TRADES Application# / r:/ ( I7 e
Harnett County Central Permitting ,23 <
PO Box 65 Lillington, NC 27546
910 - 893 -7525 Fax 910 - 893 -2793
www.harnett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: Don & Debra Jeffers Phone: 910- 893 -5701
Owner (s) Mailing Address: 290 Papoose Trail Lillington, NC 27546
Land Owner Name (s): Don & Debra Jeffers Phone: 910- 893 -5701
Construction or Site Address: 290 Papoose Trail Lillington, NC 27546
PIN or Parcel # from G I S: Ctrl .4 13- 4(9 act . (1t )o
Job Co Description of Work to be done ductwork
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork _ Gas Piping
Electrical *: 200 Amp _ <200 Amp Service Change _ Service Reconnect _ Other _
* For Progress Energy customers we need the premise number
Plumbing: Water /Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillington:
EAST on E FRONT ST toward S 2ND ST /2ND ST. Turn RIGHT onto S 2ND ST /2ND ST. Turn RIGHT onto E KILLIEC
Turn LEFT onto S MAIN ST /US- 401/NC- 210/NC -27. Turn RIGHT onto W OLD RD /NC -27 W /NC -27. Continue to folio'
Turn LEFT onto DOCS RD. Turn RIGHT onto MICRO TOWER RD.Turn RIGHT onto PAPOOSE TRL.
Subdivision: Lot #:
Wes McLeod will provide the Mechanical labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 29266 , which entitles me to
perform such work on the above structure legally. All work shall comply with the State Building Code
and all other applicable State and local laws, ordinances and regulations.
Structure owner(s) signature: Date: 6/11/10
Company Name: 72 Degrees Heating &Ai Phone: 919 - 777 -2777
Address: 2600 Jefferson Davis Hwy Sanford, NC 27332 County: Lee
Contractor's License #: 29266� • • 1 ddress:
Contractor's Signatur:: -►- \�h �it Date: /1v10
*Company name, address, & phone must match information on license.
Individual Trade Application 1 of 1 06/10
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