L L c ator
Address; a z8 a a y .Poona; ii sz- 5v-r~ av
Directions to job site, Subdlvlslon;
1~7e Construcdon: (Please Check) B>a;ldwg Use: (Please Ckeck).
New-Renovation 0 Addition t) R%sidentiat,6 Modular Q
Moved House O Other O Commercial 0 multi-Peron,
speciq Type of Work: iyi3w iii ~r yZAe i/rr
Bu11dthePermft rnrormatign
Heated-2.&" C mwJ Space Q Building-Construction Cost
Unheated ::~,W Slabs Acres Disturbed ' - ? ; 3tos1'ea
5 -3
Building ontraetor' ompany Name Ad ess
r sturo of O cer(s) of Corporation license # . Telephone
e a r n
Description of Work i~ eo .u, rte. BlectHoal cost $ 3L---SOT!
TS Polo: Yeso No 0 Undergro' Overheard 0
Permanent Service: Undcrground$! Overhead 0 Service Size; 7. V Amps
2~1 S 2 LA/as l/~ GIl4.C~ ,eQ~i/. ~,~P~rLisC-
Blectrical Contractor's Company Name Address z Fs 15,3
'Ylp.,~ ' s--L Signature ebr(d)•bfCorporatiou•. Licensa# Telepr0:
rniulatlon Per nrl$ rnfarmatton
Residential Other 0 _ 'NotReguired 0
1... i . _z ire ~S3 y '/vc1_o__G die
Iamulation.Contmctor'b CompanyNamo Address
Telephono
A, Hechanlcar'Permft Infohnatfoh
Description of Work 1+0=- NnmbcrofUnits L TypeSystem~MechanicalCost$S~
Numbs of Tons
fi~wet.- ~ T..~.r L~ Sz~~ h•sire.o~t.n Q/_ ~>~.oo lii1~/I'.Ki
Me ical Contractor's Comp Name Address
ignature of Officer( of Corporation License # Telephone
R o,~ PlumbinePermft o
Description of Work ~ t)t~.I(- Number of Hatha Plumbing Cost S
Lta zi ~
PI b' ontractor's m any ant Address
Sig p,; of Off er(a o orporation License # telephone
02/01
Affidavit of Worker's Compensation Coverage
N.C.G.8.87-14
The undersigned applicant for Building Permit # being the
Contractor
Owner
Officer/Agent of the Contractor or Owner
do hereby confirm underpenalties ofperjury that. the person(s), firm(s) or corpora- io,
perfouning the work set forth in tha permit:
_ has/have three (3) or more employees and lias/have obtained workers.'
compensation insurance to cover thein.
has/have one or more subcontractor(s) and has/havek obtained workers'
compensation insurance covering them.
has/have one or more subcontractor(s) who has/have their own policy of
woil¢men'a compcwatlon covering themselves.
_ has/have notmore than two (2) employees and no subcontractors.
Whle working on theproject.for which this permit is sought it is understood that the
Central pitting Department issuing the permit may require certificates of. coverage of
walkers' compensation insurance prior to issuance of the permit and at any time during
the permitted work from any parson, firm or corporatian`carrying out the work. An>
Firm name:
Hy:
Title:
02/01
SUrinkler System Information
Sprinkler Contractor's Company Name Address
Contact Person Telephone
License Number '
t
Fire Alarm Svstem.Informatioor
Alarm Contracto s Company Name Address
Contact Person Telephone
License Number
prlvewavAccess
NC Department of Transportation Driveway Access Yes- No f~.
I hereby, certify that I have the authority to make necessary application, that the. application is co=ct and,
'
that the construction will conform to thereguladons in the Building, Electrical', Plumbing and Mechanical
codes, and the Harnett County Zoning Ordinance. I state the information on the $bove contractors is
correct as known to me and if any changes, occur in tho above contractors I certify( it is my.resporrsibility to
notify the Hamett County Inspections Division of any changes.
Signa Owner ontruc or/Officer(s) of Corporation Da a
J 4, -o
Required Inspections for SFA/SFD apps # '-66 5n o ),56 12
valuation ` , 7 8 13
Sq. Ft p~
SSe Seq
10 R'Bldg Footing 60 Two Trade Final > 2500
10-30 l Elec Temp Service Pole 60 One Trade Final
20 R'Bldg Foundation 60 One Trade Final > 2500
20 Address Confirmation 999 ----~Envir. Operations Permit
30-999 R'Open Floor
30-999 fR"Bldg Slab Insp
30-999 R'Elec Under Slab
30-999 R'Plumb under Slab
30-999 R'Bldg Water/Damp Proofing
40 Four Trade Rough In
40 Four Trade Rough In > 2500
40 Three Trade Rough In
40 Three Trade Rough In > 2500
40 Two Trade Rough In
40 Two Trade Rough In > 2500
40 One Trade Rough In
40 OOne,Trade Rough In > 2500
50 /Insulatlon Inspection
60 Four Trade Final
60 Four Trade Final > 2500
60 Three Trade Final
60 Three Trade Final > 2500
60 Two Trade Final