DOCUMENTS a lac> ) t� Application# 15b0LDJ
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: / 4k
,S 'S Phone:
Owner(s)Mailing Address:
Land Owner Name(s): f43 Phone:
7r i
Construction or Site Address: /1;// �} /
�4,t; ��4� ( � �f C
PIN# D 5-34 '— DAA —e).'1C13 .00D Parcel# O\ t 3 LP Ctc-7�i
�•
Job Cost:a50t7� Description of Work to be done a,,•_.���p
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 Lillinaton: ^ /4 ///J
Crirt L cot,
Subdivision: Lot#:
I At a /4-x./-1?(://24'will provide the /='( '� ),1 cam✓' labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 9 y 24 " , 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.
/ SL<C C (c �-; 7(\0 - 77 -4r-3 d z
Contractors Company Name / Telephone
Z±7{7 Ac//0
Address Email Address
License#
Structure Owner/Contractor Signature: (( Y � Date: /II,—ZG'l
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 17-50042963 Date 12/20/17
Intersection
Property Address 8038 NC 210 S
PARCEL NUMBER 01-0536- - -0079- - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning PENDING
Owner Contractor
SMITH RALPH BRUCE HOGUE ELECTRIC CO INC
79 ROCK HILL LANE 2951 MCDOUGALD ROAD
BUNNLEVEL NC 28323 LILLINGTON NC 27546
(910) 893-9747 (910) 893-5302
Applicant
SMITH RALPH
79 ROCK HILL LANE BUNNLEVEL,
NC 28323
BUNNLEVEL NC 28323
- - - Structure Information 000 000 200 AMP SERVICE
Flood Zone FLOOD ZONE X
Other struct info . . . . PROPOSED USE ELE SERVICE
WATER SUPPLY NA
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1222660
Issue Date . . . 12/20/17 Valuation . . . . 0
Expiration Date . 12/20/18
Special Notes and Comments
T/S : 12/20/2017 09 : 37 AM JBROCK - - - -
HWY 210 TOWARD SPRING LAKE ON R JUST
BEFORE S HARNETT ELE
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 . . . . . 17-50042963 Date 12/20/17
Property Address 8038 NC 210 S
PARCEL NUMBER 01-0536- - -0079- - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning PENDING
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1222660
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
REPRINT
*** CUSTOMER RECEIPT ***
Oper: JBROCK Type: CP Drawer: 1
Date: 12/20/17 52 Receipt no: 192939
Year Number Amount
2017 50842963
8038 NC 210 S
BUNNLEVEL, NC 28323
B1 BP - PERMIT FEES
$86.66
ELE PERMIT
HOGUE ELE
Tender detail $90.80
CP CREDIT CARD $80,08
Total tendered $80.00
Total payment
Trans date: 12/20/17 Time: 9:40:11
** THANK YOU FOR YOUR PAYMENT **