DOCUMENTS 09109/11 Application#
Harnett County Central Permitting 1 ri SexY-ti 53 (p
E.rh..coon below lo be Mad out Po am.6 Langton NC 27606
by.Monlew portormxp wart
60.1 7626 Fax Oto eat 2790 wow homed ayparind.
Aust G owner aliened
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AoobPintatton for Residential Budding and Trades Pet
Owners Name areal Ju /1t Date
Site Address Oto la e1let a n0.` v S}•. Phone 01 .siti
ry
Directions tojob site from ldimgton "(..ILL. IJ(L 14.1a1 ttc-1. dowel
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3 VI Subdwlslon Otele-Cf.11v1 di (14.t Lot Vaal)
In 5. Description of Proposed work 12-t-3 fiCfl )ct /of Bedrooms
Heated SF Unheated SF ' Finished Room/ _Crawl Space _Slats
r- general Contractor Infarmatat
WSJ4Y333(,287-5tlege
But Ing Co s Company Name Telephone
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License #
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Desmpton of Work 1`L1L44 (aX Mkt,1 Service Size ZaLAmps T-Pole Vies No
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El. -:I Contract. s Company Name T., .. a • •
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...rose Emed Address
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License
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Description of Work . . . _ C,
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Mechanical Conl •rs Company Name Telephone
0. Bre Z? Clt.rnmaas 271o1Z
ress Email Address
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License c'
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Descriptio''of Wok 1, . • . ,/ . . . Baths 2.c
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Address Email EmailAddress
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License
Insulation Contractor Information
Insulation Contractor. 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 appltcatan that the application is correct
and that-the construction conform to the regulations in the Budding Electrical Plumbing and
Mechanical codes and the Harnett County Zoning Ordinance I state the sdormabon on the above
contractors is correct as known to me and that pv marline below I have obtained all subcontractors
permission to obtain these permits and if agy changes occur including hated contractors site plan
number of bedrooms buiding and bade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Harnett County Central Permdbng Department of
any and all changes
EXPIRED PERMIT FEES-6 Months to 2 years permit re-issue fee is $150 00 Met 2 years re-issue fee
is assperrccurrent fee sdie ple
Signature of r!Conn ilegcer(s)d Corporation Date 11 . 1,
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 pequry that the person(s) firm(s)or corporation(s)performing the work
sat forth in the permit
Has three(3) or more empoyees end has obtained workers compensation insurance to cover them
Has one(1)or more subcontractors(a)and has obtained workers compensation insurance to cover
them
7-Has one(1)or more subcontractors(s)who has their own policy of workers compensation insurance
covenrg themselves
_
Has no more than two(2)employees and no subcontractors
While working on the project S which this permits sought it is understood that the Central Penmtting
Department issuing the permit may requre certificates ofcoverage ofworkers compensabon insurance pnor
to issuance of the permit and at any time dung the permitted work from any person firm or corporation
carrying out the work
Company or Name id11d.t[1L
Sign wrtme4 ZA.wits t . P(rlvyiJ-L aofl4l na,t, ,e— Date 5.11 •11
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 17-50041536 Date 6/02/17
Intersection
Property Address 91749 TECH 2
PARCEL NUMBER - -
Application type description CP ADD & ALTER RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
WADE JURNEY HOMES INC WJH LLC
3300 BATTLEGROUND AVE 3300 BATTLEGROUND AVE
STE 230 STE 230
GREENSBORO NC 27410 GREENSBORO NC 27410
(919) 995-5654 (336) 282-3606
Applicant
WJH LLC #130 RETAINING WALL
3300 BATTLEGROUND AVE
STE 230
GREENSBORO NC 27410
(336) 282-3606
--- Structure Information 000 000 RETAINING WALL
Flood Zone FLOOD ZONE X
Other struct info SEPTIC - EXISTING? NA
WATER SUPPLY COUNTY
Permit RESIDENTIAL BUILDING PERMIT
Additional desc .
Phone Access Code 1194224
Issue Date . . . 6/02/17 Valuation . . . . 0
Expiration Date . 6/02/18
Special Notes and Comments
T/S : 06/02/2017 09 : 12 AM JBROCK --- -
TAKE NC 210 S R ONTO RAY RD L ONTO
OVERHILLS RD L INTO SUBDIVISION
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 17-50041536 Date 6/02/17
Property Address 91749 TECH 2
PARCEL NUMBER - - -
Application description . . CP ADD & ALTER RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Permit RESIDENTIAL BUILDING PERMIT
Additional desc .
Phone Access Code 1194224
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 103 B103 R*BLDG FOUND & TEMP SVC POLE / /_
999 101 8101 R*BLDG FOOTING / TEMP SVC POLE / /_
999 131 R131 ONE TRADE FINAL _/—/