TRADES Jun 14 IU U`J:J1a AIrraur'I F1 VAL; y1U-L40-J3U1 p.L
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Application it /a g 9..17
Please r+ote ;r dmis application )Marl In appisration
apP Harnett County Central Permitting
is part of a job in progress PO Sox 65 Liltinglon, NC 27546 �QD
with permits. 913. 893.7525 Fax 910 893 - 2793
'wnnaharnett.org/perrnile
yes - - oo 1 / 4
Certification of Work Perlomned by OvmeriContreec:or
(Individual Trade Application)
11JJ `'-�"�° Contractor Information
1. 7�onnlp. ZUkn io fl will complete the eledriCTA . (Yf/NIhPtrwork on the projector
(Name) A (Trade)
structure herein described. My stele license number ie < �P$FO 4 5iat. Alt work shalt compll with the Stare Building
Code and all other applicable State & Lora; law, ordinances and regulations.
Company Name: f I1d</ � 1 : alliTtr i a
Mailing Address: pie, J Q "I Io n Ltrnnl1 r��rivr s N t p;�sJS
Street Address: in'rq �P4 a r5 {[ d r � ar tP fr�A I " 1 � t e , ,- :3,4 ry
Business Phone: 9,9 -1)9F-Sa EMS( AddressF 3 ® – gjeg eerjot+,nel
'Company name, address,* phone must match Infonaai'ion on license.
+ Job Information
Land Owner's Name: AMA I � t; . 5 Or"- Phone: 91?
4 17g c 963
Tenant/Building Owner Of different): Phone:
Construction of Site Address: acai re, re5 ri wJr ,Came rm. „AA G a 5? 3 ZSc
PIN or Parcel it from GIS:
S • :neilL 4 -_ •n6 _• Job o i ill • on: < i - M ? u: Z
e 5
r,rc'r DA a r- ...r.p o n Ike ier 'rob r –
�"
To
Description afworlc c be done: Acke�eo/td /1aiy e -' r a'' Job Cost ell_ � wrc�tt 5 l�Thcc
Mechanical: New Unit With Ductwork New U-sg Without Ductwork — Gas Piping
Eledreat: 200 Amp _ X200 Arnp ` Service Change _ Service Reconnect✓ Other —
Plumbing: Wafer /Sewer Tap Number of Baths Water Heater
—
Permit Cost -
Permit Fee: $ (calculated from fee schedule)
Mak In Processing Fee: 53.09 Per lob For Electrical Permits with Progress Energy we
need the premise number provided.
Total Enclosed: S
Make check payable & Mall completed apvilcatlon form to: H e _ 8n t C my Central Permitting (HCCP;
/ Lillington. NC 27546
Contractor's Signatu s ,IIYJ. _ . ll . . . =� Dale: 4/7 .9,0,0
"'DO NOT SEND • SH. !N / -LETEAPPLICATIONS WILL. NOT BE PROCESSED"
JUn 14 11) U`J:31a RIrKlcrl HVA(J V IU- Z4O-JJUl p.3
Application #
Please note if this application Mail In application
Hamett County Central Permitting
Is part of a job in progress PO Box 65 Lillington, NC 27546
with own permits. 910 - B93 - 7525 Fax 910 - 893 - 2793
www .hamett.orglpermits
_ yes no
Certification of Work Performed by OwnerfCentractor
(Individual Trade Application)
// Contractor Information
I, R,C 4.4r-d Tn AE 5 will complete the m,Pr >n an, rA. i work on the project or
(Name) (Trade)
structure herein described. My state license number is 30( . An work shall comply with the State Building
Code and all other applicable State & Local law, ordinances and regulations.
Company Name: A; rktcW 1- (e4TinC1 ct.nc( Conti/11 =tit.
Mailing Address: P.D, 6o x 35 to Coon et- on, / JVg (. as 3 2G,
Street Address: 1029 Pim'y (Jinn el c(1urr , , Ccawt erey.- , ji..4 C• 2. a 3eG
Business Phone: it D ,2 Y 5 — 34'0/ Email Address: it : rR i Lc, 6' e yez400. Ca•"
'Company name, address, & phone most match In ormaeon on license.
Job Information
Land Owner's Name: .44/ pp y r, t j, S U« a Phone: ? Y7 8 996 3
Tenant/Building Owner (if different): I Phone:
Construction or Site Address: a fo t CA ,-r S Y ) r i yr , Ca m e rrn. „AA C a Si 3 2-G
PIN or Parcel # from GIS:
g�=}icc Directions to Job from Lillinuton:
y re 4 o i 9 7 ran s r % A e7n 1, a SAN.. �> 2 I I. rjn-AJ • T ' e Z
ryry��� 3-T.,../ Tura) Le T n,.. :yl r /rrZy/ r � =rte -. 1 I TT $ I ' Lr nnTc
`rs+:rs'r Or:ue - +.-.nw nn L err �d�a
Description of work to be done: jacketeC/H /t Chang e -nut �� Job Cost: H90/7 r c /
Mechanical: New Unit With Ductwork New UM 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
Pemit Fee: S co S / (calculated from fee schedule)
Mail In Processing Fee: $3.00 per lob For Electrical Permits with Progress Energy we
need the premise number provided.
Total Enclosed: $
Make check payable & Mall completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
- e //�/ Lilfstgton, NC 27546
Contractor's Signature: 42-G� : 9 7 Date: 6 /t,%
**DO NOT SEND CASH. INC MO PLETEAPPL!CATTONS WILL NOT BE PROCESSED**
Online Register Page 1 of 2
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Licensee Details
SA License No: 30049
�� License Expires On 12/31/2010
Class(es): H 2, 11-3-1 •
!km salt •
Business: Air Rich Heating ft Cooling, Inc.
north Carolina 1029 Pineywood Church Road
State Board ofExaminers Cameron, NC 28326
of Plumbing, Heating and Phone: 910- 245 -9955
Fire Sprinkler Contractors
Fax:
A Home By: Jones, Richard Nigel (H -2, H -3 -I)
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http:// www. nclicensing .org/_asp /OnlineReg2.asp 6/14/2010