DOCUMENTS slSl ( ( Application# 1 fl 5O( -413a.
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx: 910-893-2793 - www.harnett.org/permits
Certification of Work Performed By Owner/Contractor
9 '{ — - (IndividualivTrade Application) 7
Owner(s)of tructure: t4fILaV o4'PV.1 -7 , Phone: 71, - 61.? 40C-a
Owner(s)Mailing Address: Jor ,4r 1�r3e 1) Y (ot_w`wo r tL )fr 7)6
Land Owner Name (s): Phone:
Construction or SitecAddress: ..'�ff
PIN# 95 $J cto - an(c parcel# bet Cs(5 b2 cya�ss.3
Job Cost: 6I 4 7' C7 Description of Work to be done C.tewrf CO/ 027v✓t WO
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork 4Gas 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 Lillington:
Subdivision: Lot#:
I )a+x<S t_ c.c'p/�l will provide the A-t.rc l,; t,,, ,c„-( labor on this structure.
(Contractofs Name) (Trade)
I am the building owner or my NC state license number is 7=7616- G ,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.
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Contractor's Company Name Telephone 0
r .) /l7ci ( Ato.-,5 kc1 7....s..-/e_ tic �wSL 2c.00t,) ..cXhen,, c o u-.__
Address Email Address
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License#
Structure Owner/Contractor Signatur : Date: Sri-ly- 1 / .
By signing this application you affirm you have obtained permission from the above listed(cense holder to
purchase permits on their behalf. If ing 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, 8 phone must match information on license
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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 17-50041322 Date 5/05/17
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
KINGSLEY JONATHAN D SERVICES UNLIMITED
35 BURNS VIEW CT 5762 ROYAL FARMS RD
LAWRENCEVILLE, GA 30044-0000 HAMLET NC 28345
LAWRENCEVILLE GA 30044 (910) 978-4440
(770) 633-6052
Applicant
DEMINO ANTHONY
205 ARLINGTON DR
CAMERON NC 28326
(770) 633-6052
--- Structure Information 000 000 CHANGE OUT 2 TON HP
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE MECH / ELE
WATER SUPPLY UNKNOWN
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1190123
Issue Date . 5/05/17 Valuation . . . . 0
Expiration Date . 5/05/18
Special Notes and Comments
T/S : 05/05/2017 04 : 18 PM JBROCK ----
205 ARLINGTON DR
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 17-50041322 Date 5/05/17
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 1190123
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 / /_