TRADE Application* / 5 26 7 )9
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910 - 893 -7525 Fax 910 -893 -2793
www.hamett.org/perrnits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: Paulby Anderson Phone: 919 -801 -9005
Owner (s) Mailing Address: US Hwy 401 North, Fuquay Varina NC 27526
Land Owner Name (s): same Phone:
Construction or Site Address: 4119 US Hwy 401 North, Fuquay Varina NC 27526
PIN or Parcel # from GIS: // A &4 ri 429 7 /
Job Cost: 2,500 Description of Work to be done Replacing electric tank style water heater with a
gas tankless water heater
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 d
Specific Directions to Job from Lillington:
take Hwy 401 north from Lillington towards Fuquay. House will be on left before you get to Christian Light Road.
Subdivision: Lot #:
wes Matthews will provide the electrical labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 21204 , 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: Wes Matthews Residential Service Phone: 919-868
Address: 5691 Rawls Church Road, Fuquay - Varina NC 27526 County: Harnett
Contractor's License #: 21204 Email Address:
Contractor's Signature: Z-4---17- Date: 12-12-2010
*Company name, address, & phone must match information on license.
Individual Trade Application 1 of 1 06/10
Application # / Z C 7 7
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910 - 893 -7525 Fax 910 -893 -2793
www.hamett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: Paulby Anderso Phone: 919 - 601 -9005
Owner (s) Mailing Address:4119 US Hwy 401 North, Fuquay Varina NC 27526
Land Owner Name (s): same Phone:
Construction or Site Address: / 4119 US Hwy 401 North, Fuquay Varina NC 27526
PIN or Parcel # from GIS: // 2 t% y / ✓gi 5 - 17 /
Job Cost: 2,500 Description of Work to be done Replacing electric tank style water heater with a
gas tankless water heater
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 Lillinaton:
take Hwy 401 north from Lillington towards Fuquay. House will be on left before you get to Christian Light Road.
Subdivision: Lot #:
Plumbing Solutions of NC, Inc. will provide the Mechanical(gas piping and vent) labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 23°76 , 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: Plumbing Solutions of NC, Inc. Phone: 919 - 557 -3977
Address: 1315 Olive Branch Road, Fu Varina NC 27526 County: Harnett
Contractor's License #: 23 °76 ' ' !t mail As -' wedwardsQplumbingsolutionsnc.com
Contractor's Signature: . `, -res
� Date: 12-12-2010
*Company name, address, & phone must match information on license.
Individual Trade Application 1 of 1 06/10
Application # /a 17— �� ? C - 2 22
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
910-893 -7525 Fax 910 - 893 -2793
www.hamett.org/permits
Certification of Work Performed By Owner /Contractor
(Individual Trade Application)
Owner (s) of Structure: Paulby Anderson Phone: 9194601 -9005
Owner (s) Mailing Address: 4119 US Hwy 401 North, Fuquay Varina NC 27526
Land Owner Name (s): same Phone:
Construction or Site Address: 1 4119 US Hwy 401 North, Fuquay Varina NC 27526
PIN or Parcel # from GIS: (/ y ✓b J 7 Pa 2/
Job Cost: 2,500 Description of Work to be done Replacing electric tank style water heater with a
gas tankless water heater
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:
take Hwy 401 north from Lillington towards Fuquay. House will be on left before you get to Christian Light Road.
Subdivision: Lot #:
Plumbing Solutions of NC, Inc. will provide the Plumbing labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 23076 , 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: Plumbing Solutions of NC, Inc. Phone: 919 - 557 -3977
AddreSS: 1315 Olive Branch Road, Fuqua Varina NC 27526 County: Harnett
Contractor's License #: 23076 mail A dre . wedwards @plumbingsolufionsnc.com
Contractor's Signature: Date: 12 -12 -2010
*Company name, address, & phone must match information on license.
Individual Trade Application 1 of 1 06/10