TRADES Application # io a2) D
Mail Harnett ea P 4 �/�,
Please note if this application Harnett County Cenntrral l Permitting
is part of a job in progress PO Box 65 Lillington, NC 27546
with open permits. 910 - 893 -7525 Fax 910- 893 -2793
www.hamettorg/permits
yes no
Certification of Work Performed by Owner /Contractor
(Individual Trade Application)
Contractor Information
Brent Beasley, Beasley's Heating and Air will complete the HVAC/ Mechanical work on the project or
(Name) (Trade)
structure herein described. My state license number is 9497 . All work shall comply with the State Building
Code'and all other applicable State & Local law, ordinances and regulations
Company Name: Beasleys Heating and Air, Inc.
Mailing Address: 57 WC Beasley Lane, Coats, NC 27521
Street Address: same
Business Phone: 919 - 8944248 Email Address: beasleyshvac@aol.com
'Company name, address, & phone must match information on license.
Job Information
Land Owner's Name: Larry & Elizabeth Vanover Phone: 919 - 602 - 0358
Tenant/Building Owner Of different): Phone:
Construction or Site Address: 148 Summerville Ct. Lillington , NC 27546
PIN or Parcel # from GIS:
Specific Directions to Job from Lillinnton:
Take 421 across the bridge, turn right on Front SL/ 421
Left on Tirzah Dr., left onto Summerville Ct., 148 Summerville CL is on right
Description of work to be done: Changeout Job Cost: $ 5,031110
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
Permit Fee: $ 50.00 (calculated from fee schedule)
Mail In Processing Fee: $3.00 per iob For Electrical Permits with Progress Energy we
need the premise number provided.
Total Enclosed: $ 53.00
Make check payable & Mail completed application form to: Hamett County Central Permitting (HCCP)
PO Box 65
- – -- - -- - -- Lillington, NC 27546 — -
Contractor's Signature: ,-)lt 'Y/7% h ---. Date: 8/31110
*"DO NOT SEND CASH. INCOIWPLETE APPLICATIONS WILL NOT BE PROCESSED**
Individual Trade Mail In Application 1 of 1 . 04/10
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