BUILDING 09/09/11 Application#
Harnett County Central Permitting ni 5LN1 L,O S7
PO Box 65 Liilington NC 27546
Each section below to be filled 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+Arlc l 611,-/ 1 ers Tr Date
Site Address � 247/Aerhy C+. A+ ye - tJC, .0I 756! Phone 919'-lv.�" 20 '3
Directions to job site from Lillington /I try -,o y-d �rn ;�✓ n f Slop / h4- take,
a ,,ght el) ss lx + on S; Ias gayrs s/v twain on le;5h+,
Subdivision M arlTr✓S !0;/1 Lot o?7
Description of Proposed Work Single Earn;�y a)t 11•nq #of Bedrooms 3
Heated SF 1307 Unheated SF Finished Bonus Roomy Crawl Space ✓ Slab
General Contractor Information
Shane') &,/drrs I . 411-139-ao 93
Building Contractor s Company Name Telephone
'G4 Sian e d Rd. A J i er A(Arc, x'1501 b 1,154on em rqb;1.Caf►1.
Address Erfr'ail Address G
21/533
License #
Electrical Contractor Information
Description of Work S Service Size , a00 Amps T-Pole ✓Yes No
SNo 6/ec71r;e. 911- Ya 7--
Electrical Contractor s Company Name Telephone
/9Gss Nwy p? 10 Allier Alt A9561
Address Email Address
/36Z--(-
License #
Mechanical/HVAC Contractor Information
Description of Work SFD
Sep))enson 1-1 eak nj ; A;r m-nc. 9/9-3.29- o�gG
Mechanical Contractor s Comp ny Name Telephone
31/3 SA;ptciash Dr. (rarnef Aft a 95.29
Address Email Address
License#
Plumbing Contractor Information
Description of Work S FT #Baths ea
Ernes P/amb;not Inc. 919- y --2/33
PI Bing Contractors Company Name Telephone
v gay a Allier nee ..7W/
Address Email Address
P17735
License #
Insulation Contractor Information
Tar/-urn - n5u64-;on 919-W- D999
Insulation Contractors Company N me &Address Telephone
S/9 4/ -Prt j S to rL 61. Warner
*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 and all changes
EXPI D PERMIT FES - 6 Months to 2 years permit re-issue fee is $150 00 After 2 years re-issue fee
is as p r current fee sch ule v Q I lig
Signature of Owner/Contractor/Officer(s)of Corporation Date
Affidavit 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
✓ 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 Na; ...5.44/r;1 4/de-5 rne.
Sign w/Title i FltNt. I.P • Date a -6 - 14
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 09/16/2014
Entry #: 190678
Initially filed by: StancllBuilderslnc
Designated Lien Agent Project Property
Print & Post
Fidelity National Title Company,LLC Lot 27 Hunters Point Phase]Map 2006 Pages
1128 thru 1131 Deed Book 3228 Page 961 ❑1.r•, T 0
Online:www.liensnc.com 76 Weatherby Court 3.
Angier,NC 27501
Address:19 W.Hargett St.,Suite 507/Raleigh,NC
Harnett County +' r
27601 ❑ r17
Phone:888-690-7384
Contractors:
Fax:913-489-5231 Property Type Please post this notice on the Job Site.
Email:suppon(ulliensnc.cony.....•.... ... • 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
Plan Sox# Job Name .11 4,1 •
App # �0q5 - ; Valuational y 9 G 1 Heated SQ Feet 13 67
Garage L(C Z
Inspections for SFD/SFA
l ' Co S
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