TRADES
w Each section below to be filled out by Application # C/ a:' Y 6
whomever performing work. Must be owner
oHicensed Contractor. Address, company Harnett County Central Permitting
name 8 phone must match information on g
license. PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793 www.hameft.org/permits
Application for Residential Buildina and Trades Permit Owner's Name: A A ),L) 9_C/~ F/2_~OJ A pate: I /
Site Address: ac./3 r~ T Ley (LLD Phone/ IT 14 8- 0
Directions to job site from Lillington:5 E_
Subdivision: Lot:
Description of Proposed Work: #Bedrooms:
Heated SF Unheated SF Finished Rec Room? Crawl Space Slab ( )
General Contractor Information
Building Contractor's Company Name Telephone
Address License #
Must sign & fill out second page
Signature of Owner/Contractor/Officer(s) of Corporation
Electrical Permit Information
Description of Work Service Size: Amps TPole: yestno
Electrical Contractor's Company Name Telephone
Address License #
Signature of Officer(s) of Corporation
MechanicallHVAC Permit Information ~t-
Description of Work `O~' . N&OmA-1 if _ U "L, NQ
Mechanical Contractor's Company Name Telephone
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Address on License #
Sig re of Office s) of Corporation _
Plumbina Permit Information
Description of Work # Baths
Plumbing Contractor's Company Name Telephone
Address License #
Signature of Officer(s) of Corporation
Insulation Permit Information
Insulation Contractor's Company Name & Address Telephone
8/21/08
Online Register Page 1 of 2
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Licensee Details
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License No: 27232
J a License Expires
On: 12/31/2009
~3A>;asClass(es): H-3-II
North Carolina Business: Down South Htg and Air Cond Repair Service,
State Board of Examiners Inc
of Plumbing, Heating and 109 Breckenridge Dr.
fire Sprinkler Contractors Raeford, NC 28376
Home Phone: (910) 797-5792
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11t.L Fax: (910) 904-2290
By: Rose, James Henry III (H-3-II)
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http://www.nelicensing.or"sp/OnlineReg2.asp 9/3/2009