BUILDING • Must section below to be fated out by . - / ee 2� / /
w homever forming work rret be owner Application �/__ , L ,( j% /
or 6ceneed comrsstar. per Addre, ca rnpany
n ames phone must match Information on Harnett County Central Permitting
•
license. PO Box 85 Llllingtsn, NC 27548
Phone B10 -699 -7525 Fax 91 b-893 -2793 www
Application to•Resldentlel Building and Trades Permit •
�'
Owner's Name: o
�aat•CI Dlt,l` an es IS 1.1t.-1-6:119 L.LC Date-' 4113 /10
Site Address: 076 Se aye, D Phone O G_
Directions to Job she from Llllington: .
Rt27 towards Rtg7. Tumleft on flagon Read. Tum left Into Subdivision on Strike Eagle Drive.
Subdivision; I'A'll'anl Po,.r • Lot: 95
Description of Proposed Wont: S i (es le 1•0,m i' l > ux n l g , #bedrooms: 3
Heated SF /9(o0 Unheated SF 4 120, FlnisheRec Room? wo
General Contractor Information Gnaw! Space () Sieb
1 ; ;llC1a' k14ostrde1s curl(,I-c 191o) y,c3 -a$9y
Building Contractor's Company Name Telephone
Address Po Bu x' g�e'a! ,,, /:'e ...ve_�ze 3ys9a -BUJ u
fY /
�L "_ License #
Sigma a of O 0 Must sign & MI out second page
cer(s) of Corporation
Electrical Permit Information
Description of Work A/c.,../.4 £,,,,� Service Size: Z°o
1 Amps TPole� /no
Sc...��y 1�7 c 't t o , $n G. 3 a 3
sec tion C orilr§ctoes Company Name Telephone
LiSg 1
1,N ;i , a l kvrllef0C X -
83)2. IgOaG,_1
/ 1 License ft
Signature of Offloer(s) of Corporation
Mechanical Permit Information
Description of Work /✓e,., //v4-C
mn.Q`V, — A1it Ian C r . (910) 45x4— �S6S
Mechanical Contractors Company Name Telephone
. S•an7. - Ion 120.�A A '0.X, • `�..y Rc. ; iL,
..
Addres
I . License #
Signature of . cer(s) of Corporation
Plumbing Permit Information
Description of Work N'c.... O/,,. -4.."-21,.. # Bathe Z.
Aitg n ..- 7rflc( / PL4fozety► /l 2M -Y. -G''z,
Plumbing Contractor's Company Name Telephone
as aim P..��N� DR Fi97 NP. ,-293:14 h - -P/
dress,
. �_ en sa
Signature of Offlc r(s of ration
insulation Permit Information
-. 1 C',L .7; r-1....1,1,- 4119 l'a St. F .,,v /c / ac 3,0 Yee - sSrs
Insulatfor'Contractors Company Name & Addrbss
283 o1 Telephone
•
Page 1 of 2 9/07
Apollonian #
Homeowners Applying to Build Their Own Home
Please answer the following queetlone then see a Permit Technician to determine If you qualify for permit under Owners Exemption.
Questionnaire per G.S. 87 -14 Regulations as to Issue of Building Permits (Memo avaaabie upon request)
1. Do you own the land on which this building will be constructed? yes no
2. Have you hired or intend to hire an indMdual to superintend and manage construction of the
project?
yes no
3. Do you intend to directly control & supervise construction activities? yes no
4. Do you intend to schedule, contract, or directly pay for all phases of construction work to be
done?
_ yes _ no
5. Do you intend to personally occupy the building for at least 12 consecutive months following
completion of construction and do you understand that If you do not do so, it creates the
presumption under law that you fraudulently secured the permit?
__ yea ___ no
I hereby certify that I have the authority to make necessary application, that the application is correct
and that the construction will conform to the regulations in the Building, Electrical, Plumbing and
Mechanical codes, and the Harnett County Zoning Ordinance. I state the information on the above
contractors Is correct as known to me and If gay changes occur including listed contractors, site plan,
number of bedrooms, building and trade plans, Environmental Health permit changes or proposed use
changes, t certify it is my redponaibfity to notify the Harnett County Central Permitting Department of
any and all changes.
Signature of Owner /Officer(s) of Corporation Date Il /O
Aff davit for Worker's Compensation N.C.G.S. 87 -14
The undersigned applicant being the:
General Contractor Owner Officer /Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s), firm(s). or corporation(s) performing the work
set forth In the permit
Has three (3) or more employees and has obtained workers' compensation Insurance to cover them.
Has one (1) or more subcontractors(s) and has obtained workers' compensation Insurance to cover
them.
X Has one (1) or more subcontractors(s) who has their own policy of workers' compensation Insurance
covering themselves.
_ Has no more than two (2) employees and no subcontractors.
While working on the project for which this permit is sought it is understood that the Central Permitting
Department Issuing the permit may require certificates of coverage of worker's compensation Insurance prior
to Issuance of the permit and at any time during the permitted work from any person, fine or corporation
Carrying out the work. /, 1
Company or Name: % %1, l_ \aa�( \--‘0 M QS n To 1 o44 tU; tt e , L L L
Sign w/Tttie:t� -- Lou , tle AA( Coat e∎440 ft- Date: 6 / /8//O
Page 2 of 2 8/07
1 SL
1� t fiv.,S c)
Plan Box Number , IQ 2 Job Name - ` 9.
Date: Co - /? -/O
Required Inspections for SFA.%SFD
Appl. # J6 —S662 / I%
Valuation 0/ 229q /
Sq. Feet /
Sequence
10 ✓ R* Bldg. Footing
10 -30 R* Elec. Temp Service Pole
20 ,✓ R* Building Foundation
20 Address Confirmation
30 -999 Open Floor
30 -999 ✓ R* Bldg. Slab Insp.
30 -999 R* Elec. Under Slab
30 -999 ✓ R *Plumb. Under Slab
40 ✓ Four Trade Rough In
40 Four Trade Rough In> 2500
40 Three Trade Rough In
40 Three Trade Rough In> 2500
40 Two Trade Rough In
40 Two Trade Rough In> 2500
40 One Trade Rough In
40 One Trade Rough In > 2500
50 ✓ R* Insulation
60 L / Four Trade Final
60 Four Trade Final > 2500
60 Chree Trade Final
60 ' Chree Trade Final > 2500
60 Cwo Trade Final
60 Two Trade Final > 2500
60 One Trade Final
60 One Trade Final > 2500
999 INnvir. Operations Permit