TRADES
Application # D 1 cc-C/
Mail
Please note if this application In application
is part of a job i progress Harnett County Central Permitting
with open permits. PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
_ yes _ no www.hamett.org/permits
Certification of Work Performed by Owner/Contractor
(individual Trade Application)
Contractor Information
I, c J-Y2~)Rc-n' fl~l t S will complete the e_ke& uk,, work on the project or
(Name) (Trade)
structure herein described. My state license number is 00644 All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: r
KhOnS
Mailing Address: 511 Main S! . Ford Nc . Qr11,2,3a
Street Address:
Business Phone: (q m) q'i-I - 5999 Email Address: <Sma4P r,erau g4ar c aol.rpm
'Company name, address, & phone must match information on license.
Job Information
Land Owner's Name: ,OGIYI ( - --a Floe Phone: ~q 10~ - Ba l 7
Tenant/Building Owner(if different): Phone:
Construction or Site Address: Q&4 C7•rame+o, LaaQ.
PIN or Parcel # from GIS: 06 10 -1e6 - D q9A - 000
cific Directions to Job from Lillington:
Pe E 1"ren+S+ ~n ,mod Sa^ s!-1a~4~ alrn le R on+o3a&L Sklat.4 S+..IM;i 2 onto
F •IveL Sk. .Imi1~ R t 1F-"' S+ ''a 1MrS+ • MiI2. Lai\* E y= A S& .01 rrAs F,.'Fym* S+, heraves
IAS 1 to-2 n tes L or to mwr.~ r% VA Q n.iles 11- o1,kb Old US 421 ,ttti tts L ehio Cyrc w+a Lh. •.1 rvw11ts
Description of work to be done: Re-v ' re Fib AC 14%&j Job Cost: ?00-00
Mechanical: New Unit With Ductwork New Unit Without Ductwork- Gas Piping _
Electrical: 200 Amp _ <200 Amp _ Service Change _ Service Reconnect - Other _
Plumbing: Water/Sewer Tap _ Number of Baths _ Water Heater
Permit Cost
Permit Fee: $ c;Q .Od (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application For Electrical Permits with Progress Energy
we need the premise number provided.
Total Enclosed: $ rJ 3.00
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
Lillington, NC 27546
c
/
Contractor's Signature: Date: A9-'f_-02
DO NOT SEND C%SHANCOMPLEM-APPLICA TIONS WILL NOT BE PROCESSED.
TRADE 4/08
Application #
Please note if this application Mail In aoolication
is part of a job in progress Hamett County Central Permitting
with open permits. PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
_ yes _ no www.hamett.org/permits
Certification of Work Performed by Owner/Contractor
(Individual Trade Application)
Contractor Information
I, Wes Mc Le oA. will complete the (Yit? 6oax;"I work on the project or
(Name) (Trade)
structure heroin described. My state license number is oQrms ..All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name:
Mailing Address: C a
Street Address:
Business Phone: 99 Email Address: 1,~)t?S dear1ai r nC. Corn
"Company name, address, & phone must match information on license.
Job Information
Land Owner's Name: kJoan Pa`A-kc.Ysnn Phone:
-gI0~ ,%-$9Irl
Tenant(Building Owner(if different): Phone:
Construction or Site Address: 204- C-sm mpla Lo-ne_
PIN or Parcel # from GIS: D(D to - 6 S- 099g. WO
Specific Directions to Job from Lillington:
S+ • m'. 0.
S s S S od
.1 mile, onkn IN't S ~*SF o .R i k
a l , a z . ..;i Miks
Description of work to be done: Ins-61 a,flon of WK- Ll n 4- Job Cost: , 8 SD
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork Gas Piping _
Electrical: 200 Amp _ <200 Amp _ Service Change _ Service Reconnect _ Other _
Plumbing: Water/Sewer Tap _ Number of Baths _ Water Heater _
Permit Cost
Permit Fee: $ 50. 00 (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application For Electrical Permits with Progress Energy
we need the premise number provided.
Total Enclosed: $ 53-00
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
I (~lington, NC 27546
Contractor's Signature: / /fit ►!^(L Date: ~6 1~ o
DO NOT SEND CASH. INCOMPLETE APPLICATIONS WILL NOT BE R CESSED.
TRADE 4/08