DOCUMENTS 09109/11 Application# ��
Harnett County Central Permitting `1,•V( ,1•
PO Box 65 Lillington NC 27546
Each section
filled below be lletl out otoog work
910 093 7525 Fax 910 893 2793 www harnett org/permits
M whomever performing
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name&phone must match
Owners Name Royal Oaks Building Group Date
Site Address 55 Dot Court Phone 919-233 -3886
Directions to job site from Lillington North on 401; Right onto Rawls Church Road; Right onto Atkins Road
left onto Atkins Village Court
Subdivision Atkins Village Lot 47
Description of Proposed Work Single Family Home #of Bedrooms 4
Heated SF 2785 Unheated SF 910 Finished Bonus Room9 Crawl Space X Slab
General Contractor Information
Royal Oaks Building Group, LLC 919-233-3886
Building Contractors Company Name Telephone
1210 Trinity Road, Suite 102 Raleigh,NC 27607 cobrien@royaloaksbg.com
Address Email Address
49775
License#
Electrical Contractor Information
Description of Work Electrical Rough in and Final Service Size 200 Amps T-Pole Yes_No
Imperial Electric 919-363-7474
Electrical Contractors Company Name Telephone
PO Box 162 , Apex, NC 27502
Address Email Address
19850
License#
Mechanical/HVAC Contractor Information
Description of Work Install HVAC and duct system
Enhanced Heating & Air 919-467-6464
Mechanical Contractors Company Name Telephone
5813 Lease Lane Raleigh, NC 27617
Address Email Address
31660
License#
Plumbing Contractor Information,
Description of Work Plumb single Family home #Baths 3
Barbour & Pourron 919-533-4455
Plumbing Contractors Company Name Telephone
PO Box 934, Clayton, NC 27528
Address Email Address
27132
License#
Insulation Contractor Information
Tatum Insulation II 919-661-0999
Insulation Contractors Company Name&Address Telephone
*NOTE General Contractor must fill out and sign the second page of this application
I hereby certify that I have the authority to make necessary application that the application is correct
and that-the construction will conform to the regulations in the Building Electrical Plumbing and
Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that by sigma below I have obtained all subcontractors
permission to obtain these permits and if ay changes occur including listed contractors site plan
number of bedrooms building and trade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Harnett County Central Permitting Department of
any and all changes
EXPIRED PERMIT FEES - 8 Months to 2 years permit re-issue fee is $150 00 After 2 years re-issue fee
is as per cunt a schedule
rao
LIPL2(i
Signatur f Owner/Contractor OfOc of Corporation Date
Affidavit for Worker's Compensation NC G S 87-14
The undersigned applicant being the
X General Contractor Owner Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporation(s) performing the work
set forth in the permit
X Has three(3) or more employees and has obtained workers compensation insurance to cover them
Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover
them
_Has one (1)or more subcontractors(s)who has their own policy of workers compensation insurance
covering themselves
Has no more than two(2)employees and no subcontractors
While working on the project for which this permit is sought it is understood that the Central Permitting
Department issuing the permit may require certificates of coverage of workers compensation insurance prior
to issuance of the permit and at any time during the permitted work from any person firm or corporation
carrying out the work
Company or Name -• al Oaks B • ildin• Grou•
Sign w/Title -`, r ., '� Pla s Coordinator Date "I/ic/iy
LIEN AGENT INFORMATION
Effective April 1, 2013
In accordance with North Carolina General Assembly Session Law 2012-158,
inspections offices are not allowed to issue any permit where the project cost is $30,000
or more unless the application is for improvements to an existing dwelling that the
applicant uses as a residence OR the property owner has designated a lien agent and
provided the inspections office with the information below.
Name of Lien Agent Chicago Title Company, LLC
Mailing address of Agent 19 W. Hargett Street, Suite 507
Raleigh, NC 27601
Physical address of Agent 19 W. Hargett Street, Suite 507
Raleigh, NC 27607
Telephone 888-690-7384 Fax 919-489-5231
Email support@liensnc . com
This information will be attached to the permit record and a copy provided to the
applicant. The applicant is required to post a copy on the property.
Excerpt from North Carolina G.S. 153A-357:
"(Effective April 1,2013)No permit shall be issued pursuant to subdivision(I)of subsection (a)of this
section where the cost of the work is thirty thousand dollars ($30,000)or more, other than for
improvements to an existing single-family residential dwelling unit as defined in G.S. 87-15.5(7)that the
applicant uses as a residence, unless the name, physical and mailing address, telephone number, facsimile
number, and electronic mail address of the lien agent designated by the owner pursuant to G.S.
44A-11.1(a) is conspicuously set forth in the permit or in an attachment thereto.The building permit may
contain the lien agent's electronic mail address. The lien agent information for each permit issued
pursuant to this subsection shall be maintained by the inspection department in the same manner and in
the same location in which it maintains its record of building permits issued."
PLOT PLAN FOR
ROYAL OAKS BUILDING GROUP, LLC
55 DOT COURT
LOT 47, ATKINS VILLAGE, PHASE THREE
BLACK RIVER TOWNSHIP, HARNETT COUNTY, NORTH CAROLINA
/
JOHN B. WELLS
DB 2042, 85
DBOBPG. /
P N 04 . 2012-1
SEF fee
FENENOF
S10'52'52 50,14'
IMPERVIOUS SURFACE TABI E
HOUSE 2,390 S.F.
DECK 190 S.F.
WALE k ORME 680 S,F
TOTAL IMPERVIOOS....3.260 S.F.
ALLOWABLE IMPERVIOUS - 1240.
ALLOWABLE IMPERVIOUS -24R. /
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OS EXISTING IRON STAKE SETBACK INFO
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EPN EXISTING PK NAIL fAONI: 35'
ES ELECTRIC SNB REAR: 25'
XFLARED END SECTION SIDES: 10'
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