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BUILDING Sprinkler Contractor Information Spanker Contractors Company Name Telephone Adorer., Email Address I Signature of OHlcerlsl of Corporation License# Fire Alarm Contractor Information Fre Alarm Contractor Contractorrs s Company _. Name Telephone Address Email Address S gnanne of Officer{et of Corp oration Lmense# l)rirend% .Alief%- sit Uyem nisi..r wn Hn atm A..c„ I':a ani lr� ♦, I hereby certif., thai I have the authority to make necessary application. Ihat the application is correct and that the construction will conform to the regulations in the Building. Electrical. Plumbing and Mechanical codesand the Harnett County Zoning Ordinance I state the Information on the above unlradors is collect as known to me and if am changes occur including listed contractors site plan. :umoer of bedroom ouildmg 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 or any and al'.change.- Expired Permit Fees Cmonths to 2 years permit re-rssue tee is $150 00 After 2 years re-taste fee = Maned at full price per current fee schedule (ifins /v'/7t—/Z — tr,gnatureof(howler l C.ttmc or OHlcersi of Corporation Date Affidavit for Worker's Compensation N.C.G.S. 87-14 The .uluer9.yneu applicant bene the V Genera. 9 Go��tiaclor Owner Olficer/A ervl of Inc Contractor or Owner It Perc-hy cc it rm m der peualhes of penury that Rhe person h Iri_sl or corporanunlsl performing INe work set fonts in the pt rnul ✓ Has tree it 01 n tole employees and nas obtained workers compensation insurance to cover then1 Has one(I1 or nwre Suhlvntrac!Orsis)and Par obtained workers compensation insurance to cover Men, Has one 11 i or more putt=nitractolst9 Nn0 has the'r own poemy C workers compensation insurance NVH:nG thenntseives Has no more n+an tvo i11 employees and nc_uhcontrac',o! V%tie wortng on Rte nroierI tot which this permit Is sought it is undel5l0cm that the Centra,Pem,ttrr9 Department issuing the permit may requite certificates of coverage of worker S compensation insurance poor t ss lame ci try- and at ant, lime dun tq the pee` tied work from any person firm or rorporaticn cry vl_ o.0 the wrirk. C..r �paryr l4 ;n la r /1�u I rile fes LLrw 1rQ1� ._'.._"17 "u'a cPCGr.w.7rii[ _. Dlnc /0 -q-/7_.... Application# In 5::D1-1 Dae l *Each section below must be filled out by Hamett County Central Permitting whoever is performing the woos. Must be PC Box 65 Lillington,NC 27546 owner or licensed contractor. Address. 910-893-75253 Fax 910-69 -2wwwm 793 .haen.org/pennita company name 8 phone must match93., ..:. .. information on state license. - - Application for Buildina and Trades Permit Owner's Name: Anderson Creek Partnership,LLC Date: 10/2117 Site Address: 174 Scholar Drive,Spring Lake NC 28390 Phone: Directions to job site from Lillington: Subdivision: Anderson Creek Lot: Description of Proposed Work: Concrete swimming pool and path Heated SF Unheated SF 1750 General Contractor Information: Building Cost$ 147,500.00 Clayton Britt and Sons Inc 910.868.8319 Building Contractor's Company Name Telephone PO Box 29 mbhaire@spaandpoolworld.com Address Email Address A/ .r /c_. & �';'AD UNBLDG-35207 Signature of Ow(neery/Contractor/Off c!eer((s))of Corporation License# Electrical Contractor Information: Electrical Cost$ 4,000.00 Description of Work Bonding and equipment hook-up Service Size: Amps #T-Poles_ Pioneer Electric 919.499.7767 Electrical Contractor's Company Name Telephone 80 Neil Thomas Road Lillington,NC 28303 pioneerelectrlclearthlink.net address . . _ Email Address _ — 21643-U _ ne Cntractor/Officerjs)of Col poration License# Mechanical Contractor Information: Mechanical Cost$ Description of Work #Units Mechanical Contractor's Company Name Telephone Address Email Address Signature of Owner/Contractor/Officer(s)of Corporation License# Plumbing Contractor Information: Plumbing Cost$ Description of Work #Baths Plumbing Contractor's Company Name Telephone Address Email Address Signature of Owner/Contractor/Officer(s)of Corporation License# Insulation Contractor Information Insulation Contractors Company Name&Address Telephone 'NOTE:General Contractor must fill out and sign the second page of this application Appointment of Lien Agent: Details-LiensNC Lien Service https://apps.liensnc.com/scr/appointment/details.html?entryNumber=... DO NOT REMOVE! Details: Appointment of Lien Agent Flied on: 10/05/2017 Entry it: 733665 Initially filed by: fairway' Designated Lien Agent Project Property Print & Post First American Title Insurance Company Academy Swim Club,Phase 7,Anderson Creek 0a E l Club4.4 Online:www IiepsiicCom,w--1....r 174 Scholar Drive - ?i'S Addres:19 W.Hegen Sr.Suite 507/Raleigh NC Spring Lake,NC 28390 Oj��o Henn County 27601 Contractors: Phone:888.690-7384 Please post this notice on the Job Site. Fn:913-489-5231 Suppliers and Subcontractors: emril:support(nRienmccome.n..m.>a.�a.� Property Type Scan this image with your smart phone to view this filing.You can then file a Notice to Lien Agent for this project. Other Owner information Date of First Furnishing ANDERSON CREEK PARTNERS,LP 125 Whispering Pines Dr Spring Lake, NC 28390 10109/2017 United States Email:eo0per@nndersoncreekclub.com Phone 910-814-8651 View Comments(0) Technical Support Hotline(888)690-7384 I of 1 10/5/2017,3:09 PM