TRADE Application # 2 7jj
Harnett County Central Permitting -4
PO Box 65 Lillington; NC 27546 I ;;
910- 893 -7525 Fax 910- 893 -2793 ` '
c .
www.harnett.org/permits
Certification of Work Performed By Owner /Contractor =
(Individual Trade Application) ,,
I Owner (s) of Structure: firn a, ® Phone: j fy— 2922
(s) Mailing �"? 1Y 4 n7 4n 2
/ 1.-*/ fiati.,rin
Owner s Mailin Address: �'
Land Owner Name (s): 6 i9hf1 / Phone: ' �;
Construction or Site Address: .l %y
PIN or Parcel # from GIS: /2 9 4 ' 084 0
Job Cost: 6,000 Description of Work to be done st
S
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork Gas Piping _ 1
Electrical': 200 Amp _ <200 Amp Service Change _ Service Reconnect _ Other _ 1
• For Progress Energy customers we need the premise number
Plumbing: Water /Sewer Tap _ Number of Baths _ Water Heater 4
•:•.ii D' - - • • frill Li111•h•,:
Subdivision: Lot #:
1 OA": ,T,yy '4yl..i will provide the /i14e,g labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is , 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.
•t••ct eo er(isi• =: a `
_ Dat =. — _
Company Name: Zi7UE S HLVYJA 4 d ( J. W Phone:
Address: SW AWF//d XV.. CA/9 7
County: ifr if �//� -i Contractor's License #: /Q//1
y .�i�st/�H
Contractor's Signature: Date: /3/y), 1
*Company name, address, & plfone must match Information on license.
TRADE 4/08
Application it 5 . 0 2 x'735
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910 -893 -7525 Fax 910 - 893 -2793 ;.
www. hamett.o rg/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application) '
Owner (s) of Structure: , hh i.F leAs.Z. Phone: f /o ✓ *
Owner (s) Mailing Address: .5f 9 497,V Al A -dial/Xi
Land Owner Name (s): Phone:
Construction or Site Address:
PIN or Parcel # from GIS:
Job Cost: Description of Work to be done
Mechanical: New Unit With Ductwork _ New Unit Without Ductwork _ Gas Piping
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 _ 1
Specific Directions to Job from Lillinaton:
Subdivision: Lot #:
I BA &.le44r-'cri-/ St /tda
I ,Perms anti-hell will provide the tie c.4 r,'c k- / labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is .2 b,59- 1— , 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.
Structure owner(s) signature: Date:
Company Name: /tontr So/c/ 3; o nS Phone: ` 7(0 - 85g- o? Y Sot
Address: 90d- 7r/enily RcP Dim /VC- 0? 833V
County: ]`f 4 r/tc +t Con acto s License #: e)a /95 S
Contractor's Signature: Ziw.,r , v —t Date: 10 `1
*Company name, address, & phone must match Information on license.
TRADE 4/08