DOCUMENTS \ _ \\\1\C1 Application# I - ( Snm 14a" -t
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) 1�1
Owner(s)of Structure: k j, ne7 A ao 2 1 Phones a �y/S ca'3
Owner(s) Mailing Address: 377 R6-to nee-o fJ got
Land Owner Name(s): i ,__ ,Z 72-),.oA- .po- P (
hone: >7/o�1 Q
Construction or Site Address: 3/) /? .„a l 2P(t_ rX of R12&-a_et
PIN# Parcel#
Job Cost: Description of Work to be done
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork_ Gas Piping_Other_ In
Electrical*: 200 Amp_<200 Amp_Service Change Service Reconnect Other
*For.,Progress Energy customers we need the premise number
Plumbing: C�/Sewer Tap ✓ Number of Baths Water Heater
Specific Directions to Job from Lillington:
Subdivision: Lot#:
will provide the labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state 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.
r;v �r Pu/r, 6;N� Sc, v;ces 9/9 776 737D
Contractors Company Name Telephone
to Boy .27330
Address Email Address
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License#
Structure Owner/Contractor Signature: 7 _ Ge 7n,- - Date: /d2 // -/ 7
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 17-50042892 Date 12/11/17
Property Address 80 PINE TREE LOOP
PARCEL NUMBER 03-9589- - -0028- - -
Application type description CP SEWER/WATER TAP
Subdivision Name
Property Zoning PENDING
Owner Contractor
RIDENHOUR MARY T OWNER
C/O TERESA MOSS
660 MT PLEASANT RD NORTH
MT PLEASANT NC 26124
Applicant
MOSS TERESA R
660 MT PLEASANT RD N
MT PLEASANT NC 28124
(704) 436-6842
--- Structure Information 000 000 HOOK UP WATER TAP
PermitRESIDENTIAL PLUMBING PERMIT
Additional deqe .
Phone Access Code . 1221340
Issue Date . . . 12/11/17 Valuation 0
Expiration Date . . 12/11/18
Special Notes and Comments
T/S : 12/11/2017 12 : 12 PM JBROCK ----
80 PINE TREE LOOP - OFF OF MCNEILL RD
TAKE ROSSER PITTMAN TO MCNEILL 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
Application Number 17-50042892 Date 12/11/17
Property Address 80 PINE TREE LOOP
PARCEL NUMBER 03-9589- - -0028- - -
Application description . . CP SEWER/WATER TAP
Subdivision Name
Property Zoning PENDING
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1221340
Required Inspections
Phone Insp Initials Date
Seq Insp# Code Description
999 305 M305 R*PLUMB SEWER CONNECTION _/ /
999 307 P307 R*PLUMB WATER CONNECTION /�/�
999 309 P309 R*PLUMB UNDER SLAB —/ /—
999 131 R131 ONE TRADE FINAL —/ /—
999 125 R125 ONE TRADE ROUGH IN —/ /—
999 315 P315 R*PLUMB HW HEATER
HARNETT COUNTY CASH RECEIPTS
*4* CUSTOMER RECEIPT awa
Optee: JDRO17 50 CKType: CP Drawer: 1
Receipt no: 180097
Year Nunber
2817 50042892 Amount
80 PINE TREE LOOP
SSANFORD, NC 27338
BP - PERMIT FEES
PLUMBING PERMIT $40.00
TERESA MOSS
Tender detail
CK CHECN PAYMEH 2276 $48.00
Total tendered
Total paynent $40.803
$48.88
Trans date: 12/11/17 Time: 12:16:21
as THANK YOU FOR YOUR PAYMENT **