TRADE SEP 17,2009 10:18A 9103231185 page 1
Application #
Harnett County~Central (Permitting
PO Box 65 I.Illington, NC 27546
Telephone Number 9104893-7525 Fax 910-893.2793
www.hamett.org
Corncation of Work Performed
BY Owner/Contractor
ntrao Info tat'
Z4ihftkhk
7-- 4 will complete the work on the projector
(Name) (Trede)
structure herein d d. MY state license number is
All work shall comely with be
State Building Code s~d all other applicable State & Local law, ordinances and regulations.
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Company Name:
Mailing Addn:sa:
Street Address: P
Business Phone:
'Name, address, & Email Address: fAaLl,~ 9 r i
W+te must match information on license. O1 °d~B1L r~
Owner' Name: >r'9~ Idfom+abon p
Phone: 9 b ~O
Construction Of Site Ad real:
AP-ecOns to J D fr m Lillin
Description of work to b ` done; n
Mechanical: New Unit~With Dur3u n,tr
Electrical: 200 Am ew unit vVdhout Ductwork
Plumbing: P 6200 Amp Service Chan s P(ping
WateN3e er Tap Number of Ratite 90 Ga _ Service Reconnect Other
Job cost of work to bed ne: 6 Water Healer
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Permit Fee: $ rdm-t
Mail In Pro (calculated from fee schedul )
cea7"1 00 t~1~ 'rB G l L
Total EnclosedMake check payo; Hameft county Mail 00mpieted appltoation f to: ameti Central Permrt4ng (HCCP)
PO box 65 County Central Permitting
Ullington, NC 27546,
Contractors Signature:
DO NOT SEND S NCOMPLB Date:
APPLICATIONS W.
BE PROCESSRD.
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