TRADES Sep. 15. 2010 4:29PM 72 Degree Heating /AC No. 2283 P, 2 i f
1)4694P Application # ' «O p7eO alit
mass note if this application M ail In application
is put of job in progress 0 Harnett County Central Permitting
with open Points PO Box 65 LiHington, NC 27546
910-893 -7525 Fax 910- 893 -2793
Yes — no www.hamett.org /permits •
Certification of Work Performed•by Owner /Contractor . .
(Individual Trade Application) . • •
1 Contractor information .
I, sJts L on( will complete the Y'AI r.h.anr`a.J work on the prdject or
(Name) (Trade)
structure herein described. My state license number is acl tab . All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: t).. 7 be nets ne klt4? 4 - 2 Cone(. 4-i
, Mailing Address: _Ate n tr' 71e.. .Wet lmn ui S 4i..r / ) Snnrraenj )3 L. 2.7332
Street Address: alb a4 alnn\ft
Business Phone: 4VI- 777 - a-m Email Address: 1#1,S to thaaslrnt . to rh
'Company name, address, & phone must match information on license.
I 'on
Land Owner's Name: tolnki 0 Canti 4444/42. Phone: q I D- 8`i3 -m.2.1 •
Tenant/Building Owner(if different): Phone:
Construction or Site Address: 154,.. Lt It . , - M (. a'sw (o
PIN or Parcel #from 01S: Q5X1 41 )39D.oDD
•
e fi Di - .dons • J : . 1 . i i n ! • :
tER:erileLW • ,- a rub , r. I., u. . . • i -
Description of work to be done: c)ran . o4.01- V lw* Job st: IQ I DO
Mechanical: New Unit With Ductwork New Unit Wittlout Ductwork 7 Gas Piping
Electrical: 200 Amp _ <200 Amp T Service Change _ Service Reconnect — Other
Plumbing: Water /Sewer Tap _ Number of Baths �.. Water Heater
Permit Cost •
Permit Fee: $ 3O•d , (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application For Electrical Permits with Progress Energy
we need the premise number provided.
Total Enclosed: $ 'l • OD
Make check payable & Mail completed application form to: Hamett County Central Permitting (HCCP)
PO Box 65
63114t—CE. Ellington, NC 27546
Contractor's Signature: Date: q - I O ID
DO NOT SEND CASH. INCOM S a WILL NOT BE PROCESSED.
TRADE 4/08
Sep. 15. 2010 4:30PM 72 Degree Heating /AC No. 2283�. 3 �� a � ! /
Application # ' 1., TT
Mail In application
Please note if this application Harnett County Central Permitting sot '
is part e a job i progrss
with open tea PO Box 65 Lilliington, NC 27546 L, .15)..1 .15)..1 i k
' 910- 893 -7525 Fax 910 - 893 -2793 1 ' `
•
yes no www.hamettorg/perrnits , •
Certification of Work Performed•by Owner /Contractor • •
(Individual Trade Application) • ' , - . • '
Contractor Information . .. . ,
1, " 7"NeLinrl4 Abt'ri s will complete the P.. tMI* i. ca.( work on the projector
•(Name) (Trade)
structure herdin described. My state license number is t i on7 -L. t NI work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
0.
Company Name: ndy Rh in S 21 ec4-ri [a.1 c74.4.cifiC1 ( a
Mailing Address: 1 Bat-1 3het`i \)31:c to tied i Nnrcrd j U L 033,1
Street Address: Saws 41/4 al.xrua'
Business Phone: G. iq - `17i -R•531 Email Address: --
"Company name, address, & phone must match information on license.
Ma
ion
Land Owner's Name: " r>bl� ‘1 Phone: 4 ID ` 3 - Lw t
Tenant/Buliding Owner(if different): ` Phone:
Construction or Site Address: 151 .3.. C 1a.r4L ktia d ,1-$ l�Li ng'4W1 N L XIS 4 ,
PIN or Parcel #from GIS: C5 -139 OM _
_.,:fc -t - ..r, 1• •bf •m Lillin. on:
72, ;314- br , or K.
Description of work to be done: a - Conn #k-4- 1kl i,rk rl. Job Cost: 3 00
Mechanical: New Unit With Ductwork_ New Unit Witho DJf uctwork Gas Piping
Electrical: 200 Amp <200 Amp _ Service Change _ Service Reconnect ✓ Other
Plumbing: Water /Sewer Tap ` Number of Baths ___ Water Heater
Pernik Cost •
Permit Fee: $ SD' ° ° (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application For Electrical Penults with Progress Energy
we need the premise number provided.
Total Enclosed: $ .S0 • oO •
Make check payable & Mail completed application form to: Hamett County Central Permitting (HCCP)
PO Box 65
(a1lington, NC 27546
Contractors Signature: Date : — 9 11/0
DO NOT SEND CASH. 1 OMPLETE APPLICATIONS WILL NOT 6E OCESSED.
TRADE 4/08
GIS_Public: P By Freeance 4.3.2 - TDC Group Inc.
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