DOCUMENTS )n a.) in Application# ( n W o`i" O a,...
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph'. 910-893-7525 - Fx: 910-893-2793 - www.harnett.org/permits
Certification of Work Performed By 107-Owner/Contractor
(In.'vidual Trade Application)
Owner(s)of Structure: 6.7.mit - /.e - e I l" Phone: IO �_ �� gU
r:
Owner(s)Mailing Add : ye) bo e6-1- m(./ c5 r ' - Co- 1117 i/ 4�
Land Owner Name(s): - /air . r" Phone/:' -
Construction or Site A.i reesss: )64 -,16I/�0C 5 7/, /n 6 Q Py (-2f �0
PIN# oS34- OS - SI9 La• +� Parcel# (Thl on3a4 Osaco
Job Cost: Description of Work to be done -t -J t+ �-/ �cf.-5a
No 4P t7 o i-P Ckniti tit t �.-'Le
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork Gas Piping Other
Electrical*: 200 Amp_<200 Amp_Service Change Service Reconnect f/ 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:
Subdivision: �'/1 // Lot#:
C1'G `CCy'l✓dry Py will provide the S'/ ) labor on this structure.
(J (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 law ordinances and regulations.
( / n7"A a �eorier- 7`{eiv 9(0" <7J-733 .0
Con ors Company Name Telephone
'& idtT nCi C5jerk/w4 y 1dei
Address ft C a ,31 ti Email Address
License#
Structure Owner/Contractor Signatur- V 4yI ,e, " -- " Date: /a-/1- /7
By signing this application you aftir eu ave obtained permission from the above listed license holder to
purchase permits on their behalf. If .oing 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 17-50042902 Date 12/12/17
Property Address 1581 HAYES RD
PARCEL NUMBER 01-0524- - -0066- - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name VIOLA & A A WEST
Property Zoning PENDING
Owner Contractor
LEE LOUISE HEIRS C/O JANET OWNER
SHIRES
3309 PETTICOAT LANE
FUQUAY-VARINA NC 27526
Applicant
PARKER CYNTHIA LEE
1584 HAYES RD
SPRING LAKE NC 28390
(910) 751-3250
--- Structure Information 000 000 ELE RE-CONNECT NO WORK
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE ELE
WATER SUPPLY NA
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1221480
Issue Date 12/12/17 Valuation . . . . 0
Expiration Date . . 12/12/18
Special Notes and Comments
T/S : 12/12/2017 01 : 30 PM JBROCK ----
1581 HAYES 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 17-50042902 Date 12/12/17
Property Address 1581 HAYES RD
PARCEL NUMBER 01-0524- - -0066- - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name VIOLA & A A WEST
Property Zoning PENDING
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1221480
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
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 _/ /
HARNETT COUNTY CASH RECEIPTS
*** CUSTOMER RECEIPT ***
Uper: SMOCK Tyoe: CP Drawer: 1
Date: 12/12/17 52 Receipt no: 182366
Year Number Amount
2017 50042902
1581 HAYES RD
SPRING LAKE, NC 28398
81 BP - PERMIT FEES
$60.00
ELE PERMIT
Tender detail
CA CASH PAYMENT 360.82
Total tendered £68.0A
Total payment 468.80
Trans date: 12/12/17 Time: 13:31:56
** THANK YOU FOR YOUR PAYMENT **