The URL can be used to link to this page

TRADE / PERMITS / RECEIPT Application# t-k I. ails Harnett County Central Permitting PO Box 85 Lillington,NC 27546 •Each section below to be filled out 910-893-7525 Fax 910-893-2793 www.harnett.org/permits byM whomever eperforming work. _ �p-4/ Must contractor, owner r s ,licensed i(�Lut^'— — nan ph ne must companytchApplication for Residential Building and Trades Permit name&pM1pne must match —'c- 'l Owner's Name: .fit xv'C1SPY k \ Date: dial 11. Site Address: Phone: Directions to job site from Lillington: Subdivision: Lot: Description of Proposed Work: #of Bedrooms: Heated SF: Unheated SF: Finished Bonus Room? Crawl Space:_Slab: ne I Centra r of tlorfi Building Contractor's Company Name Telephone Address Email Address License# Electrical Contractor Information Description of Work Service Size:_Amps T-Pole:_Yes No Electrical Contractor's Company Name Telephone Address Email Address License# Mechanical/HVAC Contractor Information Description of Work Mechanical Contractor's Company Name Telephone Address Email Address License# Plumbing Contractor Information Description of Work #Baths Plumbing Contractor's Company Name Telephone Address Email Address License# Insulation Contractor Information Insulation Contractor's Company Name&Address Telephone `NOTE: General Contractor/owner must fill out and sign the second page of this application. I hereby certify that I have the authority 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 by signing below I have obtained all subcontractors permission to obtain these permits and if aj 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. EXPIRED PERMIT FEES-6 Months to 2 years permit re-issue fee is$150.00. After 2 years re-issue fee is as per current fee schedule. !/'�� /: p� zz�� A] /SIG, d.� "y O 7ergna a of QWner/Contra Officer(s)of Corporation Date Affidavit for Worker's Compensation N.C.G.S. 87-14 The undersigned applicant being the: General Contractor Owner Officer/Agent of the Contractor or Owner Do hereby confirm under penalties of perjury that the person(s),firm(s)or corporation(s)performing the work set forth in the permit: 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, 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 worker's compensation insurance prior to issuance of the permit and at any time during the permitted work from any person,firm or corporation carrying out the work. Company or Name: Sign w/Title: Date: HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call : (910) 893-7525 Fax: (910) 893-2793 Application Number 17-50041245 Date 2/09/18 Property Address 146 ELLIS STEWART LN PARCEL NUMBER 09-9555- - -0067- - - Application type description CP MANUFACTURED HOME RA20R/RA20M CRITERI Subdivision Name Property Zoning RES/AGRI DIST - RA-20R Owner Contractor HOCKENBERRY MATTHEW SHAWN OWNER 121 ELLIS STEWART LANE CAMERON NC 28326 Applicant WAY JENNIFER AND ROBERT #1 121 ELLIS STEWART LN CAMERON NC 28326 (919) 935-1140 --- Structure Information 000 000 16X76 4 BR ATT (2) 10X10 DECKS Flood Zone FLOOD ZONE X Other struct info # BEDROOMS 4 . 00 MOBILE HOME YEAR 2011 . 00 PROPOSED USE SWMH SEPTIC - EXISTING? NEW WATER SUPPLY COUNTY Permit RESIDENTIAL ELECTRICAL PERMIT Additional desc . Phone Access Code 1228287 Issue Date . . 2/09/18 Valuation . . . . 0 Expiration Date . 2/09/19 Permit RESIDENTIAL PLUMBING PERMIT Additional desc . Phone Access Code 1228295 Issue Date . 2/09/18 Valuation . . . . 0 Expiration Date . 2/09/19 Special Notes and Comments T/S: 04/27/2017 09 :56 AM DJOHNSON -- RIGHT ON 24/27 APPRX 4 MILES ON LEFT THEN LEFT ON SANDS RD CONTINUE ON YOUR LEFT 1/4 MILE BACK TO ELLIS STEWART LN. T/S : 01/29/2018 10 : 01 AM BPETRICH -- PER OLIVER IN EH - CUSTOMER IS OK'D TO HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call : (910) 893-7525 Fax: (910) 893-2793 Page 2 Application Number 17-50041245 Date 2/09/18 Special Notes and Comments ENLARGE DECK ON REAR OF HOME SINCE SEPTIC IS ON FRONT, HE DOES NOT NEED TO GO BACK THROUGH ENVIRONMENTAL HEALTH. HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call : (910) 893-7525 Fax: (910) 893-2793 Page 3 Application Number 17-50041245 Date 2/09/18 Property Address 146 ELLIS STEWART LN PARCEL NUMBER . 09-9555- - -0067- - - Application description . . CP MANUFACTURED HOME RA20R/RA20M CRITERI Subdivision Name Property Zoning RES/AGRI DIST - RA-20R Required Inspections Phone Insp Seq Insp# Code Description Initials Date Permit type . . . . RESIDENTIAL ELECTRICAL PERMIT 999 131 R131 ONE TRADE FINAL 999 125 R125 ONE TRADE ROUGH IN / / Permit type . . . . RESIDENTIAL PLUMBING PERMIT 999 131 R131 ONE TRADE FINAL 999 125 R125 ONE TRADE ROUGH IN / / Hfl*** CUSTOMUNTY CASH ERRECEIPTS RECEIPT *% Open. IBROCK Type: CP Drawer: 1 Date: 2/89/I8 52 Receipt no: 246819 Year Number Amount 2817 50841245 146 ELLIS STEUART LN CAMERON, NC 28326 B1 BP - PERMIT FEES $110.88 PLO 8 ELE JENNIFER WAY tender detail f11B.8B CP CREDIT CARD $118.88 Total tendered $110.08 Total payment Trans date: 2/89/18 Time: 10:86:22 as THANK YOU FOR YOUR PAYMENT xa