TRADE Aug, 10. 2010 4:12PM Southern Exposure Sunrooms No. 0768 P. 1
Application # (0 - Soo Pr 34(.
pail In application
Please note if this application Barnett County Central Permitting
is pan of ajob in progress PO Box 85 Lillington, NC 27548
with open permits. 910 -893 -7525 Fax 910 -893 -2793
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www.hamett. org /permits
' Certification of Work Performed by Owner /Contractor
(Individual Trade Application)
Contractor Information
So w Coca uaC 5 -`efta0/ 5wi11 complete the Ta 5u-rr- o .J work on the protect or
(Name) (Trade)
structure herein described. My state license number Is ( . All work shall comply with the Slate Building
Code and all other applicable State & Local law, ordinances and regulations.
Company Name: Swan-'4- 6r.)fl!t PP: s YtS rr_A- J( 5oazIee)'4J Etcvasvar cpa.r -o 0"S
Mailing Address: Pa kits X 1 4-o o'l b.) i t-ht , .S BTo rJ , rJ tr. f
Street Address: (n %b-I FLerfLse 5'r )ttr 1-4.1,AC -n4 4 (3C 2- *n S
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Business Phone: 9 _ Email Address:J S ..-teafn crP ur,,. -r<-
'Company name, address, & phone most match information on license. iiwvCvon+5 • cam'
,lob Information
lend Owner's Name: o / Q c tl A ti k H s2k Phone: '1 n
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Tenant/Building Owner (if different): (' � Phone:
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Construction or Site Address: at1 -RAA)G ( A'n'ti_ t 59n-.4 Locr -a t:. asrl 9 b
PIN oc:rcelA .mGIS: bso “Sog Olga D
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O D L.■ O �- yl- a. O 14 _• $ WAY 2
Description of work to be done: .1 a35u.th're $c...r to o rA 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 ,K c - .L t c.xd p 1 . rasa
Permit Fee: $ (calculated from fee schedule) q to _ 15 S Yl 6 S
Mali In Processing Fee: 83.00 per lob For Electrical Permits with Progress Energy we
need the premise number provided.
Total Enclosed: $
Make check payable & Mail completed application form lo: Harnett County Central Permitting (HCCP) ni
PO Box 85 4 '
Lfilinglon, NC 27548
Contractor's Signature: Date: t j r ° l 3- O t o gij
1 (\ ' /✓
* *DO NOT SEND SH. I COMPLETE PPLICATIONS WILL, NOT BE PROCESSED ** Indi vidual Trade Mali In Appaceiion 1 011 04(10