DOCUMENTS / RECEIPT Application# ► 5(o 4 0-0l0 a
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamett.org/pennits
Certification of Work Performed By Owner/Contractor
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(Individual Trade Application) Q
Owner(s)of Structure: rr • Ic./ (`,( L_�o (? '€C(y4q Phone: 9/ / ,P CU- 2 ?
Owner(s)Mailing Address: / 7 S 7i-/n(�cc.. Q.c,
t)c,chvn /'9c 0F37Y
Land Owner Name(s): `'nil U r'i (LY„ �re rii- n Phone: 9/ 9 Q'o2O ' 3 c-T
Constructtiionor Site Address:�' / 7,,9 C NoLCC� itc.Y o LA. y �t� /L- C
PIN# IS�"I ^ CACI 4 S 1W9•JUparcel# [c(1^52 (�/Si'g DI log
Job Cost: Description of Work to be done at Q_ Xry
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Mechanical: New Unit With Ductwork_ New Unit Without Ductwork_ Gas Piping_Other
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: n
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Subdivision: Lot#:
will provide the labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC slate 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.
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Contractor's Company Name Telephone
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Address Email Address
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License#
Structure Owner I Contractor Signature: 7 7 " / Uate: - /-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 17-50042062 Date 8/15/17
Property Address 91749 TECH 2
PARCEL NUMBER _ -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
BREWER MARILYN S BRIAN JOHNSON ELECTRIC CO INC
RT 3 BOX 376 2490 HOBSON RD
DUNN NC 28334 DUNN NC 28334
(910) 892-1175 (910) 892-9220
Applicant
BREWER MARILYN
1785 HOBSON RD
DUNN NC 28334
(919) 820-3831
--- Structure Information 000 000 ELE SERVICE FOR BLDG FOR HORSES
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE ELE 200 AMPS
WATER SUPPLY NA
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1204999
Issue Date 8/15/17 Valuation 0
Expiration Date . . 8/15/18
Special Notes and Comments
T/S: 08/15/2017 04 : 24 PM JBROCK ----
1785 HOBSON 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
17-50042062 Date 8/15/17
Application Number TECH 2
Property Address 91749 - - - -
PARCEL NUMBER
Application description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name UNZONED
Property Zoning
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1204999
Required Inspections
Phone Insp Initials Date
Seq Insp# Code Description
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 —/ /—
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