TRADE 195522917 DANRIC ELECTRIC PAGE 01
Application # l0 l �� l /,-
Hamett County Central Permitting
PO Box 65 Lilbngton, NC 27546
910- 893 -7525 Fax 910 -893 -2793
www.hamett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: (',I a }ran Brill 4 Sons r l h.0 Phone: q i o. 006• 6311
Owner (s) Mailing Address: V.Q Bo & 2.61
P . P,V . 7.8302.
Land Owner Name (s): Mi" i rs. Bruce May crr Phone: 91 0. 322 •804
Construction or Site Address: 375 Ltn & r ill") V'2
PIN or Parcel # from GIS: Pi N 05514 - 56 - 3 84 3 . 000
Job Cost: 225 Description of Work to be done 510 aim; 111, 06C
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork Gas Piping _ /
Electrical': 200 Amp , <200 Amp _ Service Change _ Service Reconnect _ Other ✓
• For Progress Energy custamers we need the premise number
Plumbing: Water/Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lilttnaton:
SU &)td -041
Subdivision: OUP' h i 1 LS CrUIK y� Lot #: `+34
1 RkharA Bros w e I I wW provide the el C c ► t (,Q.1 labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 1 17,E2 -1- , 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.
Structure owners) signature: Date:
Company Name: D An r l L Q ezi r rraI Sin LC Phone: IL q . 524 . son
1
Address: P.0 . Sox 104 I FUiUay VlVirlA • N C 11g 2C,
County: ► ! . I 1 1 Contra .i's License #: 1 1133
Contractor's Signature: Date: f 6beg°
*Company name, address, & phone must match Information on license.
TRADE 4N8
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