DOCUMENTS HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50043359 Date 2/21/18
Intersection
Property Address 2290 LEMUEL BLACK RD
PARCEL NUMBER 01-0516- - -0035- - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning PENDING
Owner Contractor
MCCOY DELBERT E & P FARMER LP GAS & OIL CO. , INC.
RT 1 BOX 188 805 US 401 S
BUNNLEVEL NC 28323 LILLINGTON NC 27546
(910) 893-2042 (910) 890-2330
Applicant
MCCOY DELBERT E & MCCOY
PHYLLIS J
2290 LEMUEL BLACK RD
BUNNLEVEL NC 28323
--- Structure Information 000 000 GENERATOR HOOK UP
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE GENERATOR
WATER SUPPLY NA
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1230366
Issue Date . . . 2/21/18 Valuation . . . . 0
Expiration Date . 2/21/19
Special Notes and Comments
T/S: 02/21/2018 02 : 12 PM JBROCK ----
2290 LEMUEL BLACK RD
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 18-50043359 Date 2/21/18
Property Address 2290 LEMUEL BLACK RD
PARCEL NUMBER 01-0516- - -0035- - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning PENDING
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1230366
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 409 M409 R*GAS PIPING / /
999 407 M407 R*MECH ABOVE CEILING / /
999 405 M405 R*MECHANICAL UNDERGROUND / /
999 131 R131 ONE TRADE FINAL / /
999 125 R125 ONE TRADE ROUGH IN / /
Application# 1 ?Ai r-34-"Z.1G5
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamettorg/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: Aber k Aqo y Phone: .
Owner(s)Mailing Address: 2290 LcmJel 131 a c La YLd
9 n\freI , PiL
Land Owner Name(s): Phone:
Construction or Site Address:
PIN# LIS 1co —'Lk l -7x'13•oail' Parcel# Dl CAS LIa # 3uS
Job Cost: Description of Work to be done Cr_MY-rACeic?r— 1-3cD 1. W 7
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork_ Gas Piping_Other I✓-)
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 Lillington:
Subdivision: Lot#:
I A wvat-Chi -etiC l e.31'will provide the 1 eek. Pr V:"r1 labor on this structure.
(Contractors Name) (Trade))
I am the building owner or my NC state license number is 224 O H ,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.
'{ av we er LP 6ss + 0. 1 Co . i In( • 910 - Sgo -2330
Contractor's Company Name Telephone
(305 05 1-101 S9-,t4 t._.r11"Plik2` PCS
Address Email Address
1,25 0`1
License#
Structure Owner/Contractor Signature: --i-\\--4J . Date: 2--21' 1g
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 CASH RECEIPTS
♦e* CUSTOMER RECEIPT aax
Oper: JBROCK Type: CP Drawer: 1
Date: 2/21/18 52 Receipt no: 261293
Year Humber Amount
2018 58843359
2290 LEMUEL BLACK RD
BUNNLEVEL, NC 28323
B1 BP - PERMIT FEES
$60.08
GAS PIPING
FARMER LP GAS
Tender detail
CK CHECK PAYMEN 18639 468.08
Total tendered $68.00
Total payment $68.08
Trans date: 2/21/18 Time: 14:17:34
** THANK YOU FOR YOUR PAYMENT **