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TRADES Mall In application Application # /©20d Please note if this aplie4tion is part of a job in progress' Harnett County Central Permitting with open permits. PO Box 65 Lillington, NC 27546 910- 893 -7525 Fax 910- 893 -2793 yes no www.harnett.org /permits Certification of Work Performed b9 Owner /Contractor (Individual Trade Application) �y� -/ Contractor Information . I itekiL. r e" will complete the go 4 4. 4 4- work on the project or (Name) (Trade) _structure herein described: My state license number is //),S7 All work shall comply with the State Building Code and all other applicable. State & Local law, ordinances and regulations. Company Name: Sir //s W7Ardinai; nil SE.U/I r F _ Mailing Address: / 93 ! A r A,. (. at F(3/ �l Street Address:: 42 AA 1/ i ascota) 44,/n , At,pt,Qyu;fir. . 17< 6 c.2 nl e Business Phone: _ 9fh -- 25 9710 Email:Address: 'Company name, address, & phone must match information on license.. // is Job Information Land Owner s Name: / I,(tC) k iS a in— Phone: 9 /4 —S'/ /6 Tenant/Building Owner(if different): Phone: Construction or Site Address: /G /y T/I, firt, -2 f h, -2 4,. PIN or Parcel # from GIS: Specific. Directions to Job from Lillinoton: 1 3 Description of work to be done:�o) 1�. ' d c n4'4 , - l .,� �� Job Cost: 86$ Mechanical: New Unit With Ductw fo k New unit : WithoGtDu6twork - Gas Piping Electrical: 200 Amp _ <200 Amp Service Change_ .Service Reconnect Other Plumbing: Water /Sewer Tap _ Number of Baths _ - Water Heater Permit Cost Permit Fee: $ /,# (calculated from fee schedule) Mail In Processing Fee: $3.00 per application . For Electrical Permits with Progress Energy - we need the premise number provided: Total Enclosed: $ /o3. : Make check payable & Mail completed application. form to: Harnett County Central Permitting (HCCP) PO Box 65 • LIIIIngton,:NC 27546 Contractor' , // !� ,_// Date: ate— /l) DON SEND CASH. INCOMPLET "APPLICATIONS WILL NOT BE PROCESSED. TD A 111 Please note if this app ' Mall In application APPlication # is part of a job in progress' Harnett County Central Permitting with open permits, PO Box 65 Lillington, NC 27546 910- 893 -7525 Fax 910 - 893 -2793 yes no www.harnett.org /permits Certification of Work Performed by Owner /Contractor (Individual Trade Application) �y� -` Contractor Information 1, 4 !//rCk e re d will complete the /444 =Fs 4 j le_ work on the project or (Name) (Trade) structure herein descr bed._My state license number is 77 . All work shall comply /,' $' ply with the State Building Code and all other applicable State & Local law, ordinances and regulations. Company Name: S 9 / /,s' YV reicl -N; tit/ / (5 E fJbt, _ Mailing Address: P/), 9, 9 / A /Air) Woe: , 4,. (3.. a S Street Address: /,23 /,J, //; iti 4 71 ityv;/ /r , 4 6 a WV Jl _ ' Business Phone: 9/h •- 5:25 Email Address: 'Company name, address, & phone must match information on license. Job Information W Land Owner's Name: 41 / /. P 3 in - Phone: 9/4 - 79 7 —r) /6 Tenant/Building Owner(if different): Phone: Construction or Site Address: /G4 Tn t "S get 0 1: f 1, ..p4-- PIN or Parcel # from GIS: Specific Directions to Job from Lillington: w._ Description of work to be done: t );, J,t,� //4; o,�lj 4 /9/ Job Cost: Mechanical: New Unit With Ductwork _ New Unit. Without Ductwork _ Gas , Piping Electrical: 200 Amp — <200 Amp _ Service Change — Service Reconnect Other Plumbing: Water /Sewer Tap _ Number of Baths Water Heater Permit Cost Permit Fee: $_ (calculated from fee schedule) Mail In Processing Fee: $3.00 per application For Electrical Permits with Progress Energy we need the premise number provided. Total Enclosed: $ Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP) PO Box 65 - Lillington, NC 27546 Contractor's ignature: / _ ,_ i i , Date: 7 - -/a DO NiT SEND CASH. INCOMP E APPLICATIONS WILL NOT BE PROCESSED. TRADE GIS_Public: Powered By Freeance 4.3.2 - TDC Group Inc. Page 1 of 1 b `'° "}' � s 3 '1, ' ' a (� r�j(C�l - ' a ,C1I t Id (,� t i��mi�pl Ii! Search � . `+5 �. k: rt _ 1k S + r l " x . 5 irli6 1�`� 11 +��[�. (II` A ... . f' II . k. „w rrID, I i 12LL, U , lip i �! 411; ,/". . 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