TRADES Nov. 3. 2010 3:21PM 72 Degree Heating /AC No. 3111 P. 2
Application # '
Mail In application
Please nom h
if this application part n ajob progress Harnett County Central Permitting
is
with epee permit
in PO Box 65 Lillington, NC 27546
910 - 893 - 7625 Fax 910 - 893 -2793
_._ne www.hamett.org /permits
• Certification of Work Perforned•by Owner / Contractor
(Individual Trade Application) • • • ` • .
•
Contractor information
i, &tilt ?loa%ckaAJ win complete the _ Yh&1.LAa n i (al work on the project or
(Name) (Trade)
structure heron described. My state license number is 2, iPas V . All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations. r
Company Name: IA. Dolt hPa.•l-1 ee_ conicI itonM
Mailing Address: . , 1► :. .. �S • = ... / • 2
Street Address:
Business Phone: ( 111 Y -a.»> Email Address; tnAMPtio_a.nutrne.. Cu h
'Company name, address, ss, & phone must match information on license.
Job Information
Land Owner's Name: Thanni t 4 la�e. Phone: Q• ID- le-51(04
Tenant/Building Owner(if differen0:11 akfnona. Ne. _ Phone:
Construction or Site Address; 11 Aktno . Ian. ��i �.aVL atAi
PIN or Parcel # from GIS: O.SD5 1ND•b00
S.- ' rcDi = 'o 1- • Job fro ill' oto,:
. "fre lirfaISINSTri:,1t1ia' . • _ o
Description of work to be done: i nc-1-4 Jo Cost; S q79 • o0
Mechanical: New Unit With Ductwork_ New Unit Without Ductwor Gas Piping
Electrical: 200 Amp Amp . Service Change _•__ Service Reconnect Other
Plumbing: Water/Sewer Tap Number of Baths Water Heater
Permit Cost '
Permit Fee: $ SD ' (calculated from fee schedule)
Mail In Processing Fee: $3.00 per mastication For Electrical Permits with Progress Energy
we need the premise number provided.
Total Enclosed: $ 53 •
Make check payable & Mail completed application form to: H Box 65 County Central Permitting (HCCP)
/ / LBGngton, NO 27646
li
Contractor's Signature: Date; 11 of D /
DO NOT SEND CAM INCOMP ETEAPPLICATIONS WILL NOT REPROCESSED.
4108
TRADE
Nov, 3. 2010 3:21PM 72 Degree Heating /AC No. 3111 P. 3
Application # •
• Mail In application
Please note if this application Harnett County Central Permitting
is part ofa job in progress PO Box 65 LiIington, NC 27546
t open P 910-893-7525 Fax 910 - 893 -2793 •
_ y am www.hamett.org/permits • •
Certification of Work Performed•by Owner/Contractor • . • •
(Individual Trade Application) • • r
Contractor Information) ' •
I, t4p,n (ovriS will complete the v'.lt( cA-) work on the project or
( ame) (Trade)
structure herdin descnbed. My state license number is 1100 7 All work shall comply with the
State Building Code and all other applicable State & Local law, orr and regulations. en •
Company Name: NOILS El �4 rr� ra t `le.rvirb¢c
Mailing Address: i - "( I o a • ' - fi .i 3 a
Street Address: S/X.m.i.
Business Phone: C AA Q - 717 -B53 Email Address: —
'Company name, address, & phone must match information on license.
1,�\ Job Information
Land Owner's Name: NINNIC.'1 Phone: e t D —4 Up — S1(.0
Tenant /Building Owner(it different):1 I Almond. AjS at. Phone:
Construction or Site Address: 1 t PA mcp.A. 1\t -t t.s t c rntnt Ladle A 83 ao
PIN or Parcel #from GIS: OSOS -yq -3R90. 080
Specific Directions o Job m Lillin o : /�
• S -t L +A w,l.1r e2/ Pi- hi- oARed/ FaIK wl Kaol Al
• .• . '.e. 4. K •., a ...' PI .. d:_-a • ' d , I : L'_d_'ta
; A :�►R ,. Cr kitiZgares oes , A 1) _, r
o►. ? + I f r n r Lek on D ecun AA M T , Atntn'rl
Description of work to be done: Re -Omer; ca. \ W i4/1 Job Cost: 3 00 -
Mechanical: New Unit With Ductwork _ New Unft ut Ductwork Gas Piping
Electrical: 200 Amp _ <200 Amp ._ Service Change _ Service Reconnect it, Other —
Plumbing: Water /Sewer Tap _ Number of Baths Water Heater
Permit Cost •
Permit Fee: $ .5 (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: $
Make check payable & Mail completed application form to: Hama County Central Permitting (HCCP)
PO Box 65
Irvington, NC 27548
Contractor's Signature Date; iiJa /d
120 NOT SEND CASH. 1 REPLETE APPLICATIONS WILL NOT BE PROCESSED.
TRADE 4/08
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