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BUILDING Application # • c T Each section below to be fitted out H County Central Permitting by whomever performing work. ty t g Must be owner or licensed PO Box 65 Lillington, NC 27546 contractor. Address, company 910 - 893-7525 Fax 910 -893 -2793 www.hamett.orgiperrnits name & phone must match Application for Residential Building and Trades Permit Owner's Name: Watermark Homes, Inc gz_x,- Lc ia5 ho Site Address: i43 5c3an SF1hh.'&xS 1)ri . (&trnRntim Phone: 910 -237 -1512 Directions to job' Site frail illingtort: &utitltuis�otli 101> x10 SLA t its Go\-F' Lot; Description of Pr oposed Wort 1\ievs t� a dex�r; c.0 Curl °rktt� a o f.1a r1s:; .5 Heated SF:c0 Linheated sF 3M 1 OFinished sons Roan? ‘ CrawiSpace: ✓rye - _ General Contractor Informatio Watermark Homes, Inc 910 Building Contractor's Company Name Telephone PO Box 53922 Fayetteville, NC 28305 kelly ©watermarkhomesnc.com Email Address 49261 Si nature of Owner /Contractor /Officer(s) of Corporation License # Electrical Contractor Information Description of Work Electrical Work Service Size: 200 Amps T -Pole: ' Yes' No Sandy Ridge Electric 910 323 - 2458 Electrical Contractor's Company Name Telephone 454 White Head Road Fayetteville, NC 28301 keith@sandyridgeelectric.com -r \> (� Email Address 1 j� 10006U Signatu of Owner /Contractor /Officer(s) of Corporation License # Mechanical/HVAC Contractor Information Description of Work HVAC Simmons Heating, Cooling & Electric, Inc. 910 - 217 - 5242 Mechanical Contractor's Company Name Telephone 1110 E 2nd Street Lum. - rton, C 28358 jsimpson@shaac.com r: Email Address I r._. ♦ , ��; 02875 S !not re of iwner/Cont'- ctor /Offtcer(s) of Corporation License # Plumbing Contractor Information Description of Work Plumbing 5 Dell Haire Plumbing 910 - 818 - 4863 Plumbing Contractor's Company Name Telephone 7612 Documentary Drive Fayetteville, NC 28306 dellhaireplumbing ©hotmail.com Address g Email Address L. ! ■ ' r 24204P -1 Signs we of Owner /Contractor /Officer(s) of Corporation License # Insulation Contractor Information Cumberland Insulation 4205 Clington Road Fayetteville, NC 28312 910 - 484 - 7118 Insulation Contractor's Company Name & Address Telephone 'NOTE: General Contractor must fill out and sign the second page of this application. kesinc,It.,11 Liuudh,o 4p. , ligation 1 of 2 0i /1J Application # 4 OD Homeowners Applying to Build Their Own Home Please answer the following questions then see a Permit Technician to determine if you qualify for permit under Owners Exemption. Questionnaire per G.S. 87 -14 Regulations as to Issue of Building Permits (Memo available upon request) 1. Do you own the land on which this building will be constructed? _ yes _ no 2. Have you hired or intend to hire an individual to superintend and manage construction of the project? _ yes _ no 3. Do you intend to directly control & supervise construction activities? _ yes _ no 4. Do you intend to schedule, contract, or directly pay for all phases of construction work to be done? _ yes no 5. Do you intend to personally occupy the building for at least 12 consecutive months following completion of construction and do you understand that if you do not do so, it creates the presumption under law that you fraudulently secured the permit? yes _ no 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 if anv changes occur including listed contractors, site plan, number of bedrooms, building and trade plans, Environmental Health permit changes or proposed use any an > certify ' I . my esgonsi to notify the Harnett County Central Permitting Department of FP--: / Signature of Owner /Contractor /Offic ) of Corporation Date Affidavit for Worker's Compensation N.C.G.S. 87 -14 The undersigned applicant being the: X 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: X Has three (3) or more employees and has obtained workers' compensation insurance to cover them. X Has one (1) or more subcontractors(s) and has obtained workers' compensation insurance to cover them. X 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 Name: Watermark Homes, Inc. Sign w/Title: / ' Date: May 21, 2010 BUILDING Page 2 of 2 4/08 Plan Box Number (.. s Job Name (A- `-'` --c Date: S ---- 1 'l e Required Inspections for SFA /SFD Appl.# /6 -Sc t Z`/ 6b Valuation Z.CB'55V Sq. Feet `3 2 1 0 Sequence 10 ✓ _ R* Bldg. Footing 10 -30 R* Elec. Temp Service Pole 20 / R* Building Foundation 20 Address Confirmation 30 -999 ,/ Open Floor 30 -999 R* Bldg. Slab Insp. 30 -999 R* Elec. Under Slab 30 -999 R *Plumb. Under Slab 40 Four Trade Rough In 40 ✓ Four Trade Rough In> 2500 40 Three Trade Rough In 40 Three Trade Rough In> 2500 40 Two Trade Rough In 40 Two Trade Rough In> 2500 40 One Trade Rough In 40 One Trade Rough In > 2500 50 ✓' R* Insulation 60 Four Trade Final 60 V Four Trade Final > 2500 60 Three Trade Final 60 Three Trade Final > 2500 60 ['wo Trade Final 60 l'wo Trade Final > 2500 60 ')ne Trade Final 60 c )ne Trade Final > 2500 999 LLnvir. Operations Permit