TRADES 2009/03/18 09:03:01 Harnett county Page: /2
Application # /6 c0-0 0 -1 YO 02
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Harnett County Central Permitting
• PO Box 65 Lillington, NC
910- 893 -7525 Fax 910 - 893 -2793 •
www.harnett.org/permitS
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
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Owner (s) of Structure: chd;e- 4 - ChrrsT,a< Qint 181 Phone: 9 2 g90 a(aS .;
Owner (s) MailingAddress:D4)8' NC }{�4 7 - 7 Weil'
Land Owner Name (s):gb/Sse, +Chnstke CRa.r/% ,i Phone:
Construction or Site Address:U/R tJ c Nw 2') 11114* L /fini976 „) Al c.-
PIN or Parcel # from GIS:
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Job Cost: 3 7Rb Description of Work to be done CkA,v trif roc - E/ecic,r
Pfttkm rE 1J.y -
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork /Gas Piping _ o
0
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
SDeclflc Dir ions o Job fr m Lillinaton // 3
� 2 / /oz_. 0 n R /r /f
ti • % i %f.
Subdivision: Lot #:
I layHe/L 6 Dichena HVAC will provide th Mechavu ca L 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.
Structureowner(s) signature: _ Date:
Company Name: lndne/r HVAC Phone: (919) 774 -6841
Address: 72181 v Avenue canbond ne 27330
County: Lee. Contractor's License #: 9369
Contractor's Signature: Date:
. *Company name, address, & phone must match information on license.
TRADE 4/08
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2009/03/18 09:03:01 Harnett county Page:: 2/2
Application 4 _
Harnett County Central Permitting •
PO Box 65 Lillington, NC,27546 •
910- 893 -7525 Fax 910 - 893 -2793 •
• www.harnett.org /permits
Certification of Work Performed By Owner /Contractor
( Individual Trade Application)
•
Owner (s) of Structure: "Ui e (‚4 ris95Na CRAM ` P `" h�one: ? / /o $ o- 34--4
Owner (s) Mailing Address: 2.-6/Cr NC.. /v/w 27 fratcl-
Litl,rvN /UC
Land Owner Name (s): g0 phi Phone:
Construction or Site Address: 7h,' % Ne - NW y e. 7 Wet 1
PIN or Parcel tf from GIS:
✓v 11
Job Cost:37fo Description of Work to be done ChnNS obi Cgs - Enec/rt
r _
P Pckl- GE ay;
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
Specific Directions to Job from Lillington:
so
Subdivision: Lot 4: •
I Jo linen 8 Dickens HVACwill provide the E.2eet& -Lcat labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state number is 20461 -L , which entitles me 10
perform such work on the above structure legally. All work shall comply with the Slate Building Code
and all other applicable State and local laws, srdinances and regulations.
s
Structure owner(s) signature: Date:
CompanyName: Joyner E D.iekena HVAC • Phone: (9191 774 -6841
Address: 2218 Lee Avenue San{yond no. 27330
County: Lee • Contractor's License 2t: 20461 -L
Contractor's Signature: Date:
*Company name, address, & phone must match information on license.
TRADE OG8
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