TRADES 2009/03/18 09:03:01 Harnett County Page:2 /2
Application #
Harnett County Central Permitting
PO Box 65 Lillington, NC
910- 893 -7525 Fax 910- 893 -2793 •
www.harnettorg/permits
Certification of Work Performed By Owner /Contractor
( T rade Application)
owner (s) of Structure: SuSAPI l Hr it /Pass 1410AP Phone -
Owner (s) Mailing Address: ;2 `IS /a 13u..Klnr,J /
.S,tn;RO N c 2
Land Owner Name (s): ' Phone:
Construction or Site Address: 8 �M4Nrr rPa/kD f /V/i4MY�e-s ,/1/C
PIN or Parcel # from G IS:
od
Job Cost: S 0 = Description of Work to be done Chin/cc 0 t - E 1 ecfrr
PitckAfe Mr4 ;* 3 ! - ]
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 L/ -
Specific Directions to Job from Lillinaton: n
— n3ke IRS. L}11 ¶NaJ, loWArel S'AN f rJ PLL )e4 ON MA Theo PO49
t'r A a mY ) Ai de4, pm) left 4t rr /I y.r tIwYyx *yr?.n1.nr /es RN fn Ka, 441o. 2nd
f *, / How e_ 14 o fL rr
. Subdivision: Lot #:
• 11u yneh. 6 Diclzen4 HVAC will provide the Mechanv.ca2 labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 9369 , 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, ordinances and regulations.
Structure_owner(s) signature: Date:
Company Name: Tnynpn 6 Die&zene HVAC Phone: (919) 774 - 6841
Address: 921kler Avenue San&ond nr. 27330
County: 1 ee Contractor's License #: 9369
Contractor's Signature: Date:
*Company name, address, & phone must match information on license.
TRADE
4/08
•
2009/03/18 09:03:01 Harnett County Page:2 /2
•
Application # _ •
•
Harnett County Central Permitting
PO Box 65 Lillington, NC,27546 •
910- 893 -7525 Fax 910- 893 -2793
• www.harneit.org /permits
Certification of Work Performed By Owner /Contractor
cc // t1 (Indivicual Trade Application)
Owner (s) of Structure�u.5.4 G rter /Ross GIJOJD Phane:9/ 9 2..'2
Owner (s) Mailing Address: J,'/,(/ gr. r. Rd
<54*FaRD
Land Owner Name (s): Q { Phone:
Construction or Site Address: yR Ro 3 9e Rotit /Vli9 P " l r O%
PIN or Parcel # from GIS:
D
•
$ 1.b Cost: % 1 00 �Description of Work to be done einr.i e- Oat GA - E lee
t
.Mechanical: New Unit With Ductwork t / 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 Lillinoton:
• Subdivision: Lot #:
I Jo ynen 8 Dickews HVACWiII provide the Hee tit Leal labor on this structure.
(Contractors Name) (Trade) •
.f am the building owner or my NC state license number is 2046 1 -L , which entitles nie 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, ordinances and regulations.
4
Structure owner(s) signature: Date:
Company Joyner• € D- .cken.a HVAC Phone: (919) 774 -6841
Address: 2218 Lee Avenue Scu' okd ne 27330
County: Lee Contractor's License #: 20461 -L,
Contractor's Signature: Date:
•
*Company name, address, & phone must match information on license.
• TRADE • 41012
•
•
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