BUILDING 09/09/11 Application#
Harnett County Central Permitting l COG SCi
PO Box 65 Liihngton NC 27546
Each section below to be filled out 910 893 7525 Fax 910 893 2793 www harnett orglpermtts
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)-anc/ 61,:«eys 2ne_. Date
Site Address /OV GilPa/herby cf. An5 ey Ak! ai3 / Phone 9/9- 39-- o73
Directions to job site from Lillington //W lD VIl h Arli fir a+ 5fp 1:111+ f-urn £f.
en r!c SS L��'� on 5; 1,0,5 Ala 5 &Crrd� S 7D down one h-1-.
� � g
Subdivision /Qt7 hers O;of Lot �6
Description of Proposed Work S; if Fair ly 1 iA ll: #of Bedrooms 3
Heated SF 134'0 Unheated SF Finished Bonus Roomy Crawl Space ✓ Slab
General Contractor Information
5714/6/Igu!/cd ers Inc. 919-G, I�ao�3
Building Contractor s Company Name Telephone
X66 Si-LW;1 'Raid byla!slontembTma;l.caM
Address Email Address
34i533
License#
Electrical Contractor Information
Description of Work SrD Service Size e.263 Amps T-Pole ✓ Yes No
E/eCir;C 9/9- 952
Electrical Contractors Company Name Telephone
19655 Hwy �Io Artjer' nlC a 9501
Address Email Address
130 T5-L
License#
Mechanical/HVAC Contractor Information
Description of Work SFD
S+rphfn5on FICA}r not A;r Iri 9/9-3a9- 0694
Mechanical Contractor s Company Name Telephone
3113 s11;p104.51, "Tr. Lrarnr✓ ►JC a'J5�-/
Address Email Address
License#
Plumbing Contractor Information
Description of Work 5F 17 #Baths , --
iSarne5 P mmb; 919- 9 -x133
Plumbing Contractors'Company Name '156 Telephone
Ps°r pox /aO7 I1n3i /JC. a /
A dress Email Address
Address
License #
II 1 II Insulation Contractor Information
TA'�illrt 1 n5 u,a4•o n q/9-le /--6 999
Insulation Contractors Company Name &Addregss Telephone
d/d Dru' 5-Ibre �,L Gar rev IBC �7c L9
*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 a0 all changes
EXPIRD PERMIT)FEES - 6 Months to 2 years permit re-issue fee is $150 00 After 2 years re-issue fee
is as r current fee hedule 2
_7,,, t
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
v 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 worker s 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 Nam .54-11/1C; I �C�u,Iders Inc.
Sign w/Title ) _ I'uN1� Y ' �)
' Date 4 ,6' - 114
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 09/16/2014
Entry #: 190673 Initially filed by: StancllBuildersinc
Designated Lien Agent Project Property
Print & Post
Fidelity National Title Company,LLC Lot 26 Hunters Point Phase I Map 2006 Pages
1128 thru 1131 Deed Book 3228 Page 961 0 . 0
Online:www.liensnc.e.gm - 104 Weatherby Court � , r{
Addrea:19 W.Hargett St.,Suite 507/Raleigh,NC Angier,NC 27501 '•r:�y
Harnett County r.r#,io•
27601 0 • v .
Phone:888-690-7384
Contractors:
Fax:913-489-5231 Property Type Please post this notice on the Job Site.
Emati:gu000rt(a3licnsnc.com. 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
Stencil Builders Inc
466 Stancil Road 10/16/2014
Angier, NC 27501
United States
Email:bgoldston(aembargmail.com
Phone:919-639-2073
View Comments(0)
Technical Support Hotline:(888)690-7384
Date �j� - ) 7 ' /
Plan Box # \D T Job Name C
App # I (0g5(rD Valuation 1 I S 2-1- Heated SQ Feet t 3 410
Garage L13 6
177
Inspections for SFD/SFA
Crawl Slab Mono Basement
Footing Footing Plum Under Slab Footing
Foundation 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___