BUILDING mash "r,r.,y.�� x11 775
Application #
Each section below to be filled out H County Central Permitting
whomever performing work. PO Box 65 Lillington, NC 27546 g
Must be owner or licensed
contractor. Address, company 910- 893 -7525 Fax 910 - 893 -2793 www.harnett.org /permits
name & phone must match
Application for Residential Building and Trades Permit
Owner's Name: Wynn Construction, Inc. 9 - Z, 10
Date:
Site Address: 162 (00\ 1 r t • Phone: co (003-77t.
Directions to job site from Lillington: NC 27W to Omaha Dr.
Left on Omaha Dr. into Tingen Pointe Subdivision, F.�. Gk ' Ohio &OkaC n N QT(//T
Subdivision: Tingen Pointe Ca 1VPna N Lot 9 3 6 e._
Description of Proposed Work: New Construction # of Bedrooms: 3
Heated SF: pi Jnheated SF: SY 2. Finished Bonus Room? Crawl Space: Slab:
General Contractor Information
Wynn Construction, Inc. 919 603 -7965
Building Contractor's Company Name Telephone
2550 Capitol Dr. Creedmoor, NC 27522 edward @wynnconstruct.com
Ad ss L � O mail E Address
4 ail
gnature of Owner /Contractor /Officer(s) of Corporation License #
Electrical Contractor Information
Description of Work New Construction Service Size: 200 Amps T -Pole: ✓ Yes No
R. A. Jackson 919 730 - 1251
Electrical Contractor's Company Name Telephone
9261 Raleigh Road Benson NC 27504
f: Email Address
i ''-� 1' 2114
Signa re of Owner /Contractor / Officer(s) of Corporation License #
Mechanical /HVAC Contractor Information
Description of Work New Construction
Stephenson HVAC 919 329 0686
Mechanical Contractor's Company Name Telephone
343 Shipwash Dr. Garner, NC 27529
ress Email Address
18644
Signa e o Own: /Contractor / Officer(s) of Corporation License #
Plumbing Contractor Information
Description of Work New Construction # Baths
Thorton's Plumbing 919 669 - 8655
Plumbing Contractor's Company Name Telephone
3160 - A Omar Rd. Clayton, NC
Ad�Jress Address
Email
,C )' 2
n mail
re of Owner /Contractor / Officer(s) of Corporation License #
Insulation Contractor Information
Tatum Insulation 919 661 -0999
Insulation Contractor's Company Name & Address Telephone
*NOTE: General Contractor must fill out and sign the second page of this application.
I: -1 . - p J Their O wn H om e e Ex emption. t)
Du t'u / palifyforp unde Own on requ es
- tY � ttq f� eteimv, « y ou q p Aem o ava uP
eow rie r - AP P ing Per
of Build l
f{om a permit Issue to d Yes N
G.S. lo6 tins th u ions as to
Please answer the follow . C
d
which building will be
Questionnaire Yes ___NO
wn the land °n to superintend an
1. Do y ° ich this to hire an individual
fired or intend project? Yes
- - 1 ‘ 1°
2 Have you h of the prol struction activities?
manage construction Control &supervise con
to directly ay for all phases o Yes �
3 Do yo u intend or directly P
contract
you intend to , consecutive
Yes No
4_ st schedule
work to be done
construction w Occupy
e building f °r at least 12 understand that if
erletion o ou
5 n you intend top th that yo
u fraudulently
completion of cons r under W
months following ft creates the presumption
you r not do e
secured the p that the application is mbing correct
certify that I have the authority to make necessary
lication' Electrical, Plu and
to the regulations in app the Building, site plan,
I hereby Zoning Ordinance. I state thlist dreonttroactorsthe above
and t hat the construction
the Harnett County changes occur including es or proposed use
Mechanical codes, Environmental Health permit changes aliment of
contractors is correct as known to me and
chhange s , I cerbedrooms, building y responsibility b trade y to notify the Harnett C ounty Central Permitting Dep
nmber cange, certify it is my any
EXPIRED PERMIT
. e
E all ERMIT FEES Months to 2 Y s. ears permit reissue fee is $150.00. After 2 years re -issue fee
EXPIR he ' ,
• nature of Owner /Contra For/Officer(s) of Corporation Date
Affidavit for Worker's Compensation N:C.G.S. 87 -14 •
The undersigned applicant being the:
✓ 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
;,y
set forth in the permit: i
✓ Has three (3) or more employees and has obtained workers' compensation insurance to cover them.
_ Has one (1) or more subcontractors(s) and has obtained workers' compensation insurance to cover
them.
Has one (1) or more subcontractors(s) who has their own policAworkers' 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 erstood that the Central Permitting
Depart ment issuing the permit may require certificates of cover of worker's compensation insurance prior
to issuance of the permit and at any time during the permitted k from any person, firm or corporation
carrying out the work.
W Construction, Inc
Company or Name: —
�. ,�� .
Sign w/Title: . ..1. �• ��� Date. - 2S= /0
l i
.
I
Plan Box Number 13 Job Name `
Date: ' - 2 c- 1G
Required Inspections for SFA /SFD
Appl. # kk_ 6a2�1'� 7r
Valuation / / R G ! Z
Sq. Feet / R y
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 A / 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 i/ Four Trade Final
60 Four Trade Final > 2500
60 Three Trade Final
60 Three Trade Final > 2500
60 Two Trade Final
60 Two Trade Final > 2500
60 One Trade Final
60 One Trade Final > 2500
999 Envir. Operations Permit