TRADES Application # /P LV Z O�y
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910 - 893 -7525 Fax 910 - 893 -2793
www.harnett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: ,/A -p,.. (,v , Phone: cjl -20 -7 6 41&
Owner (s) Mailing Address: /Wig r,,4 /cd
co .
Land Owner Name (s): J Itit4^�+ -- C,t t,ias ..� Phone:
Construction or Site Address: / 3 £. C - f,,4a.
PIN or Parcel # from GIS: ✓ 7 0 61,E 4 ,7
Job Cost: Description of Work to be done kiwi fraic
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork Gas Piping _
Electrical *: 200 Amp _ <200 Amp _ Service Change _ Service Reconnect _ Other
• For Progress Energy customers we need the premise number
Plumbing: Water /Sewer Tap _ Number of Baths _ Water Heater _
Specific Directions to Job from Lillinaton: `
Subdivision: N_ / Lot #:
I gee/ S /e'9 f A& will provide the 4(`Lttg c/ labor on this structure.
(Cofitracto m e) (Trade)
I am the building owner or my NC state license number is 94/ 7 , 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, ordinanc- - and regulations.
Structure owner(s) signature: I L..►: = Date: r
•
$ - to
Company Name: b , 1 Phone:
Address: J/J•iiTl►/ L, County:
Contractor's License #: ' 9 E5ail ■/d/�tress: p
Contractor's Signature: / 8 42/ 1 "/ Date: d - p - /
*Company name, address, & phone must match information on license.
Individual Trade Application 1 of 1 06/10 .
Application # o// 4
Harnett County Central Permitting Y 111
PO Box 65 Lillington, NC 27546
910 - 893 -7525 Fax 910 - 893 -2793
www. harnett. org /permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: �,(I4..gs..0- (')_. n / Phone: / 7 -Z'0 7 - 7( 4/ a
Owner (s) Mailing Address: /0 9'9' F ,; AI • .
J'.s7 .e. 0 2752 /
Land Owner Name (s): 22.mAce•.,.4. C•rvwcr,.s Phone:
Construction or Site Address: 13V cr. (//a.0 s'f'
PIN or Parcel # from GIS: i7 O• (r / 06/
Job Cost: Description of Work to be done /- d, ,
•
Mechanical: New Unit With Ductwork New Unit Without Ductwork Gas Piping
>y Electrical *: 200 Amp <200 Amp _ Service Change _ Service Reconnect _ Other
3 • For Progress Energy customers we need the premise number
0 Plumbing: Water /Sewer Tap _ Number of Baths _ Water Heater
S.ecific irections to Job from Lillington: -
a e_ / L 7. if li S.f e 141 f-
■
40 1 111 CA rr S
Subdivision: Lot #:
I nri /Z Gd -f,o4/ w' ill provide the %,44. labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is gf /» / , which entitles me to
perform such work on the above structure legally. All work shall comply with the State Building Code
O and all other applicable State and local laws, ord nanr. < a • reg ations.
�
Ids %P ,
Structure owner(s) signature: : ✓ s .;��..� Date:
Company Name: r �► —�. 1 •hone: f - C
Address: /' i i /., _ _,! .a % County:
Contractor's License #: / / ' dress
Contractor's Signature: �i e / // Z Date:
7
*Company name, address, & phone must match information on license.
Individual Trade Application 1 of 1 06/10
1
•