DOCUMENTS Application# j l,) SOO 31/4-1 SL -1
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph: 910-893-7525 - Fx: 910-893-2793 - www.harnett.org/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: Ed/ .?C C. Phone: 3 3 6- 9)‘ 3 - 271
Owner(s) Mailing Address:
Land Owner Name (s): c Phone:
`PConstruction or Site Address: r"-r-C e 7 T /I�/A L -4Y,
C,4,07 e ea.-1/ /ICI g.3,4
PIN# Parcel#
Job Cost: Description of Work to be done 4 C 1 —co, 6'T'C4 C' '-1`r`;
Mechanical: New Unit With Ductwork New Unit Without Ductwork Gas Piping_Other_
ignIP 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
S ecific Directions to Job from Lillin ton:
Ham' d Jos ttsw wi sPi-'S L,4k'C, e h 8' ? h o /-'n c
7' A r fa - '
Subdivision: L.ex/-is /D n //f}-,7 /a 7-6"i Lot#:
IS - will provide the U.Jet.41-i- I labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is , 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.
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Contractor's Company Name Telephone
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Address 2 73i 7 Email Address V
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License#
iI I Date: (r � /
Structure Owner/Contractor Signature: ■_ 11�_ ?
By signing this application you affirm that you a o* ained permission from the above listed license holder to
purchase permits on their behalf. If doing the irk as owner you understand that you cannot rent, lease or sell
the listed property for 12 months after completion of the listed work.
*Company name, address, & phone must match information on license
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Application Number 14-50034567 Date 11/06/14
Property Address 92532 *UNASSIGNED
PARCEL NUMBER . 01-9594- - -0029- -01-
Application type description CP TEMPORARY LAND USE
Subdivision Name
Property Zoning PENDING
Owner Contractor
LEXINGTON INVESTORS LLC OWNER
PO BOX 1685
JACKSONVILLE NC 28541
Applicant
MEHALL DAVID
- - - Structure Information 000 000 OFFICE TRAILER FOR MED CENTER
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE LAND USE
SEPTIC - EXISTING? NA
Permit TEMPORARY ELECTRICAL PERMIT
Additional desc . T POLE FOR CONST TRAILER
Phone Access Code 1060482
Issue Date . . . 11/06/14 Valuation . . . . 0
Expiration Date . 11/06/15
Special Notes and Comments
T/S : 09/08/2014 01 : 51 PM LSEGARS ---
ENTRANCE OF LEXINGTON PLANTATION,
ADDRESS IS 55 CENTENNIAL PARKWAY
HARNETT COUNTY CENTRAL PERMITTING
P .O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Page 2
Application Number 14-50034567 Date 11/06/14
Property Address 92532 *UNASSIGNED
PARCEL NUMBER . 01-9594- - -0029- -01-
Application description . . CP TEMPORARY LAND USE
Subdivision Name
Property Zoning PENDING
Permit TEMPORARY ELECTRICAL PERMIT
Additional desc . T POLE FOR CONST TRAILER
Phone Access Code 1060482
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 207 E207 R*ELEC TEMP SERVICE POLE / /_
999 267 E267 C*ELEC TEMP SERVICE POLE / /