TRADES 11/21/2011 23:29 9196624057 PAGE 01/02
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Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910 - 893 -7525 Fax 910 - 893 -2793
www.harnett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (a) of Structure: Robert & Hezet Matthews Phone: 8061146
Owner (s) Mailing Address: 921 Pentsh Road
Fuquay -Varna
• Land Owner Name (s): Robert & Hazel Matthews Phone_
Construction or Site Address: 921 Perrier' Road •
PIN or Parcel # from GIS:
Job Cost 480040 Description of Work to be done HVAC Change Out like for like
Mechanical: New Unit with Ductwork _ New Unit Without Ductwork Gas Piping
Electrical': 200 Amp _ c200 Amp _ Service Change _ Service Reconnect Other
• For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap _ Number of Baths Water Heater
Specific Directions to Job from Lillinaton:
RIGHT onto 3 MAIN STNS -401 NUS-421 NMC -210 E. Turn LEFT onto W CORNELIUS HARNEIT BLVD/US-401
Tum RIGHT onto CHALYBEATE SPRINGS RD, Tum RIGHT onto PARRISH RD.
Subdivision: Lot #:
Duncan Aire will provide the HvAC Change out labor on this structure.
(Contractors Name) (T)
I am the building owner or my NC state license number is 17430 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: DunatonAlre Phone: 919 6624094
Address: Po Box 14368 Raleigh NC 27620 County: wake
Contractor's License # :17430 Email Address: dunstonalre@belisoum.net
Contractor's Signature: �� �rxgr6 -, Date:11/222010
'Company name, address, & phone must match information on license.
Individual Trade Application 1 of 1 0610
11/21/2011 23:29 9196624057 PAGE 02/02
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Application #
Harnett County Central Permitting
• PO Box 65 Lillington. NC 27546
910 -893 -7525 Fax 910 -893 -2793
www.harett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure Rotrert s Hazel Mathews Phone: 5551146
Owner (s) Mailing Address: 921 Panes Road
Fuquay- Verine
Land Owner Name (s): Hebert Hazel Matthews pi ao5 t 149
Construction or Site Address: 921 Parrish Read
PIN or Parcel # from GIS:
Job Cost 2 aaaa Description of Work to be done HVAC Connect after change out
Mechanical: New Unit With Ductwork New Unit Without Ductwork Piping _
Electricar: 200 Amp _ <200 Amp 1 Service Change _ Service Reconnect Other
' For Progress Energy customers we need the premise number
Plumbing: Water /Sewer Tap , Number of Baths _ Water Heater
Specific Directions to Job from Lillinotor:
RIGHT onto S MAIN ST/US-401 N/US -421 N/NC -210 E, Tum LEFT onto , W CORNELIUS HARNETT BLVD/US-401
Tum RIGHT onto CHALYBEATE SPRINGS RD, Tum RIGHT onto PARRISH RD.
Subdivision: Lot it
will provide the labor on this structure.
(Contractors Name) (Trade)
I,am the building owner or my NC state license number Is , which entities 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: FJacvktxPres9ion Phone: 9195241627
Address: 9031 Masse St County: Wake
Contractor's License #: th.
flue ` Email Address: dwawas rerabeksounet
Contractors Signature: t obt t `� _ D ate: 11/22/2010
'Company name, address, lis phone must match information on license.
Individual Trade Apoli®uon 1 of 1 08/10
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0690 -55 - , ' EDNA
1 0706900270 2.0 5433.000 6 PARRISH LN COATS
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2112600000706901520000511020 W PARRISH ST COATS
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