TRADE Application # �d arQ 6 0? `x"02 -6
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
Telephone Number 910- 802 -8525 Fax 910 - 803 -2793
www.harnett.org
Certification of Work Performed By Owner /Contractor
Owner (s) of Structure: Campbell University Phone: 910- 893 -1610
Owner (s) Mailing Address: PO Box 97
Buies Creek, NC 27506
Land Owner Name (s): Campbell University
Construction or Site Address: Science Building, 141 T.T. Lanier Street Extension
Buies Creek, NC 27506
PIN or Parcel #:
Job Cost: $29,000,00 Description of Work to be done Demo the existing exterior service. Install
a new disconnect to reefed the existing MOP. Install an additional 400 amp exterior
disconnect feeding a new interior panel. The new panel shall supply heat strips.
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
Specific Directions to Job from Lillington:
From Hwy 421 take Leslie Campbell Drive; then left on to T.T. Lanier Street
Subdivision: Lot #:
I, Triple -R Electric, Inc. have provided or will provide the Electrical labor
(Contractors Name) (Trade)
on this structure. I am the building owner or hold a NC state Electrical license
(Trade)
number 13241 -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) signature: Date:
Company Name: Triple -R Electric, Inc. Phone: 252 -523 -3558
Address: PO Box 6116, Kinston, NC 28501
County: Lenoir • Contractor's License #: 13241 -U
Contractor's Signature: Gd`/4' •/ • Date: 10 -19 -10
*Company name, address and phone m tch information on license