TRADES
Application # t5~ F
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
www.harnett.org/pormhs
Certification of Work Performed By Owner/Contractor
l (Inddividual Trade Application)
V t. h
Owner (s) of Structure: Y 1 V1 t~Ul n , h Phone: " I a 'C~~ 3• ~v
Owner (s) Mailing Address: 1 Ir-Az C e. I 'j t,
I I Y1 ~ 1113, N, G4 LP
Land Owner Name (s): l n Phone: 10. 8 13.SS3O
Construction or site Address: !~31)1 Y. l M 1oV-.t71 Aja h DV- I v e
PIN or Parccell# from GIS:
Job Cost: 41 r o0 Description of Work to be done C h ru l g i n q p C "Ja e
u'ki l k
Mechanical: New Unit With Ductwork, New Unit Without Ductwork h 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
ci ' ire on
to o -q ~ r llin on:
D Ai t. t t7u~C 1~ YQ• ) I o w S. Magiti dfi
~ni~hf-6Ythn W oidld-CAht'1h'.L-tD+bl1DW S a1WTUJ41I-.ft6h+u
S% VA~ui[.r "f-fonio weed Vb n~I7tt-.Tuy-„ F-iq +onivPhi-br_.maah.
S~ V v
Subdivision: Lot
I _aU inA (fiMft&4 6Ur, will provide the GG a-A labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is Q410-1Z which entitles 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,~ordiinna'nnces and regulations.
Structure owner(s) signature: Date: l 1 D
Company Name: CtX-o l i n CA CAYYI Vbg+ 6U V- Phone: 611 CT. G GO, s-A L.9
Address. mat U -1 D P5u S t~ lGi~ ~-Dl t. N C ~'1S a o
County: 1 n StV Y1 CM LAajal= a s License
Contractor's Signature: Date:
a
`Company name, address, & phone must match information an license.
a/08
TRADE
Application #
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793
www-harneti.org/permfts
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner (s) of Structure: h n " Ci.YI Phone:I I D 81~
Owner (s) Mailing Address: 30k Y-I1 n ~02-a)~111~
Land Owner Name (s): 11 Y1 12411 Phone:qI D•~0
Construction or Site Address: Oj 1L I Ii~ DU.~i1't L71E, 1 V-C,
PIN or Parcel # from GIS:
Job Cost: 100, 00 Description of Work to be done e ~L Q ~U I lUl i
Y1~ fl,~ I h01 GIXId 1 1~ l.l.Vl.l
Mechanical: New Unit With Ductwork- New Unit Without Ductwork- Gas Piping
Electrical': 200 Amp _ <200 Amp _ Service Change _ Service Reconnect - Other -k
For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap _ Number of Baths _ Water Heater
Specific Directions to Job from Lillinaton:
Subdivision: Lot
I G'YtL t 1(Z 1 C•C tle I twill provide the t1 C Cty-i C CO labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is Q 1 Lc'9 3- U . which entitles 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) slgnature: Date: (oZ ~1 ~I
Company Name: P W-e ttK- E1 of j-V i G A< MOA ~(AAGe Co kjnc.
one. t ~i , y ei 19 . i l lo'l
Address; '00 N t 11 1 ThDMAS Mf I j I 11Yqh2"j N G D_1S'q
County: Co ctor's License 21 Lc4 - U
Contractor's Signature: Date: 1 ~;l I"l I L-Y
'Company name, address, & phone must match information on license.
TRADE 4/08
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