TRADES Sep. 23. 2010 6;51PM /2 Degree Heating /AC No. 241d 3
Application # •/O O 0
Please note if this application Malik gipPlicat(on c E 5
is part of a job in progress Harnett County Central Permitting q �
with open permits. PO Box 65 Lillington, NC 27546
910 -893 -7525 Fax 910- 893 -2793
_yes _fie www.hamettorg/permits .
Certification of Work Performed-by Owner/Contractor
(Individual Trade Application)
Contractorfo!Jnation ' .
I, A will complete the r..144- Q,?ra.l work on the project or
•(Kf 14fl ame) (Trade)
structure heroin described. My state license number is P 1 Dh"7 - L .All work shall comply with the
State Building Code and all othe ° other applicable State & Local law, ordinances and regulations. •
Company Name: r%4 p
41 )'►.DCP ! I.2G i (ceJ SJJUice
Mailing Address: \pjal{ Sly rim VICIAlkert -.oat(
Street Address: 400 ve_
Business Phone: RA - - SC. c51 Email Address: -
*Company name, address, & phone must match intormatton on license.
ob infor
•
Land Owner's Name: 40.4 -Zo Inetruv.._ M;. 1 k4 Phone:
Tenant/Building Owner((f diiferent)i. okrI 0Fifth rf Phone: %V\ —Ma 4 :5014 b
Construction or Site Address: 5b4 V,lari chive-Ft - RA., Li it i n n NG &75
PIN or Parcel # from GIS: 8504 - D8 - K.3 - 701. T 0b
tor y . oJobfro r refer:
S• '..t ur 1' _t :1.. h•R• r,
1
Description of work to be done: 1'P_- rpnne[ 1+Ulett Job Cost: 3 r
Mechanical: New Unit With Ductwork New Unit Without Ductwork Gas Piping
Electrical: 200 Amp _ <200 Amp — Service Change _ Service Reconnect V Other
Plumbing: Water /Sewer Tap _ Number of Baths _ Water Heater
Permit Cost '
so
Permit Fee: $ J (calculated from fee schedule)
Mail In Processing Fee: $3.00 Der aaalication For Electrical Permits with Progress Energy
we need the premise number provided.
Total Enclosed: $ t Capp
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
Lillington, NC 27546
Contractor's Signature: t � —. 17 Date; q a3 elD1
DO NOT SEND CASH. 1 %• MPLETE APPLICATIONS WILL NOT BE P OCESSED.
TRADE 4/08
Sep. 23. 2010 6:b1YM l2 Degree Heating /AG No. 241d Y. 2
Application # Ye9 a7 &
Mail In application
Please note if this application Hamel( County Central Permitting �7 d ��
rn
is part of a job in progress PO Box 65 Lilfington, NC 27546
kvitb open 910-893 -7525 Fax 910- 893 -2793
� yes www.hameti org/permits
•
Certification of Work Performed•by Owner /Contractor .
(Individual Trade Application)
`' 1 ,�y� 1 e Contractotirjformation - - -
I, W t I' t_C' 1 thel will complete the rrteiSan iris) work on the p rdject or
(Name) (Trade)
structure herdin described. My state license number is . AUL ip - All work shall comply with the
State Building Code and all other applicable State & Local Iaw, and regulations. '
Company Name: la a ' reuS 4'l' 6 M A-10— LDr0.) `4 o jnc
Mailing Address: oZ � . U �� 1( i r � �1
Street Address: , 11 4S OJObuC
Business Phone: q - ai Email Address: WCS ) riPQ.hai rnt. ID I'S-
'Company name, address, & phone must match Infomrafon on license-
'D� I 'on
Land Owner's Name: ,�wd+ef1' t Sinn& h Phone:
•
Tenant/Building Owner('rf different): 7 fl ldchdD( Phone: Fro 3 - 4 icy - 9 d e 0
Construction or Site Address.3b4 U)or•A. t(.ku.ur., '2 t. U % 41 n h 1.3 C. a.1Sti k
PIN Or Parcel #from GIS: cSbla 1) 2 C -Q37 too
S•ecific Directions to Job f • UIin.
{✓I l 1 � ~, i• r_4L- ! — � . ,a ' '' hf 1, - tea_ _� _L
4
Description of work to be done: C (314 A 444) M' . Jo Cost: S000 Mechanical: New Unit With Ductwork _ New Unit Without Ductwork t Gas Piping
Electrical: 200 Amp <200 Amp _ Service Change _ Service Reconnect — Other
Plumbing: Water /SewerTap Number of Baths Water Heater
Permit Cost
Permit Fee: $ LSI" • (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: $ 53• Da
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
LAlington, NC 27546
Contractor's Signature: 1.0.-k # Date: 7 id -3/.10M
DO NOT SEND CASH. INCOMPLETE APPLICATIONS WILL NOT SE PROCESSED.
TRADE 4/08