TRADES 2009/03/18 09:03:01 Harnett county Page:2 /2
Application # /A, c9
Harnett County Central Permitting 41-6C6
PO Box 65 Lillington, NC
910- 893 -7525 Fax 910- 893 -2793
www.harnettorg/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure:-37,1 t-IN � / FRA Phone:
.• (s) Mailing Address: • 1 1 70 / e - ✓sa,.l ACP
i rA •
Land Owner Name (s): 04n " - t — ba /} 'NA /l / E /1R Phone:
Construction or Site Address: 1 I ) o Af /t rsn. 0 42
PIN or Parcel # from GIS:
Job Cost: L� Z
tL t: a 63 Description of Work to be done at A %6- exu
+ T
z.5 -
HPA -j/J P
lrm •
Mechanical: / / New Unit With Ductwork _ New Unit Without Ductwork ✓ Gas Piping
•
Electrical *: 200 • Amp _ <200 Amp _ Service Change _ Service Reconnect Other So
For Progress Energy customers we need the premise number
Plumbing: Water /Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillinaton:
. Subdivision: Lot #:
•
I Jnynen 6 D.ickena HVAC will provide the Mechanical labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 9369 , which entitles rile 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, ordipances and regulations.
Structure signature: Date:
Company Name: 7ngnen. 6 D.ickene HVAC Phone: ( 919 )174 -6k41
Address: 221R1v Avenue San 4o) nr. 27330
County: L'p. Contractor's License #: 9369
Contractor's Signature: Date:
. *Company name, address, & phone must match information on license.
TRADE
4/08
2009/03/18 09:03:01 Harnett county Page:2 /2
•
Application 4_ •
Harnett County Central Permitting
PO Box 65 Liltington, NC,27546
910- 893 -7525 Fax 910 -893 -2793
• www.harneti.org /permiis
Certification of Work Performed By Owner /Contractor
��
(Individual Trade Application)
Owner (s) of Structure: tL, 4 N n R lik A Phone:
Owner (s) Mailing Address: 1) 7o l eIkk✓s4A; ROern
— ro A7J,t+1 N t/ N
Land Owner Nano (s): Co(�nr t , )0 1Jr�4 1216.RA Phone:,
Construction or Site Address: 1170 /3 fl-er.c , 2v4n
PIN or Parcel # from GIS:
•
of
Job COst :: io L o--' Description of Work to be done C - / s5e O 2..- •
i
Mechanical: New Unit With Ductwork Unit Without Ductwork Gas Piping
Electrical`:' 200 Amp _ <200 Amp • Service Change Service Reconnect Other
For Progress. Enorgy customers we need the premise number
Plumbing: Water /Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillington:
•
Subdivision: Lot #:
•
I Joyner 8 Dh.c12en6 HVACwill provide the Elea-VI-Lea labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 20461 - L which entitles rune 10
perform such work on the above structure legally. All work shall comply with the State Building Coda
and all other applicable State and local laws, ordinances and regulations.
• Structure owrier(s) signature: Date:
Company,Name: Jo yner 8 DX.claens HVAC Phone: [919) 774 - 6841
Address: 2218 Lee Avenue San6okd ne. 27330
County: Lee Contractor's License #: 20461 -L
Contractor's Signature: Date:
*Company name, address, & phone must match information on license.
TRADE 4 /Oh
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