change of cont 'Each section below to be filled out by
Application# IR S COL/43(4i
Mromaver performing work. Must be owner
n licensed contractor. Address,company Harnett County Central Permitting.
kens phone must match Information on Po Boa BS lJM)gton,NC 2759e
Telephone Number 810-803-7525 wvw.hernett.org
` Q - A•.11 :tion for :ulidtn• add Trade Permit
Owner's Name: 1`t rek\ I p It ( 4�P 1 -- 3D /7
Address: . S - ! t Date:
r4 1 _ -9: -(a-A0.1-(a-A0.1Phone: r'
Directions to job site fromLlll�p„_ l.////
ingtan:
Subdivision: 421"-_ Cid,
Lot: I
Consimetion Type: (Please Check) Build' se: (Please Check)
eco Moved House _ esldentlal
_Renovation _Addition Other Commercial
— _Modular Multi-Family •
Total Project Cost: Description of Proposed Work: ,
Heated SF General Contractor Information
_Crawl Space( ) Building Construction Cost$
Unheated SF Slab ( ) Acres Disturbed
.19C� ' / / /(r Stories__
AIng 1ctors omp;«� c phone9(0 7 8-byoy �,
Bu Ing Contractor'snCo'm�pan(y Name Telephone
1✓•O. �J• / COLI ACS eileid �C .�93cu 65/66
Adrr A /-� L License#
1r�`
- -e nature of • er/Contractor/Oflicer(s) of Corporation-Must sign back of town a workers comp
Electrical Contractor Information /tCS
�, �,
Dsepription of Valor Service Size: Amps T-Pole: Yes No VU of LI¢ATic LLC 9/0 -77-.3 I `} 37 p
Electrical Contractors Company Name Telephone ,V
947 Vali I)r Net Wilts- NC Zf3N7 albe.lzekric`7-10 r;JycL,0-,.(-0,-"
Addrgga j
NA) Eomail Address
I 2y _
Signature of Owner/Contractor/Officers of CorporationLicense#
uISpi Loi e ..t .ao., r..r „ ., r_ _.._.
Mechanical Permit Information
Deaedption of wet* - -
/py�,�,tube�rr��o�f lUn�ita -- Type$yalem __ _ Machar cel Dots
L(_11�r__ r gyp_ 'AiJ I . • 1 • - 1. .:
TTa t .meal Cm -c•r'. C•n any Nt'em"f I„ n. rye,'
Ad*. •aS f I„ V�'_: A B-*_ h1 a Ili
'/pC-U}7�
1 License• •
5!-.-irre of Offcer(s)of Corporation
Plumbing Permit information
Description of Work 1,,_ ..1.i.
Number of Baths ]s Plumbing Cost$
i kInfe 3 ekeie.. P1.41r)
Plumbing Contractors Company Name Telephone
)490 Ql✓rrk te) L;Ilr.,�.4 _ r4•c. z7S�/S- alrp99
Address License#
ature of fficer(s) of Corporation
Insulation Permit-information Residential ( ) Other ( ) Not Required ( )
- 1 ._"� �Il�'0/06- 855'
Inulation Con ractors ompany Name& A.dress Telephone
Page 1 of 3 1/07