DOCUMENTS U9l loft Hppucaeun e
Harnett County Central Permitting /7- S?2O VI b 2,0
PO Box 65 Lillington NC 27548
Each section below to be filled out 910 893 7625 Fax 910 893 2703 www harnelt org/permits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name 8 phone must match /r1�
Owners Name LOth lsdSiritet:rnU t rmc, Date /O /'7
Site Address 2-92, flaery Foal Phone 9/9GOj-7745—
Directions to lob site from Lillington AIM NG tP r.g kt a 2-10 thWt, 3A4r des Leff 61440•91,ti<t
for ISrtsgIr4, Le-erDtu Lhallbeafe 2.d Cor YR m;le , Auer, Rae 1,,4lee;
Subdivision Act load Lot (o 3
Description of Proposed Work A/C& COdsiniel4s/ SEt #of Bedrooms 1-
Heated SF ZI Bio Unhealed SF 77Z- Finished Bonus Room? /4 Crawl Space ✓Slab _
General Contractor Information
ti PA LnAS-1-rU.0+;setno. 9,9 /003 . 776S-
BuildiA�g Contractors Company Name Telephone
lab Ca p;+oI f. S/e /45"('reerleorAt 27s7.2 Pdi..O+rJ@G/yndhones.Cawc
Address Email Address /
/429.5—
License#
EVc ac oetisa
Description of Work Neu} Contrite rola Service Size 2°C Amps T-Pole _Yes_No
Q. A. ale-sou eksL*-Ie_ 9/t 73o- /Zr/
Electrical Contractors Company Name Telephone
9261 2aketlk4A. Boast ki,Nc 2-7sD #
Address Email Address
all III
License #
)1echanscal/HVAC Contractor Information
Description of Work Neu.) LoaIsfr!!670F/
ref- :C:el Heat a.Nd- A:r 9/0 85-8-&oo
Mechanical Contractors Company Name Telephone
797isi feflaked• Asha-371dya/1/C 1$3s7
Address Email Address
/►ICzoo2/2 113 &idol
License#
Contractor Information
Description of Work J/e.iJ / StM_T4rc1 #Baths .2. $
1-40rd7 Res f' 4 in 4 9/9.rs0- /833
Plumbing Contractor s Company Name Telephone
31/00-4 Otorkl. e/arf#.r Nt 27S2-17
Address Email Address
zein--
License#
Insulation Contractor Information
714#14 ..Thso/ztroR/ 9/74&1-0999
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 pv signing below I have obtained all subcontractors
permission to obtain these permit%and if any 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
EXPIRE PERMIT FEES-6 Mon s to 2 years permi e-issue fee is $150 00 After 2 years re-issue fee
is asp cur�r/e�nje hedule
C — ► 7
81 tur o TOwner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
General Contractor Owner V.—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
6,- s 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 subcontraclors(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 Nam, 11-10CM&&4-& L,ad//JigC. // /� /CD
Sign w/Title Al �// - /49 Ga»4Lr� Date -17
DO NOT REMOVEI
Details: Appointment of Lien Agent Filed on, 030 6/2017
Entry n: 820407 initially filed by: wynnhomes
Designated Lien Agent Project Property Print & Post
Investors Tele Insurance Company j even pane subdivision Int 063 I -
1 292 avers pond di. F.y
Oore'.aVRdI4uWS39aw ,.. . .„ Away varier,NC 27526 0 I
-v
AtlJrtn:l9 W H n rhe Il SL Suite 307r Ra:ei86 NC bemeI:County
27601
Contractors:
eeenc ata6n0-7184 Please post NY not tee on the Job Siva
I °WIMY°t231 Property Type
Supplierscanod ulownlurunre:
mu
u ..wronmPemercum-...._.am,_. sun Nis image FM your-smart Monne to
1-2 Family Dwelling
view Ibis ming.You sect men lies Nmive
to ben Agent for Otis project
Owner Information
awnnbemes
2550 nap riot JL
ecMmoa,NC 27522
United States
Email nancy@wYnnhMenttorn
Phone:919-528-1347
View Comments(0)
Technical Support Hotline:(B08)600-7304
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Application Number 17-50041020 Date 11/30/17
Intersection
Property Address 292 AVERY POND DR
PARCEL NUMBER 08-0653- - -0029- -67-
Application type description CP NEW RESIDENTIAL (SFD)
Subdivision Name AVERY POND PH2 30LTS
Property Zoning RES/AGRI DIST - RA-30
Owner Contractor
LITTLE CROSS LLC WYNN CONSTRUCTION, INC.
8625 MT PLEASANT CHURCH RD 1696 HAYES RD
WILLOW SPRINGS NC 27592 CREEDMOOR NC 27522
(919) 528-1347
Applicant
WYNN CONST INC #63
2550 CAPITOL DR
STE 105
CREEDMOOR NC 27522
(919) 603-7965
- -- Structure Information 000 000 60X60 4BDR CRAWL W/ GARAGE & COV PORCH
Flood Zone FLOOD ZONE X
Other struct info # BEDROOMS 4000000 . 00
PROPOSED USE SFD
SEPTIC - EXISTING? NEW TANK
WATER SUPPLY COUNTY
Permit BLDG,MECH, ELEC, PLB, INSU PERMIT
Additional desc .
Phone Access Code . 1197110
Issue Date . . . 6/26/17 Valuation . . . . 0
Expiration Date . 6/26/18
Special Notes and Comments
T/S : 03/23/2017 10 : 32 AM JBROCK ----
AVERY POND #63
T/S : 08/15/2017 10 : 57 AM JBROCK --- -
premise # 68048179
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
PERMIT INCLUDES BLDG, ELEC, MECH, PLUMB
INSULATION AND LAND USE.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Work must conform and comply with the
STATE BUILDING CODE and all other State
and local laws , ordinances & regulations
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Pae 2
Application Number 17-50041020 Date 11/30/17
Property Address 292 AVERY POND DR
PARCEL NUMBER 08-0653- - -0029- -67-
Application description . . CP NEW RESIDENTIAL (SFD)
Subdivision Name AVERY POND PH2 30LTS
Property Zoning RES/AGRI DIST - RA-30
Permit BLDG,MECH, ELEC, PLB, INSU PERMIT
Additional desc .
Phone Access Code 1197110
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
10-30 814 A814 ADDRESS CONFIRMATION SB AP 8/07/17
10 101 3101 R*BLDG FOOTING / TEMP SVC POLE BS AP 8/07/17
20 103 B103 R*BLDG FOUND & TEMP SVC POLE BS AP 8/15/17
30-999 105 B105 R*OPEN FLOOR BS AP 8/21/17
30 104 B104 R*FOUND & SETBACK VERIF SURVEY JB AP 9/15/17
40-50 129 I129 R*INSULATION INSPECTION TSG AP 9/25/17
40-60 425 R425 FOUR TRADE ROUGH IN JLP AP 9/21/17
40-60 125 R125 ONE TRADE ROUGH IN BS AP 10/27/17
40-60 325 R325 THREE TRADE ROUGH IN / /
40-60 225 R225 TWO TRADE ROUGH IN / /
50-60 429 R429 FOUR TRADE FINAL KS AP 11/30/17
50-60 131 R131 ONE TRADE FINAL / /
50-60 329 R329 THREE TRADE FINAL / /
50-60 229 R229 TWO TRADE FINAL / /
50-60 209 E209 R*ELEC TEMP POWER CERT KS AP 11/02/17
999 H824 ENVIR. OPERATIONS PERMIT AC AP 11/21/17