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Application # al An
Please note if this application Mail In apollcation
is part of a job in prowess Harnett County Central Permitting
is p permits. PO Box 65 Lillington, NC 27546
with °l
Telephone Number 910-893-7525 Fax 910-893-2793
ryes -no www.hemett.org
Certification of Work Performed
.By Owner/Contractor
Contractor Informatio
DONALD LOWDER will complete the ELECTRICAL work on the project or
(Name) (Trade)
structure herein described. My state license number is 6136-U All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: ALLMAN ELECTRIC CORPORATION
Mailing Address: 345 WILKES ROAD rAVETTEVILLE, NC 28306
Street Address: SAME
Business Phone: 91 -485-861 7 Email Address: Pam. anderson@allmanelectric,
"Company name, address, & phone must match information on license. . Com
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Land Owner's Name: GINGER Phone: 964-6359
Tenant/Building Owner(if different): Phone:
Construction or Site Address: 279 MONTANA LANE SPRING LAKE, NC
Sneeffic Directions to Job r •II n ton:
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Description of work to be done: 3 TON SPLIT 1 OKW Job Cost: 4>
Mechanical: New Unit With Ductwork- New Unit Without Ductwork- Gas Piping _
Electrical: 200 Amp _ X200 Amp J Service Change - Service Reconnect- Other
Plumbing: Water/Sewer Tap Number of Baths T Water Heater
Permit Cost
Permit Fee: $ (calculated from fee schedule)
Mail In Processing Fee: $3.00 Per aonlicaUon
Total Enclosed: $
Make check payable to: Harnett County Central Permitting (HCCP)
Mail completed application form to: Harnett County Central Permitting
PO Box 65
Lillington, NC 2754e
Contractor's signature: r_ Date:
DO NOT SEND CASH. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
8/06