TRADE Sep 29 10 02:12p Comfort Heating & Air inc 910 - 904 -5761 p.1
Application 1/ a D 0 .0? 017:3//
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910 -893 -7525 Fax 910 -893 -2793
www.harnettorg/perrnitS •
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: 'ts, Phone: n?.Nt i74 890/ 1*4'
Owner (s) Mailing Address: tab Cl0.1/dnQo X. Mi P )rk act 34 0
Land Owner Name (s): fiJo C Pn t vnt Ar, 67 A Phone: -CZ - > 1 Y
Construction or Site Address:
PIN or Parcel # from GIS:
Job Cost: 2-0° w Description of Work to be done Poe lo P 0 e1LsCtt'1 i l l At e ll
J1) t h e C i 4a k,.Q. ,' m CM) % kA ktan fe.A. )
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork r Gas Piping _
•
Electrical*: 200 Amp _ <200 Amp _ Service Change Service Reconnect _ Other ) . t 1p
For Progress Energy customers we need the premise number
Plumbing: Water /Sewer Tap _ Number of Baths _ Water Heater
Specific Directions to Job from UIIirgton 1
tea 514 a., e4y bet jvcAO
f{ : sit r iti l/ /.'i r - y c..<.. £ /or
Subdivision: _` d� p1 Lot #:
I _ 074 ` — `d `/ II %.4 - will provide the v4C. labor on this structure.
(Contractors Name) ' (Trade))
1 am the building owner or my NC state license number is . 2 a to y Which entitles me to
perform such work on the above structure legally. All work shalt comply with the State Building Code
and all other applicable State and local laws, ordinances and regulations.
Structure owner(s) signature: i�� '' Date: 9 R it -
Company Name: Ctvij?rt flerrt a - Irr Phone: 9//1 90
Address: P. r) , 9 c%c ) W(n E p 4n rte AJC a 4 3 O
County: M ra iia Contractor's License #: anti; - t ; 153-7
Contractor's Signature: 4&PM010.t' r Date: 9 29- /LD
'Company name, address, & phone must match information on license.
TRADE 4/08