BUILDING 09/09/11 Application# 1
Harnett County Central Permitting 0� Sw l ( 9(
PO Box 65 Lillington NC 27546
Each section below to be piled out 910 893 7525 Fax 910 893 2793 www harnett org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name&phone must match
Owners Name S-izinc:1 (3u;lde's In Date
Site Address 074 111;,311 h 51-andarvi Lane. r�no;,ec xJC .29,50 I Phone 9/9-4.19-020V
Directions to job site from Lillington Nwy a/D W An3it/ fake r:5h1 , n Ne 55
Di1 S:las Hayes • S/1) dotn on 614.
Subdivision Nzm/rS Poi of Lot 33
Description of Proposed Work Si()&e. FAnt:1 y 73u0cll;n9 #of Bedrooms .3
Heated SF 1340 Unheated SF Finished Bonus Room/ Crawl Space ✓ Slab
General Contractor Information
Elan," &u;/deeS Xi-re 919--439-a073
Building Contractor s Company Name Telephone
51a 5I4,e l Road Ilng;rr .2Z01 rr :I �o•e w
Address Ernelil Address
License#
Electrical Contractor Information
Description of Work SFD Service Size 0260 Amps T-Pole --/Yes No
SAO 6itC y;c 9/9-'/ 1-19.5"A
Electrical Contractors Company Name Telephone
/95S .aW Ann;>° - AfC a1561
Address Email Address
j:3o?S-C
License#
Mechanical/HVAC Contractor Information
Description of Work 51D
$'}-fpher,son N ea};nqq l /?;0' 919—SQ9- 0684
Mechanical Contractors Cor 1'pany Name Telephone
343 Ship 11.1451i jar. barn et, ne .2'75.29
Address Email Address
f/3-z
License#
Plumbing Contractor Information
Description of Work SFD #Baths aZ-
y e5 umb,n ire 919-1/20?-a/33
Plumbing Contractors ompany Name Telephone
Vie. &x /02OLAilliev me -?'1co/
Address Email Address
P197.35
License#
Insulation Contractor Information
Ia--ur1- Tr.5u-la4-;on 9/9-GAO/-e999
Insulation Contractors Company Name &Address Telephone
J27 Did 2ru9 54-ere red. artier Ate, aisa1
*NOTE General Contractor must fill out and sign the second page of this application
I hereby certify that I have the authority to make necessary application that the application is correct
and that-the construction will conform to the regulations in the Building Electrical Plumbing and
Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that by signing below I have obtained all subcontractors
permission to obtain these permits and if any changes occur including listed contractors site plan
number of bedrooms building and trade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Harnett County Central Permitting Department of
any d all changes N.
EX IR D PERMIT FEE$-6 Months to 2 years permit re-issue fee is $150 00 After 2 years re-issue fee
is as p current fee sch le
�
.I R -4 - t4
Signature of Owner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation NC G S 87-14
The undersigned applicant being the
_✓ General Contractor 1/ Owner Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporation(s)performing the work
set forth in the permit
✓ Has three(3)or more employees and has obtained workers compensation insurance to cover them
Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover
them
✓ Has one (1)or more subcontractors(s)who has their own policy of workers compensation insurance
covering themselves
Has no more than two(2)employees and no subcontractors
While working on the project for which this permit is sought it is understood that the Central Permitting
Department issuing the permit may require certificates of coverage of workers compensation insurance prior
to issuance of the permit and at any time during the permitted work from any person firm or corporation
carrying out the work
Company or a e Stare 1 t .ld�ers Inc .
Sign wattle( M{)4A_ .. 11 .I • Date i -/ "/
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 09/16/2014
Entry #: 190739
Initially filed by: StancilBuilderslnc
Designated Lien Agent Project Property
Print & Post
Fidelity National Title Company,LLC Lot 33 Hunters Point Phase I Map 2006 Pages
1128 thru 1131 Deed Book 3226 Page 573 c". 'r 0
Online:www.liensnc.com - 24 High Standard Lane �� _rti•$
Address:19 W.Hargett St.,Suite 507/Raleigh,NC Angier,NC 27501
27601 Harnett County O .?Aa;o
A •
Phone:888-690-7384
Contractors:
Fax:913-489-5231 Property Type Please post this notice on the Job Site.
Email:suoportOliensnc.com r Suppliers and Subcontractors:
1-2 Family Dwelling Scan this image with your smart phone to
view this filing.You can then file a Notice
Owner Information to Lien Agent for this project.
Date of First Furnishing
Stancil Builders Inc
466 Stancil Road 10/16/2014
Angier, NC 27501
United States
Email:bgoldston @embarqmail.com
Phone:919-639-2073
View Comments(0)
Technical Support Hotline:(888)690-7384
Date ‘L)-- •
Plan Box# Job Name ip'J`fi
App # \ OQ I VaIuati I N �{ 2Z Heated SQ Feet ( 3 Li v
Garage
)776
Inspections for SF9/SFA
Crawl ✓ Slab Mono Basement
Footing Footing Plum Under Slab Footing
Fou ndation Foundation Ele. Under Slab Foundation
Address Address Address Waterproofing
Open Floor Slab Mono Slab Plum Under slab
Rough In Rough In Rough In Address
Insulation Insulation Insulation Slab
Final Final Final Open Floor
Rough In
Insulation
Final
Foundation Survey Envir. Health Other
..•.
Additions/ Other
Footing
Foundation
Slab
Mono
Open Floor
Rough in
Insulation
Final,____