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TRADE M it in application P~;:;se. en~,iilhc; zppiicuior, ! - is part of o 1oh m progress Harnett County Central Permitting ! A °aiti; c,Pcn PO BOX Fc, . Lilingrcry NC _n70c•.6 r 910-893-7525 Fax 910-893-2793 l ye. no arww.harnetI.orgipermils Certification of Work Pertormed by Owner/Contractor tindividusl Trade Application) Contractor information qq ~e (eM FG of will complete the f(I W.Col U(C4601 work on the project or iJamel ;Trade) ltruoiure Pterein +-escribed. My state iicena° number is Xly)a SP R,1! work shall compiy with ths t Stale Building Code and ail other applicable Stale $ Local law, ordinances and regulations. Company Name: A ir (on I rots l t hAaKIC°ll, LLC Mailing Address: 1 c Street Address: 10qq 11 I r T~ornewoog Cp(y NC Q51A Business Phone: 9j 531Q Email Address: Atrconjrol e wvJAraw%.ncl Co;npany::art; avtdress, pnore muss omatch inforrnafion o^ license. ¢ Job Information LanitOwnE?i s tJame_ bAVtd ke;*( phone: 30'x' 3113 TO Tenant-Building Ownerfif different)__.-___ _r Phone: Construction or Site Address _-,Z9 R; Orin_~Nk G~Eord ~C X) B) PIN or Parcel # from GIS: Soecific Directions to Job from Lillinaton: ~ SL. '}o ~jn g y t.a 4 0.-46-, 4 a c o QAI - (A L on u~,~~Oy • Descriotion of work to be done: eD luC( ~ey1-p4nes. atrw11(-SJo Cost: Oft Mechanical: New Unit With Duct Work _ New it it ut Ductwork Gas Piping _ Flectrical: 2.00 Amp <200 Amp _ Service Change Service Pecon„e;;t _ Other V/ Plumbing: Water/Sewer Tap Number of Baths Water Heater 00 Permit, Cost Permit Fee: 5~._~ (calcr!lated from fne schedule) Mail In Processing Fee: j.0.0,0 per ap cation For Electrical Permits with Progress Energy we need the premise number provided. Total Enclosed: $ Make check payable & Mail completed application fnrm to: Harne t County C©nfraf Permitting ,HCCP? PU Box 65 Lillinnton. NO 27546 / q Contractor's Signature: Daie: DO NOT SEND CASK. OMPL fE A PLO TIONS WILL NOT BE PROCESSED. "LR ADE »;.)R GIS_Public: Powered By Freeance 4.3.2 - TDC Group Inc. Page 1 of 1 i'(~ 1 ,~Jri~dTev' 's' : ~S ( Tt+i :R n9 t(j ~t pLi I~f{i a li n l i -a+~i~ 9 ~i: # ~{ids i~~rl°3,>1s~1#l~.ru Search I _ orxc~ "'r UG'H' Selections Clear R ure I + ER DAVID J_ & WIFE ER FLORA L & ~ A , 129 ` m+. D R ;Cl~lt RIBBON OAK COURT FORD _ : 32_0000 ~ A 6-59-5514 000 RA 7± 58706 0020 95 ' a7ttA ~i l" Y ; :,r I' 9' REI ! 0149 pppS, Ea#" C SI DD BON OAK CT X 6PEACHTREE I'" SSING low f b a~ ~ formation PID PIN LEt3AL1 LT#66 PH2 RIBBON OAK 1 ~5 0001 -ACHTREE M#98 0.46 02320 0342 130000123180 I f 0020 95 '5 14.0 CT X CROSSING 413 Zoom To Result Set http://gistooIs. harnett.org/Freeance/Client/PublicAccess 1 /index.htmI?appconfig=public 1 12/17/2009