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TRADE 10/01/2010 16:01 9196620730 ALLEN KELLY C11 1NC PAGE 01/01 rirf " sw APPrICatiOh # /0.7 O O v Harnett County Central Permitting c9 Li C PO Box 65 Lillington, NC 27546 � {` Telephone Number 910 -893 -7525 Fax 910-893 -2793 `A # r• www.hamett.org Certification of Work Performed By Owner /Contractor Owner (s) of Structure: SC.0 a l tr ct Phone; 2 IS 0 8 Owner (s) Mailing Address: 1 7 5 Cr Q4 w Fo Yet Land Owner Name (s): S co 4-1 Ata -yytai, Phone: 'Z let 6 )fg Constriction or Site Address: 2 S t4W �v PIN or Parcel #: II Job Cost 0 Description of Work to be done ' e r f Q ce ? cc halt i, r fi 1 Mechanical: New Unit With Ductwork — New Unit Without Ductwork _ Gas Piping Electrical: 200 Amp _ 400 Amp Service Change Service Reconnect _ Other Plumbing: Water /Sewer Tap Number of Baths Water Heater Sneciflc Directions to Job from Lillington: Subdivision: Lott: I tt Li% Kg- Il K Co. have provided or will provide the labor (Contractors Name) (Trade) on this structure. 1 am the building owner or hold a NC state E-1 eci-ii col / M ecIn or, ;es d license (Trade) number L 01711/07019, which entitles me to perform such work on the above structure legally. Ali work shall comply with the State Building Code and all other applicable State and local laws, ordinances and regulations. j� f l Structure owner(s) signature: Date:[ 6 / 0 \ 1 Z3 ` Company Name: R tt p h Kel4 (:a. Phone: t 7 1 — N1 71 Yo Address: 12f)- A - 'Tr Lei t RU Rn1 N(- 2 ► County: W o h e- Contractor's License #: L10 It I M'' 171 ` Contractor's Signature: 0, , _2 mod" � Date: 10 0 l/10 `.Company name, address, & phone must match information on license. 12/06 GIS_Public: Powered By Freeance 4.3.2 - TDC Group Inc. Page 1 of 1 � f y „ p p -.-ii }' ! . " . • 1 ? S 4 ,rC, r '4 + ; I . N�ij' 0 Ni I �. "' y l�i . ! I I 3 �� I Nu ` Pi i l ei � ''ri b ig, .., , II . .s,4 J14T„ 1 ,, . i I iK9 i il1f� . a r„ ) ��I b E e Witt, I,]E� (N „„t "`+ 'v e: k ' h; :'i -; Search • � x a 1 Ehow All Selections tit e, 1 6 _ ; d / � r ? , c 6 y u m, a ?b ons Clear) 0 141,1.'2;9r . { ie , 9 i a " i i i r p :r8 , b,, , ^;P ati Feature i q Yi t *. i i r” -i v e x M x 12 � 4 n , u,, r 116 -; „ s; ; . 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Zjac Phone :119 - 4Q9 Construction or Site Addressrai'a5 f iAOWN,C £/Ar& PIN or Parcel # from GIS: Job Cost: Description of Work to be done Mechanical: New Unit With Ductwork New Unit Without Ductwork _ Gas Piping Electrical': 200 Amp _ .4200 Amp _ Service Change _ Service Reconnect Z Other ' For Progress Energy customers we need the premise number Plumbing: Water /Sewer Tap _ Number of Baths Water Heater — Soecific Directions to Job from Lillinaton: • Subdivision: Lot #: 1 /14-A. 1 01/ 4 5FRvirr (so will provide the k V13 '(, labor on this structure. (Contractors Name) (Trade) I am the building owner or my NC state license number is as u , 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)signat�ure Date: Company Name: ARNokGtt .J�' ERV iA.F• / • Phone: ( b0 ` 42t- S Sffo Address: i M;lLc4pi6 -Si: fitygf -ke vtnA N.C. 4R„oe. County: Or i rnlienka.n/rt Contractor's License #:- .22f741 Contractor's Signature: -c-A si r ° rns �-wt .- -- Date: 10 - /D `Company name, address, & phone must match Information on license. TRADE (45700 o D 41" t¢ /a6 ° GIS_Public: Powered By Freeance 4.3.2 - TDC Group Inc. Page 1 of 1 t -- " ,. TOT 't „.r t+ A , . s . .1 ■ I f 3_ 3r :ii� Ii +L� fiE:€ 'lout it 3 .. t {i ;�li �:;� � I � �ill`.. t � r '' : rei�� y. m " "a' A t . , II t: i^ , „; �. � . • :• � i ing Search i ,,, � ul 1 -apt ,. "S i t �,u ho soFnea lec tions , a, , k * I lions Clear ( na. . €,d r o-� �t�': ,, 38 _ celsFea ,, Iq " . r ih. + ' , lit .5 . iP � y ': 4 ,Owner lntar anon r { 0 , i k1 t r 3 4 .4. -. V i n MD JANICE S 3 ,� l V e nm R. 11 COI ': ,� prt €�g, Ot t r � , �' { y "'' DDRS"�_ CROWN POINT DRIV €i i,. `. 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I....t .J €.3 .:L� ,. w ;� 13�I1L...3'.t"'Yr` ° .> w L €I I3 i http: / /gistools.harnett.org /Freeance /Client/PublicAccess 1 /index.html ?appconfig = public 1 10/1 /2010 19/01/2919 16:91 9196629739 ALLEN KELLY CO INC NAGS 91/91 Application ft d Q c" Harnett County Central Permitting O7 U JO PO Box 65 Lillington, NC 27546 rP r Telephone Number 910- 893 -7525 Fax 910 -893 -2793 www.hamett.org Certification of Work Performed By Owner /Contractor Owner (s) of Structure: Scot+ aI "(Waif I Phone: 21`i - 0g i Owner (s) Mailing Address: 7 7 5 C y Cp M, Fo y4 Land Owner Name (s): S ca {1- At f yIetat, Phone: Z I`l 6 gg Construction or Site Address: 71- 5 C etywCari PIN or Parcel #: Job Cost: )3 O L Description of Work to be done g e p I e car ?ac hrrl c 1- %€ GO 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 Jo from LIIIi Subdivision: Lot #: Sc _L`SII I r^ 1<C..IL �i. Co, have provided or will provide the labor (Contractors Name) (Trade) on this structure. I am the building owner or hold a NC state £- (ecFricol1 M tea, or, icyJ license (Trade) number “0"1111/07019, 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:1 U /0 \I Z 01 9 / 9 �/ 3 °? � " Company Name: P tl t Yte L & (A Phone: et c( ~ 7 l" t ccl %)9 Address: 0-10-A- Tf � B RA R a ' e',� N( 2764 . County: _ Wo 11c Contractor's License #: &0912 M -0 ` I Contractor's Signature: 6 j Date: 1010 Ii1 D `Company name, address, & phone must match information on license. 12106 GIS_Public: Powered By Freeance 4.3.2 - TDC Group Inc. Page 1 of 1 1 N '� _" e tl ▪ WN a" m: w '4 ! P !� II UR I - • n1 ` Mzlid qQ i. ( ' +' i[ ' v , . ., p l.a 4 I § �Hjf7}, !'[ `, t 1 ' 1 n a i l (� g I i .� a�R w F ± r rfli4'a .,I1 1H }11. 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