TRADES
Application #
Harnett County Central Permitting
PO Box 65 Lillington, NIC 27546
910-893-7525 Fax 910-893-2793
www.hamott.org/parmits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner (s) of Structure: Phoneflt4) 41q Owner (s) Mailing Address: 'S
Land Owner Name (s):~ ° Phonne;CiA-1441 &U _
Construction or Site Address: ~v~_ _ Q,
PIN or Parcel # from GIS:
Job /Cost: Description of Work to be done
QL/NlCi /l0 an.N SpaI-,L..
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork Gas Piping
Electrical': 200 Amp_ <200 Amp_ Service Change, Service Reconnect _ Other
. For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap _ Number of Baths _ Water Heater A
Specific Directions to Job from Lillin on:
Subdivision: Lot
19AidA -5ovOrz !t d will provide the. 14 VA Lr labor on this structure.
(Gordrectors Name) (Trade)
I am the building owner or my NC state license number is aA 1-q . 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.
Structure owner(s)) signature: Date:
Company Name:AaNo1A GrRVi&d ~p Phone: 210 406=385-tl
Address: l nab n : L~nj F .Ff~E tr; E) 6 N. G 41? 90 Co
Courtly: j
nh L4,p~Contractor's License J.1,OOYJJ
Contractor's Signature: =AA' ,•G3-/I'!`~ru:r a. Dater' ~a -Q9
'Company name, address, & phone must match Information on license.
TRADE 4108
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Application # '
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
www. ham eft, org/penTiits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner (s) of Structure; Phone.CtlR - UR~~~A'3
Owner (s) Mailing Address: 540 tL0QAnr,&,-e~f
aura c~
.0-1
Land Owner Name (s): Phone: Q19 -jJgq _,2eg33
Construction or Site Address,-410 PIN or Parcel # from GIS:Q -5g iy~pr . ag ~a (p
Job Cost: Description of Work to be done „3}
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork ` Gas Piping _
Electrical`: 200 Amp _ a200 Amp _ Service Change _ Service Reconnect Other
For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap T Number of Baths _ Water Heater
Scoolfic Directions to Job from Lillinoton:
Subdivision: Lot
I AqArgW SERy,eg Lam. will provide the UAL labor on this structure.
(Contraaors Name) (rrado)
I am the building owner or my NC state license number is 146121 which entities mo 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.
Structure owner(s) signature: Date:
Company Name: .4.4 Phone:9lp-42F_.?33D _
Address: f~oZif(~dalt~7~~d. X1200- AJ C
County: Contractor'sUcense#:/4,0/7..1 i'LnQr:T;.'f~
Contractor's Signature: Date: R - Jc~ - b ~3
'Company name, address, & phone must match Information on license.
TRADE 4/08
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WOMB Re Information
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1099564 LT#1 HILLMON
10105 9564-27 LONGHORN MAP#98- 'GROVE& '1 013430471 19990409 CH
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0995649564 29LOT#4B MAP#2000 HILLMON _ OB
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