BUILDING 09/09/11 Application#
Harnett County Central Permitting 0 /Cr' r
Each eecbon below to be fined outPF Box 65 3i 2723igton NC 27548
bywhomem performing work 910 8937548 Fax 01088934783 www hametl ay/permits
Must be owner or bend
conbactor nedmss Company Application for Residential Budding and Trades Permit;
name a phone must match
Owners Name aYNN NST9UCTIOt�ijC. Datn— I - q
o Ig
Site Address Ao rlr?, 1'
fat Plane I - 5T�&)
Direct ns to lob sits.from I ilington $oor'Y7 H&JPy- hf .2/o /i/A 4
fa-F-1- 0.0‘) 1-101 w ei &c IS a '..is 4 r .S OAD-11 _ , ,1 ,
Subdivision A 1/1/11 e PI 1 Lot d G 3
Description of Proposed Work NEW CONSTRUCTION, SFD #of Bedroomsl
Heated SF4R4' Unheated SF 8 D4 Finished Bonus Room'?H-(3.5 Crawl Spac7C Slab
General Contractor Informabbh
WYNN CONSTRUCTION, INC. 919-258-2430
Building Contractors Company Name Telephone
2550 CAPITOL DR., STE. 105 CREEDMOOR. NC 27522 ttrefftzs@wynnhomes.com
Address Email Address
46295
License#
Electrical Contractor Information
Description of Work NEW CONSTRUCTION Service Size 200 Amps T-Pole itYes_No
BUFORD ELECTRIC 910-723-1937
Electrical Contractors Company Name Telephone
948 PAN DRIVE, HOPE MILLS, NC 28348 bufordelectric(alcmail.com
Address Email Address
31424-U
License#
MechanicalIHVAC Contractor Information
Descnption of Work NEW CONSTRUCTION
CERTIFIED HEAT AND AIR 910-858-0000
Mechanical Contractors Company Name Telephone
779 SUNSET LAKE RD., LUMBER BRIDGE, NC 28357
Address Email Address
NC 200212 H3 CLASS 1
License#
Plumbing Contractor Information
Description of Work NEW CONSTRUCTION #Baths
THORNTON'S PLUMBING 919-550-4833
Plumbing Contractors Company Name Telephone
3160A Vinson Road, Clayton, NC 27527 brendaactpi@gmail.com
Address Email Address
22152
License#
Insulation Contractor Information
TATUM INSULATION 919-661-0999
Insulation Contractors Company Name&Address 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 Electrical Plumbing and
Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above
contractors Is correct as known to me and that pv stoma below I have obtained all subcontractors
permission to obtain these Derma and if gay 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
EXPI: r PERMIT - - : Mon is'
s • 2 years perm reissue fee is$150 00 After 2 years re-issue fee
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Signature of • •r/Contracto r- icer(-) Corporation Date
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
General Contractor _Owner I Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporatwn(s)performing the work
set forth in the permit
J 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
J 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 prior
to issuance of the permit and at an dunng the permitted work from any person firm or corporation
carrying out the work !/
Co •cny or Na 41111,1 Z STRUCTION, INC.
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Si.r w/To , flog/ I CONSTRUCTION, COORD. Datp/ 0
11
LIEN AGENT INFORMATION
Effective April 1,2013
In accordance with North Carolina General Assembly Session Law 2012-158,
Inspection Departments are not allowed to issue any permit where the project cost
is $30,000 or more unless the application is for improvements to an existing
dwelling that the applicant uses as a residence OR the property owner has
designated a lien agent and provided the inspections office with the information
below: •
Name of Lien Agent TITLE INSURANCE COMPANY
Mailing address of Agent 19 W. HARGETT STREET, SUITE 507
RALEIGH, NC 27601
Physical address of Agent 19 W. HARGETT STREET, SUITE 507
RALEIGH, NC 27601
Telephone 888-690-7384 pax 913-4859-5231
Email support @liensnc.com
The information will be attached to the permit record and a copy provided to the
applicant. The applicant is required to post a copy on the construction site.
Excerpt from North Carolina G.S. I60A-417:
"(Effective April 1,2013)No permit shall be issued pursuant to subdivision(1)of subsection(a)of
this section where the cost of the work is thirty thousand dollars($30,000)or more,other than for
improvements to an existing single-family residential dwelling unit as defined in G.S. 87-15.5(7)that
the applicant uses as a residence,unless the name,physical and mailing address,telephone number,
facsimile number,and electronic mail address of the lien agent designated by the owner pursuant to
G.S.44A-11.1(a)is conspicuously set forth in the permit or in an attachment thereto.The building
permit may contain the lien agents electronic mail address.The lien agent information for each
permit issued pursuant to this subsection shall be maintained by the inspection department in the
same manner and in the same location in which it maintains its record of building permits issued."
www.liensnc.com
Appointment of Lien Agent:Details-LiensNC Lien Service https://apps.Iiensnc.com/sertappoinhnentldetails.html7entryNumbel=... j
DO NOT REMOVE!
Details: Appointment of Lien Agent
Entry #: 793142 Filed on: 2018
Initially filleedd by:by: wynnhomea
Dtslgnated Lien Agent Project Property Print & Post
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Investors Title Wee wmCCompri, _every pond subdivision id 026 j ��
• 120squire �
Nese gowarmegrgimwermipms Nq:ayCoins,NC 27536Addrj el
27601
nas 19 w� L.AL
3Me50LRe1tlBb.rlr haMal:OWlp
hazemammaContradon:
Please peel this notice on the Job Site.
Per 913an4231 Property Type ', V
Suppliers cad Bebnotneton:
Emev:paoon®liauec.amr+xe—r Scan this Sage with your smut phone b ', )
view this filing.You cin Alen Ne it Notice !
project.1-2 Family Dwelling to Lien Agent for this • Si{
•
•
Owner Information
•
wynn homes
2550 capital de I..
Weedmmr,NC 27522 •
United Slates
Email:nary®wylW:oneseom
Plop:919.5281347
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Technical Sepport Hotline:(888)690.7384
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I of I 2/2/2018,9:15 AM