TRADES
Application # See Slanton's Heating
Mail In application And Air of Fayetteville
Harnett County Central Permitting q
PO Box 65 Lillington, NC 27546
Telephone Number 910-893-7525 Fax 910-893-2793
www,harnett.org
Certification of Work Performed
By Owner/Contractor
Contractor Information
I, Thomas K. Smalls will complete the Electrical work on the project or
(Name) (Trade)
structure herein described. My state license number is 13791-1 All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: - Power Source Electrical Construction Company. INC - -
Mailing Address: PO Box 684, Fayetteville, NC 28302
Street Address: 6227 Twiggs Court, Hope Mills, NC 28346
Business Phone: 910423-7209 Email Address:
'Name, address, & phone must match information on license.
Job Information
Owner' Name: Scott Assman Phone: 910-497-6681
Construction or Site Address: 400 Eileen Street, Spring Lake, NC
Specific Directions to Job from Lillinoton:
SEE OTHER SIDE OF THIS SHEET. "
Description of work to be done: Reconnect s/Heat Pump
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork_ Gas Piping _
Electrical: 200 Amp _ <200 Amp _ Service Change _ Service Reconnect _ Other Xx
Plumbing: Water/Sewer Tap _ Number of Baths _ Water Heater _
Job cost of work to be done: 330.00
Permit Cost
Pall Fea: $ 50.00 -
(calculated from fee schedule)
Mail In Processing Fee: $3.00 per application
Total Enclosed: $ 53.00
Make check payable to: Harriett County Central Permitting (HCCP)
Mall completed application forth to. Harnett County Central Permitting
PO Box 65
Lillington, NC 27764466,
Contractor's Signature:_ ihmou ~CJ1 lt~ LUG"J Date:
DO NOT SEND CASH. INCOMPLETE APPLICATIONS W U NOT BE PROCESSED.
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