DOCUMENTS a-I i 51 ,i( Application# 1 YSOCA 33lN
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:] 'A/,'X Y 4t)1/# X011/./�Phone:
i
Owner(s) Mailing Address:/,"5-7 /Cc-VFW ///�y 'o l�(4,./ r
Land Owner Name(s): C4,17-/VT:y�, / Phone:
Construction or Site Address: �S ` (d/7T'L ' OA' /2L / / 2/' 7'
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PIN# D - 3.5 74'oo t, parcel# - 92-IC / 5
?1
Job Cost:c' Al Description of Work to be donee h/>.L. 4/,/-✓ 5-6.41(Vel)
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
ecific Directions to Job from Lillin ton:
amu/ � /47-5/7
i a.cT/e7.- /�T �i_ 4T 12/�iT���
1z7"--5'^‹, F ¢/l!/ 6 ,./Z./ L.22/e7
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Subdivision: Lot#:
7:47.�iier�
I will provide the/_-(4.el, labor on this structure.
(Contractors Name) (Trade) /
I am the building owner or my NC state license number is y9� a (/ , 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
e and local laws,ordinances and regulations.
to/,t///� CA1�'l/17,;1), //7/ i/C2.r(//7 J/i
Contractor's Comp ny Name /v,Telephone
n
Address - Email Address
l'iql() (/
License# �//,_ fir.` $7
Structure Owner/Contractor Signature: yi Date'2.:-,":✓ /0
By signing this application you affirm that you have osartpermission from the above listed license holder to
purchase permits on their behalf. If doing the work as •, er 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
Application Number 18-50043318 Date 2/15/18
Property Address *UNASSIGNED
PARCEL NUMBER 05-0633- - -0208- -02-
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning RES/AGRI DIST - RA-30
Owner Contractor
JONES STANLEY A & DONNA SMITH PATRICK LLC
RT 1 BOX 289
EET
FUQUAY-VARINA NC 27526 LILLINGTON NC 27546
(910) 893-5774
Applicant
JONES DONNA
659 COKESBURY RD
FUQUAY-VARINA NC 27526
--- Structure Information 000 000 ELE RE-CONNECT
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE ELE
WATER SUPPLY NA
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1229137 0
Issue Date . . . 2/15/18 Valuation . . . .
Expiration Date . 2/15/19
Special Notes and Comments
T/S: 02/15/2018 01:57 PM JBROCK ----
659 COKEBURY RD
T/S : 02/15/2018 01 : 58 PM JBROCK ----
PREMISE # 97463715
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 18-50043318 Date 2/15/18
Property Address *UNASSIGNED
PARCEL NUMBER 05-0633- - -0208- -02-
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning RES/AGRI DIST - RA-30
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1229137
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
444 CUSTOMER RECEIPT 444
Oper: SHOCK Type: CP Drawer: 1
Date: 2/15/18 52 Receipt no: 254507
Year Number Amount
2018 50043318
*UNASSIGNED
H1 BP - PERMIT FEES
460.00
ELE
PATRICK ELE
Tender detail
CK CHECK PAYMEN 5818 460.88
Total tendered $60.00
Total payment 460.00
Trans date: 2/15/18 Time: 13:58:44
44 THANK YOU FOR YOUR PAYMENT 44