DOCUMENTS 9161 i n Application# l in 5[i4 i '7 -13
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
(Individual Trade Application)
Owner(s)of Structure: )4 cznt.ti I� P-bf c cal qf u u Phone: r-1 J(l - (nG`I '(A S 3 �
Owner(s)Mailing Address: Matt u (h- RPIJP r r rar6;c.
`1625;x -IF�z�rdvn,.n t CS,4 f' nn N .c, ..)S1'..)S1'339&' 3y
Land Owner Name(s): nuy) - 1S2Perm G.cr gym, Phone: 910 - 479 /'44-3
Construction or Site Address: It 5' Fc i r, ock'rr' 1J.G �? 33 9
PIN# JS/8 - t,o1 Lj7.at-/•U6&Parcel# O /5J8' DCl1I 05
$D -Cr-ob Cos#aDescription of Work to be done - C(r U/cierif In bcx r n
Mechanical: New Unit With Ductwork New Unit Without Ductwork Gas Piping_Other_
Electrical": 200 Amp ✓00 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 Lillinuton:
�tA '1b r4,UAnf Sat -pp5 CccA
Subdivision: Lot#:
will provide the labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is OI sat t4' - 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.
Contractor's Company Name Telephone
Address Email Address
License# ��(,J
Structure Owner/Contractor Signature: />�/LGCq _G Date: 7' 5-/
By signing this application you affirm that you have obtained permission from the above listed license holder to
purchase permits on their behalf. If doing 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, & phone must match information on license
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 17-50041773 Date 7/05/17
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
GARCIA MANUEL & GARCIA REBECCA OWNER
4525 FAIRGROUND RD
DUNN NC 28334
(910) 694-6534
Applicant
GARCIA MANUEL & GARCIA REBECCA
4525 FAIRGROUD RD
DUNN NC 28334
(910) 694-6535
--- Structure Information 000 000 ELE FOR BARN
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE ELE
WATER SUPPLY COUNTY
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1198951
Issue Date . . . 7/05/17 Valuation . . . . 0
Expiration Date . . 7/05/18
Special Notes and Comments
T/S: 07/05/2017 02 : 02 PM JBROCK ----
421 TO DUNN 301 TO FAIRGROUND RD TO
4525 FAIRGROUND RD
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 17-50041773 Date 7/05/17
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1198951
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 211 E211 R*ELEC ABOVE CEILING
999 217 E217 R*ELEC RECONNECT _/_/_
999 205 E205 R*ELEC UNDER SLAB / /_
999 215 E215 R*ELEC. UND. POOL / /_
999 213 E213 R*ELECTRICAL UNDERGROUND
999 131 R131 ONE TRADE FINAL _/_/_
999 125 R125 ONE TRADE ROUGH IN /_/_