TRADES
Application # 0 7
=this ation Nell In aDpliCatiOn
ss Harnett County Central Permitting t~
PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
www.hamett.org/permits
Certification of Work Performed by Owner/Contractor
(Individual Trade Application)
Contractor Information
will complete the e IPC~,~ cl work on the project or
(Name) (Trade)
structure herein described. My state license number is a pS~l£~ All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: 5 E ~Lc~0
Mailing Address: 15\\ F.. Mn1 n ~,n(; , ~ N t Q3 A3(-~
Street Address:
Business Phone: r7H'1-S°Ig9 -Email Address:Srvn .pw,,,S~w 1 cm~
'Company name, address, & phone must match information on license.
Job Information
Land Owner's Name: Sk1Gx , n r- + = Phone: `-(•q$ - clcs a,.(_
Tenant/Building Owner(if different): Phone:
Construction or Site Address:
PIN or Parcel # from GIS:
Specific Directions to Job from Lillinoton:
} bk Si, .QrvGle R oyt1o kltkten Sk anile
L ov i., S Me ( ~loi h7C. 9to~Ne- aT a th. 1n {L n-lo In1 ntrl (Za ['JJ3M;kesl'pttbLo
Nc ~n +oL~w d__~n cn~w~NCa~
t-on* Yti,lton We; ~ l.~- -.la L on~a Mint N. _In„~4
Description of work to be done: LkNIre A~UAr t, Kxk- Job Cost:_&?] n.cr
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: $ ~.oo (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: $ C~3.oo
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
Lillington, NC 27546
Contractor's Signature: Date:_jl J(o J~~
DO NOT SEND CASH. INC MP APPLICATIONS WILL NOT BE PROCESSED.
TRADE
d/08
Application #
[Plealse note this application Mail Harnett in application
County Central Permitting
pof a job its. progress PO Box 65 Lillie9ton, NC 27546
th open permit
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, W es MCI-Cod will complete the2c~p co- work on the project or
(Name) (Trade)
structure herein described. My state license number is 01 (AS All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: r -f r / P
Mailing Address: a(errt , A trSc n t~ pis wu ~~amprq I a7 ~4a
Street Address:
Business Phone: 7~1 - `7'11 Email Address: r
`Company name, address, & phone must match information on license.
Job Information
Land Owner's Name: S4)n.WO C r (.±c ab 1~- Phone: (9 1-q) `15Q4--
Tenant/Building Owner(if different): Phone:
Construction or Site Address: _ 140 f A to nine cm m t
PIN or Parcel # from GIS:
Specific Directions to Job from Lillinaton:
E. ~r . T:re>µ sk. -4owc" C, a^^ a am sE ~ w:.,t a. ~ s a=" skl a^~-.+ a m tE V.
SA-. D l L- ft-k> 5 . Kour\ Sb. 1e omit> W. \d Vd. 12.3 rn: low
NC a'7 ~ ~1 NC ~'I4 .kn,..w.~d. Sn .ti:...1 Ian..\t l_orAe h1't{u `1J 1 xd I'~'n,.l t- ortlo M, n. Ln.
Description of work to be done: i2e42lc-,c.er y,4 of~ +IV-0.C l ly~i+ Job,,Cost-49 5D `l .oo
Mechanical: New Unit With Ductwork • New Unit Without Ductwork V Gas Piptng
Electrical: 200 Amp _ <200 Amp _ Service Change _ Service Reconnect _ Other_
Plumbing: Water/Sewer Tap _ Number of Baths Water Heater
Permit Cost
Permit Fee: $ SO • oo (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: $ G3.00
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
~ Lillington, NC 27546
r
Contractor's Signature: Date: ~j Ore OS
DO NOT SEND CASH. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
TRADE 4108