TRADE r
Jun 01 2006 3:37PM Bill Clark Homes of Fa9et 1910426W198S P.3
AppllCatjonl N Eo~y1 .~e-~ k' `
i Harnett County Central Permitting
PO Box 85 Lillington, NC 27548
Telephone Number 910-893.4759
www.hamett.org et
Certification of Worts Performed CJ' ) r U4~~ ~
By Owner/Contractor
owner (s) of Structure:
ClQd~ 14 QS
Owner (s) Telephone: 10, Owner (s) Mailing Address: 2 b S. tiJ o d
l
Construction or Site Address.,~9_l-
Job Cost:
Description of Work to be done 5c~
Mechanical: New Unit With Ductwork _ New Unlt Without Ductwork _Gas Piping
Electrical: 200 Amp _ X200 Amp _ Service Change _ Service Reconnect, Other _
Plumbing: Water ewer Tap Number of Baths , Water Heater
clfl tl to Job ro t ;
in I- le
Subdivision: Lot A _zc~ 0
i have provided or will provide the labor
(Name)
on this structure. I am the owner or hold a NC state (Trade)
Ilcenae number
(Trade)
which entities me to perform such work on the above structure legally. All
work shall comply with the State Building Code and all other applicable State and Local laws,
ordinances and regulations.
Owner (a) slgnaturs: t Date:
Pru bin amtit Info matt
Description of Work
Number of Baths. Plumbing Cost $
lambing 'ontractor'sCio any ame' Telephone
Address
License #
a
Sig a ure of CML er(s) of Corporation
Jun 01 2006 3:37PM Hill Clark Homes of Fa-jet 19104261989 p.4
~-IrC.t-V t CJA C-
Application # t7 ~0- 'OOI `i c I
Harnett County Central Permitting
PO Box 85 Lillington, NC 27546
C Telephone Number 910-893-4759
• wwwAsimett.org pp 1
Certification of Work Performed VIn
By Owner/Contractor \t~"f
Owner (s) of Structure: k HOLM L3 ~
Owner (s) Telsohone: Q i 7 , c! f '7R 4 5?
Owner (s) Mailing Address: l
Construction or Site Address: r -
Job Cost
Desaiptlon of Work to be done
Mechanlcal: New Unit With Ductwork _ New Unit Without Ductwork y Gas Piping
rical: 20o Amp _ e200 Amp _ Service Change w Service Reconnect Other
Water/Sewer Tap„ Number of Baths ^ Water Heater ` y
S fl Qirections t it Lllll
f 7 r
l;e
I ~ L
Subdivision: f- Lot # t
have provided or will provide the labor
(Name)
on this structure. I am the owner or hold a NC state (Trade) license number
(Trade)
which entitles me to perform such work on the above structure legally. Ali
work shall comply with the State Building Code and all other applicable State and Loral laws,
ordinances and regulatlons.
Owner (e) signature: Date: LA
EFoBI Permit lnrormatlon
Description of Work 7AMI
TS Pole: Yes O No Electrical Cost S
Pe O Underground O Overheard
anent Service' Underground
a p . - Overhead O Seridce Size; 0100
ID
ontr ctor's Company Name 110' x.12' 1ccZ Amps
V ¢ %I t Telephone
A re
License #
Signature of Officer(s) of Corporation