TRADE 2009/03/18 09:03:01 Harnett county / Page:2 /2
Application # ( 4 ^ 6 7 7 5 7 7/
Harnett County Central Permitting
PO Box 65 Lillinglon, NC
910- 893 -7525 Fax 910 -893 -2793
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www.hametorg/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: :7204,5 kis ` Ile 's Phone: 999 575
Owner (s) Mailing Address: '1-1.5-9 9 6/i VIA 'QUAD
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Land Owner Name (s): Do ucy / 46 % l .,a p F S' Phone:
Construction or Site Address: 2 ,9 O /, u,A ,Rn,ga
PIN or Parcel # from GIS: 01 95 7 o
oa
Job Cost: 4/9 Description of Work to be done 3 7; AI 'T4Ng 6/1s —
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L ltc71lc & nc�.,ic-
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
Specific Directions to Job from Lillington:
Subdivision: Lot #:
• I Jr _nett. 6 Victim) HVAC will provide the Meehan-Lc -at • labor on this structure.
. (Contractors Name) (Trade) . •
I am The building owner or my NC state license number is 9369 , 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: 1ndnak 6 Diekena HVAC Phone: (919 )774-6 841
Address: 771819g Avenue Savjnnd no. 27330
County: Lee � Contractor's License #: 9369
Contractor's Signature: M Date: \1 \ \O
. • *Company name, address, & phone must match information on license.
TRADE 4/08
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2009/03/18 09:03:01 Harnett county Page:2 /2
Application # P ✓G 7 4- 77/
Harnett County Central Permitting
PO Box 65 Lillinglon, NC,27546
910- 893 -7525 Fax 910- 893-2793
www.harnettorg/permits
Certification of Work Performed By Owner /Con•ractor
(Individual Trade Application)
Owner (s) of Structure: Dor. 7/ns (Acaps Phone:
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Owner (s) Mailing Address: *53? Di /W.9 /Ro,4v
Land Owner Name (s): H lH S t Apes Phone:
Construction or Site Address: y.S? / Chum Aan
PIN or Parcel 1t from G IS: _2' 9 � (7 ///
•
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
Specific Directions to Job from Lillinelon:
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Subdivision: Lot #:
I Joyner 8 DLekene HVALbtill provide the Etee to i.eae labor on this structure.
(Contractors Name) (Trade) •
tam the building owner or my NC state license number is 20461 -L , which entitles fire 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, srdinances and regulations.
s
. Structure owners) signature: _ Date:
Company Name: Joyner. 8 Dickens HVAC • Phone: (919) 774 -6841
Address: 2218 Lee Avenue Sanboh.d ne 27330
County: Lee Contractor's License #: • 20461 -L ,
,Contractor's Signature: Date: \
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*Company name, address, & p one must match information on license.
' TRADE • z1/08
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