DOCUMENTS \b I G I ii
Application# V1sa bya U'7 3
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph: 910-893-7525 - Fx:910-893-2793 - www.hamett org/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: j4\e.IR j I r r Phone:
Owner(s) Mailing Address: j-Z ¶A 1 a ., IE c,)9 P_-
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Land Owner Name(s): �T Phone:
Construction or Site Address:
PIN# Parcel#
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CO*Job 'O& Description of Work to be done (i 'c \ i`Ne_ c jt s(-AC '�CV ((//��!!I
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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 Lillinoton:
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Subdivision:diLot#:
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I ✓Are 1J A ,I.I1 e"1 Ic • Jr.will provide the cUe ) P `F : "A labor on this structure.
(Contractors Name) (Trad4)
I am the building owner or my NC state license number is 21-5e`j , 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/Contractor Signature: 1 ' Date: ib'J— II
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 17-50042473 Date 10/05/17
Property Address 52 FALCONRIDGE DR
PARCEL NUMBER 01-0535-19- -0100- -07-
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name ANDERSON CREEK PH2 ST 2 15L0TS
Property Zoning RES/AGRI DIST - RA-20R
Owner Contractor
NEVAREZ NANCY M FARMER LP GAS & OIL CO. , INC.
52 FALCONRIDGE DRIVE 805 US 401 S
SPRING LAKE NC 28390 LILLINGTON NC 27546
(910) 890-2330
--- Structure Information 000 000 GAS LINE OUTSIDE FROM PROPANE TANK
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE GAS LINE
WATER SUPPLY UNKNOWN
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1213339
Issue Date . . . 10/05/17 Valuation . . . . 0
Expiration Date . 10/05/18
Special Notes and Comments
T/S: 10/05/2017 02 : 11 PM JBROCK ----
PASS CLUBOUSE R ON ANDERSON RD ON
FALCON RIDGE
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 17-50042473 Date 10/05/17
Property Address 52 FALCONRIDGE DR
PARCEL NUMBER 01-0535-19- -0100- -07-
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name ANDERSON CREEK PH2 ST 2 15LOTS
Property Zoning RES/AGRI DIST - RA-20R
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1213339
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 409 M409 R*GAS PIPING _/_/_
999 407 M407 R*MECH ABOVE CEILING _/_/_
999 405 M405 R*MECHANICAL UNDERGROUND / /_
999 131 R131 ONE TRADE FINAL / /_
999 125 R125 ONE TRADE ROUGH IN / /_