LAND USE R 09/00/11
Application# pp
Harnett County Central Permitting S- `♦ 9 9 5 I�
Each section bbwbbe filled outPC Box854Nin ton NC 27508
by Mminen t pertaming work 810 893 7525 Fax 910 883 2793 www hame8 orypeimib
Must be owner or licensed
contractor ndaeee company Aoohcation for Residential Budding and Trades Perm
name 8 phone must matchQ
Owners Name Freci>lon (iihr unripy rani/ ��rnollp'�lon1 X71(1. )
Site Address 173 Apo rie Troll SenDate
{ � Pt 77)7? Phone 910 -981 r)/
Directions
Directions to fob site from Ldlington r7 ri, 77 til L M:Ncr rme'e , R Sur„p,
Ppari,
Subdivision `onr,rr!: Lot I )
Description of Proposed Work NnV' 5.1q. e fon;'
Heated SF 212 8 -p ! #of Bedrooms y
Unheated SF ys Finished Bonus Room9 N o Crawl Space _Slab k
General ciftfi for IMo r__
peL Pre Qroprrllog 70cf11 - Y44 (� 9Ir-9dd - Phi
Building Contractors Company Name Telephone
Zll 0 6,6r rid/ I/J, l? Cr,/ dfr [P.37( SAaanP pre ru i u of rupr r{/Pi fir crap
Address Email Address
075th°
License#
r glegtncal Contractor Information,
Description of Work if°v cam: i< Service Size 2 09 Amps T-Pole —' Yes_No
/19i.nn ! Irr}rlc ,9 ti(JJ
Electrical Contractors Company Name Telephone
940 ( e Ilow�7 0/, f47ef4P_:lir N( 11-f rl p
Address Email Address
9/2P -
License#
Mechanical/WAG Contractor Irlformation
Description of Work ( / /Et" h✓Ar (IP EPA ' �u(r.nr
{a
er .r,oaie Npr Iia? 1 /{ir .. 2/b- ? 77- 1 g'16
Mechanical Contractors Company-Name i. Telephone
1r 1-1orn Lenrw. PJ. ro;o P„�tM AlC ill
Address Email Address
97.` 975_.'
License#
plumbing Contractor Information
Description of Work Nov pi,n��n^. #Baths
Tr e) PL,rsinsi, 9/U- 7o3 - 5511
Plumbing Contractors Company Name Telephone
/7Y9 i:,,lf ) ':ton bled) 2FiOd
Address Email Address
sire/ Fi
License#
Insulation Contractor information
/- ' ir; 0.e'1lo P0. 110/ IYp rlupP Mp/it't 2lp - (1f9 - ?99 (,
Insulation Contractor a Company Name&Address e g 3 ynp Telephone
*NOTE General Contractor must fill out and sign the second page of this application
I hereby certify that I have the authonty to make necessary application that the application is correct
and that-the construction will conform to the regulations in the Building Electncal Plumbing and
Mechanical codes and the Hamet County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that pv mamma below I have obtained all subcontractors
permission to obtain these oermq and if pay changes occur including listed contractors site plan
number of bedrooms building and trade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Harnett County Central Permitting Department of
any and all changes
EXPIRED PERMIT FEES-S Months to 2 years permit re-issue fee is 6150 00 After 2 years re-issue fee
is as per current fee schedule
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Signature of Owner/Contractor/Officer(s)of Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
General Contractor _Owner Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of peryury that the person(s) firm(s)ar corporeton(s)performing the work
set forth in the permit
Has three(3)or more employees and has obtained workers compensation insurance to cover them
Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover
them
Has one(1)or more subcontractors(s)who has their own policy of workers compensation insurance
covering themselves
Has no more than two(2)employees and no subcontractors
While working on the project for which this permit is sought it is understood that the Central Permitting
Department issuing the permit may require certificates of coverage of workers compensation insurance pnor
to issuance of the permit and at any time dunng the permitted work from any person firm or corporation
carrying out the work
Company or Name M/" 1'I^r°Ir'r. ?ro(ir/l IPS
Pa
Izt 17
Sign w/Tite �� *"' ""� /'�agrr Date
Appointment of Lien Agent: Details- LiensNC Lien Service https://apps.liensnc.cam/scr/appointment/details.html?entryNumher...
DO NOT REMOVE!
Details: Appointment of Lien Agent
Entry Y: 767926 Filed on: 12/09/2017
Initially flied by: ahaungardner
Deslensted Llea Apet Project Propene Print & Post
Old Republic Nelionnl Tide Insurance Company Lot 19 Summerlin i]:t 0
123 Apache Trail "✓#. .jt
Online:wwwhensev Birch*..a.—e_, Sanford,NC 27332
Address:IA Hargett St,Sane 507 i Raleigh,NC inn Cooly El :t
27601
Contncton:
Phase:888-690-7384 Please post this notice on the lob Site.
Fee:013-489.5231 Propene Tie
Supplies and Subcontractors:
Email:hinaggigienanc corn ma..r.«r..vi Scan this image with your smart phone to
view this filing You can then file a Notice
1-2 Family Dwelling to Lien Agent for this project.
0•14•I' Information
Delo of First Fuulsldleg
Precision Custom Homes and Renovations.LLC
256 Briar Hill Rd.
Raeford, NC 28376 12/20/2017
United States
Email.shaun@precisionpropeniesnc.com
Phone'.910-988-8172
View Comments(01
Technical Support Hotline:(98 8)690-7384
of 1 12/9/17,7:10 AM