TRADES t i
Application #
Please note if this application Mail In application
Harnett County Central Permitting 9
is part of a job its. progress
with open permit PO Box 65 Lillie9ton, NC 27546
Telephone Number 910-893-7525 Fax 910-893-2793
_yes no www.harnett.org
Certification of Work Performed
By Owner/Contractor
Contractor Information
I, MARK-AIR will complete, the HEATING & A/C work on the project or
I (Name) (Trade)
structure herein described. My state license number is 15874 All work.shall _ comply with the
State Building Code and all other applicable State & Local law, ordinances and requlations.
Company Name: MARK-AIR HEATING & AIR COND.
'Mailing Address: PO Box 41104
Street Address: _ FAYETTEVILLE. nc 28309-1104
Business Phone: 910-484-6565 Email Address:
'Company name, address, & phone must match information on license.
Job Information
Land Owner's Name: VALERIE WEBSTER Phone: 495-0850
Tenant/Building Owner(if different): Phone:
Construction or Site Address:5104 MARVIN DR, SPRING LAKE NC 28390 (OFF OVERHILLS RD)
Specific Directions to Job from Lillinaton:
J OFF OVERHILLS ROAD
Desarlption:of work ti be donp-~SPLIT.HEAT_.P_U_MP_SNO DUCTWQJo' b Cost: - = -
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork ✓ Gas Piping_
Electrical: 200 Amp _ <200 Amp i Service Change _ Service Reconnect _ Other _
Plumbing: Water/Sewer Tap - Number of Baths _ Water Heater;
Permit Cost
i
Permit Fee: $ 50.00 (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application
Total Enclosed: $ 53.00
Make check payable to: Harnett County Central Permitting (HCCP)
Mail completed application form to: Harnett County Central Permitting i
PO Box 65
' Lillington NC 27546
Contractor's Signature: r (1 Date:
/ d
DO NOT SEND C . INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
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http://gistools.hamett.org/Freeance/Client/PublicAccessl/index.html?appconfig=public 1 1/13/2010