DOCUMENTS 4 I 'i I 1 -7 Application# 12 LJC1-4 ' Iats
` Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamett.org/permits
Certification of Work Performed By Owner/Contractor
�^ /� (Individual Trade Application)
Owner(s)of Structure: / + YIE1. t{'L� Phone:
Owner(s)Mailing Address: / cc �T1/, 5 , /✓x�e77. 2'J W
JGNorfl r yl/ L
Land Owner Name(s): c +L Q t Kik, Phone:
Construction or Site Address: I 'TI1 S- /✓G. D
()camel*, (D3 Ci c) f UD-E- O co
Job Cost: L1 OD o — Description of Work to be done he, 10-cj- 1 j'u t. hex.1"'L.,.n),
AOC. -1 waLIL
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork 7- Gas Piping_Other
Electrical*: 200 Amp_<200 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:
f-Lu.�
Subdivision: Lot#:
I•( ORC. e( C.
I LOA IW $ta+*&/blvill provide the )3 7,56 /5 yb2 labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is L32S6- , which entitles me to
perform such work on the above structure legally. All work shall comply with the State Building Code and all
other applicable State and local laws, ordinances and regulations.
w Mb i-#A ws 9/O u118 ISj5
Contractor's Company NameTelephone
G (v,Idcvaad Forp ik- X) ]>)J1 /n u$Meus l2G fPm%I G°"1
Address Email Address
j97SG - IS3��9
icense#
Structure Owner/Contractor Signature: 61/11-'1 Date:
By signing this application you affirm that you have obtained permission from the above listed license holder to
purchase permits on their behalf. If doing the work as owner you understand that you cannot rent, lease or sell
the listed property for 12 months after completion of the listed work.
*Company name, address, & phone must match Information on license
HARNE'1"1' 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 17-50041126 Date 4/07/17
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
KING ETHEL LONNIE RAY MATTHEWS
15925 NC 27 W 6 WILDWOOD LANE
SANFORD NC 27332 JACKSON SPRINGS NC 27281
893-5063 (910) 295-5770
Applicant
MATTHEWS LONNIE
6 WILDWOOD
JACKSON SPRINGS NC 27281
(910) 818-6533
--- Structure Information 000 000 REPLACE 2 TON HP
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE MECH
WATER SUPPLY UNKNOWN
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1186329
Issue Date . . 4/07/17 Valuation . . . . 0
Expiration Date . 4/07/18
Special Notes and Comments
T/S : 04/07/2017 01 :35 PM JBROCK ----
15925 HWY 27 W
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.
Page 2
Application Number 17-50041126 Date 4/07/17
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Permit RESIDENTIAL MECHANICAL PERMIT .
Additional desc .
Phone Access Code 1186329
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 409 M409 R*GAS PIPING _/_/-
999 407 M407 R*MECH ABOVE CEILING / /_
999 405 M405 R*MECHANICAL UNDERGROUND /_/_
999 131 R131 ONE TRADE FINAL _/_/_
999 125 R125 ONE TRADE ROUGH IN _/ /_