TRADES
Application # 16 o~r~O
Please note this application Mail Harnett In application
County Central Permitting
is part a job its. progress PO Box 65 Lillington, NC 27546 ,
with
open permit 910-893-7525 Fax 910-893-2793
_ yes _ no www.hamett.org/permits Ck 4 lobo'1
Certification of Work Performed by Owner/Contractor.. 3 O 1 I w
(Individual Trade Application)
Contractor Information
I, Wes Mc-Lcod will complete the nry_6, acc.% work on the project or
(Name) (Trade)
structure herein described. My state license number is olUoY All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: to ~cwv% ,c, ~ P r
Mailing Address: ZVQQ 1~~fvsun ~c+ 6A^1~~ 0(- 1-1330
Street Address:
Business Phone: alai • -III -L-1-11 Email Address: U+~S[` t~~u.+w.~ r+c • coM
'Company name, address, & phone must match information on license.
Job Inf rmation
Land Owner's Name: A";, c. 4J*ew kAoWw.v-& Phone: 0jt9 - 4199- 9Slor
Tenant/Building Owner(if different): Phone:
Construction or Site Address: 32q L otm i 04 LAnf~ tSA~~c+.d rtc. L nip
PIN or Parcel # from GIS: 4qs-eS- sy, - Colo, 9
Specific Directions to Job from Lillington:
2-t LjOv nw0,va% Caw&"k + 1cSk "3,rco.o C.w~cc t<~ \-CA
1.e C.s~.a\',no. l.ca~~ •t luC~ one N.no, Limb Y:b1.1 w)a L.aKu.0c
L.Ant
Description of work to be done: {LL r ";~+^r,, Job Cost:
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: $ (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
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
Lillington, NC 27546
Contractor's Signature: Date: 3-
DO to
NOT SEND CASH. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
TRADE 4/08
Application #
Mail
Please note if this application In application
Harnett County Central Permitting
is part of a job in progress
with open permits. PO Box 65 Lillington, NC 27546
910-893-7525 Fax 910-893-2793 P Ck ck-il Iboo-7
_yes _no www.hameft.org/permits 1-1 llo
Certification of Work Performed by Owner/Contractor.
(individual Trade Application)
Contractor ardor/oration
will complete the L I ~C ns lGA work on the project or
ame) (Trade)
structure herein described. My state license number is /2 b 7-L All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
ci~ Company Name: n GC E/-
Mailing Address: t
Street Address: ,e
Business Phone: Email Address:
'Company name, address, & phone must match information on license.
e ) Job Information
Land Owner's Name: ~/4 r. /Civkkv-l, Abu Phone:
TenantlBuilding Owner(if different): ~ Phone:
Construction or Site Address: N 7 z,
PIN or Parcel # from GIS:
Specific Directions to Job from Lillington:
Description of work to be done: Job Cost:
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork Foe--Reconnect Gas Piping Electrical: 200 Amp _ <200 Amp _ Service Change _ Serv_ Other
Plumbing:Water/Sewer Tap _ Number of Baths _ Water Heater _
Permit Cost
Permit Fee: $ (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: $
Make check payable & Mail completed appI. ation form to: Harnett County Central Permitting (HCCP)
PO Box 65
Lillington, NC 27546
Contractor's Signature: Date: 3-12 I d
DO NOT SEND C INCOMPtET PLICATIONS WILL NOT BE PROCESSED.
TRADE 4/08
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