TRADES Application # l CD 0 o2 'l
Please note if this application Mail In application
is part of job in progress Harnett County Central Permitting
with open permits. PO Box 65 Lillington, NC 27546
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,�,CA t1CLC.0 DI will complete the C A4 work on the project or
(Name) (Trade)
structure herdin described. My state license number is aCak.o 4 . All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: - la r
rt°,ea �GC -�-t va 4 r
Mailing Addressa0C7 ` PrN:1 NICS rC-0, -o4. �-V 'L o6'l 33a
Street AddressQ1. n l .1 t".rSbn ti k-` <S2
da1 &T(o •
Business Phon C� \G 7) T9 1) Email Address:
*Company name, address, & phone must match information on license.
Jobation
Land Owner's Name;\ Py+ 4T i-1 ra n ; r a . - Phonet t-I. .% ' 3
en ant/Buildin O r if different)'ZSU U Zt. rzJ Ur ]c \Arc Phone( Cif �� 1;3/
r.
Construction or Site Ad ress:
PIN or Parcel # from GISR -o l • C)Ol)
S ec'fic Directions to Job from Liliinoton:53-a - a.& - Cu-r.e..1l a4 \Ua Al 'lb hk - Sul A a+zl
@r tk 640.- 11 -Mac g}) -�iLA S jM - ■•l lNc n +=ILSt 14\6. -d' ►af
a - > ._ � ,.. �l '.a .- a t 1 " : .. • t\ r.... _ IZsi 44
Cork+ -8'lg Pr 6.41) ✓nc Ln-1, Srtr.4.,..ra laczan& (.� sin" ,WS tys` lad
Crk° Cujr t... LAI t ; r. we. c 'V r
'
Description of work to be done: )t.. _ . -- s CYV P i - ! v Job Cost 1 C 2
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 _
'AA�� .0 Permit Cost
l
Permit Fee: eu • . (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application For Electrical Permits with Progress Energy
we need the premise number provided.
Total Enclosed: 4 53.0
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
� Lillington, NC 27546
Contractor's Signatur-- `_ _ , _J' Date: { _.Q l . D
DO NOT SE � C N. INCOMP E A • PLICATIONS WILL NOT BE PROCESSED.
TRADE 4/08
s k i
63(
2010 - 08 . 07,59 • • • RANDY MORRIS RI�
ELECT 9194991149 » 919 774 8177 .,. • P 3/3
RANDY MORRIS ELECTRI nI'
Please remit this appltweoe Harnett Courtly Central Permitting
Is pat o[a Job in moans
watt open PO Box 05
0 910. -7625 10893.27933 �(
_ _BO wwW.harnetf.oraermlts . / / U I(,
Ceruficatlon of Work Performed•by Owner /C Mractur v b- . .
(Individual Trade Application) • • • •
.. .
•
I, Mc s _ will complete the Aaron icc l work on the Pled or
• e) (Trade)
structure hen In desilbed. My state license number is 11 OM ,, Al work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations. .
Company Nerne r eia Mrv.ris F tr4tita I & ltSlt
Mailing Address: l 3'1 nrseACCI U.ldktan SotrG n& t.LC. . ,
Street Address: Nag Sti ee PQ \acapwvtq1rsel S•rFtn1 MC. ailv'it'a.
Business Phontetue>ril -SM1 Email Address;
'comp/my name, address, & phone mum match Information on /1Derrsa
Land Owners Namet iaadr, �} Pho 4 ' `kC t43
Tenantleuilding Owner(If different): Phan Cli -
Constnlotion or Bite Address'a L Ztwrrj (i t {r~ tart- Gunton 4 1- alat%rn
PIN or Parcel 0 from GIST S,S - 1 a- LilatD, r 33
&saes cr. k4 Cr ,�t Eb.w it bi to 4 {0
.. .1li .• _ « .•.I l• .. 'Eta I: � ., 7' 4 1.. O1W � Sit e" c,,' - -U$ a , aT I
• 4�.'l•tut
L )&t- in -31 _, Cieerrl Mc r trtc41 r , • . „r.. ►;. a n a S
Description of work to be done �tk c, liar AG ?.4 r rob Coet.3 • t$
Mechanical: New Unit With New tJrrlt Without Ductwork Gas Piping
Electrical: 200 Amp 4200 Amp Service Change Service Reconnect_ Other
bin _
Plurng: Water /Sewer Tap_ Number of Baths � Watsr Heater
Permit Fee: $ a • ci , (calculated from fee schedule)
Man In Processing Fes: i OD ear ao diggilen Per Elecbteal Permits with Progress Energy
we need the pra.An number provided
Total Enclosed: $ F 4V\
Make drank payable & Mall completed eppiselon form to: Boot County Carat Permitting (HCCP) itz PO
Ullington, NO 27545
Contractor tr Signature : Date: �t It�
DO NOT SEND • • WJLL APPLICATIONS NDl1 BE P ED.
TRADE 4108
2010 -06.08 07;48 TRAMWAY STONE & 919 774 8177 Page 4/4
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4 [PIN] [RID] T[Full_addro] [City] r[House_Numb] [Pre_direct] [Street_nam]
W19 234.000099565 002875 LIZARD LICK LN LN CAMERON, _ LIZARD LICK
'099565 0006'42 LIZARD LICK
565- _._. CAMERON 75.0 `LIZARD LICK
9565 .4 -111 .000 +99565 0252107 LIZARD LICK LN
LIZARD LICK
5.5- 3- 2903.000
• 565 -53- 7600.000'.099565 0251 112 LIZARD LICK LNCAMERON 112 107.0 .0 LIZARD LICK
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