DOCUMENTS k.
Com,-i tiu^^ "' tion ii-1 S1 QA I 13O-
Harnett County Central Permitting r,,,�tg
Pp Box 85 Lillinglon.NC 27546 - Ph:910.893-7525 - Fx 916-893-2793 - vNN hamott-orgies
Certificationof Work
Performed By Ow��/Contractor
(Individual
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"rner(s)of Structure: �lG1E-- � n N � A Alt Phone: - _ to '/ -—3 Z� /
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Owner(s)Mailing Address: - •,.....,......_ Ai-
Phone: 9/ s --3 37'3
Land Owner Name(s):
Construction or Site Address:
PIN# /lY"l ^ 5 •�� el#Parc
Job Cost:_._-----Description of Work to be done 7....
�_ - �' 32(0
.I. .. \ 1\
s Piping_Other r
Mechanical: New Unit With Ductwork New Unit Without Ductwork Other
p <200 Amp_Service - : ge_ ervice Reconnect
Electrical': ?Fo Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap
Number of Baths Water Heater
s /1'`/".1�
sect c D'rectio s o Job fromi Lillin.t•n: �� Alp4 A
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Subdivision:
a Vl 1 • Lot#:
Ez` ict/ labor on this structure.
l Sates how& will provide the (Trade)
(Contractors Name) which entitles me to
I am the building owner or my NC state license number is i��-the State Building Code and all
perform such work on the above structure legally. All work shall comply w
other applicable State and local laws, ordinances and regulations.
k, 1 Ie '5 T-lephone
Contractor's Company Name Q�
x-r t.r. Yr . : �G 7 I Email • .dres lit1�4t
Address
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'. Licensei�
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��-/ Date�� � o
Structure Owner/ Contractor Signature
this application you affirm t at you hh obtained permission from the above listed license
si
purchase
e PP
permits on their behalf. If doing the work as owner you understand that you cannot rent,lee
the listed property for 12 months after completion of the listed work.
*Company an name, address, & phone must match information on license
1
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 17-50041730 Date 6/29/17
Property Address 92941 TECH 4
PARCEL NUMBER - - - - - - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
TOLLEFSON DAVID BARRY LEWIS ELECTRIC INC
326 YOUNG ROAD 19370 NC HWY 210 E
ANGIER NC 27501 ANGIER NC 27501
(919) 639-3393 (910) 639-4589
Applicant
BANNY LEWIS ELECTRIC
19370 NC 210
ANGIER NC 27501
(919) 639-4589
- -- Structure Information 000 000 HVAC C/O - OWNER DOING ELECTRICAL
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE MECH/ELEC
WATER SUPPLY UNKNOWN
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1198134
Issue Date . . . 6/29/17 Valuation . . 0
Expiration Date . 6/29/18
Special Notes and Comments
T/S: 06/28/2017 04 :45 PM BPETRICH --
326 YOUNG ROAD ANGIER 27501
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 17-50041730 Date 6/29/17
Property Address 92941 TECH 4
PARCEL NUMBER - - - - - - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1198134
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 /_/_