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building/permit/receipt Application# `t Jia Harnett County Central Permitting PO Box 65 Lillington,NC 27546 Each section below to be filled out 910-893-7525 Fax 910-893-2793 www.hamettorg/Permits by whomever performing work. Must be owner or licensed contractor. Address,company Application for Residential Building and Trades Permit name&phone must match Owner's Name: Date: Site Address: Phone: Directions to job site from Lillington: Subdivision: sy //// Lot: of Proposed Work: ‘57r/C/5 �1�`>v(57^lr/ otc��7�� o��N"" #of Bedrooms: J Heated SF: Unheated SF: Finished Bonus Room?jV, Crawl Space: Slab: General Contractor Informatio % /17 �/�� /9i4 9ione alta Building Contract s Company Name Telephone /ZJo F �-CM Arr..v�C�3r p i 44 -r -- =� -mac Addressrmail Address J/JS� License# ' / n Electrical Contractor Information Description of Work /1E+wv�r/ 7 a 'ce Si a ['Amps T-Pole: es No 'sr ritetna G'49#-a -n/0 Electrical Contractor's Company Name Telephone 3,74 2/ter> cc, r/C2a72)/ Address Email Address �Gaoa- License# /� MechhaannicallHVVAAC Contractor Information Description of Work NSU CZWAC72-1€G rA MV g a %rte 9'/�,2-)- -?9g/ Mechanical Contactors Comp�nyv Name Telephone /ao, i/fiW5r rr� /<u> // oi //7a�� o./,cr Address it Address ,y3/ /FY4 - License# /Plumbing Contractor Inf/�fo/oyf�nn�ation Description of Work ��✓ 7.10.4 arlf2Z42,te //#4$Baths Plumbing Cont tor'/ O Company Nam �7� Telephone61,9 q r- frim /4 s'/44 �L ��/� �i�n.G,'i.:�! Address Email Address 30797 X77 License# Insulation Contractor Information f eret &Of- .;tk. 9/0--990- 2e? Insulation Contractor's Company Name&Address Telephone `NOTE: General Contractor I 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 aay 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. - �Ii�� fl;er ``mature • •wner/ • trrctor/Officer(s)of Corporation Date Affidavit for Worker's Compensation N.C.G.S. 87-14 The undersi 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: :/.rI y.ace �y� �. � 75eZ- a f i - Sign wrTitle: / ',G � - - Dater/r Appointment of Lien Agent: Details-LiensNC Lien Service Page 1 of 1 DO NOT REMOVE! Details: Appointment of Lien Agent Filed on: 03/04/3016 Entry #: 810620 Initially filed by:jmstrickiandl Designated Lien Agent Project Property Print & Post investors Title[mum=Company Deed Souk 331),Page 125 Map p 2015.198 LOT El El Onl4: 4eea gun. Dunn,NC EP]]< *kliegs:19W.Hargett*,5a1¢5071 Raleigh,NC Hall Comly i]y^r.Ja* E1601 Coetntlor* pboat s8b4c ,3N Please post dm Mm on the Job Site. Ms:913.09.5231 Property Type Seppoenud Subeenreem: Email:ye .s® Scan tins usage wMyour amen phone to view Ni fdul8 You can Nen file a Notice 1-2 Family Dwelling m Lim Agent for*us pmlal. Owner information Date of First Furnishing Somy Godwin IO Box 1644 Dunn,NC 28335 03/052018 United*** Email Imsbckiatle3@Yat f con, Phone:910-890-2160 View Cameo*(0) Txkeinl Sepport 6oHim(g88)6911]81 https://apps.liensnc.com/scr/appointment/details.html?entryNumber-830620&printable= 3/4/2018 HARNETT COUNTY CENTRAL PERMITTING P.O. BOX 65 LILLINGTON, NC 27546 For Inspections Call: (910) 893-7525 Fax: (910) 893-2793 Application Number 18-50043329 Date 3/09/18 Property Address 17673 *UNASSIGNED PARCEL NUMBER 02-1527- - -0142- - - Application type description CP NEW RESIDENTIAL (SFD) Subdivision Name Property Zoning RES/AGRI DIST - RA-30 Owner Contractor GODWIN SONNY R STRICKLAND JEREMY MATT PO BOX 1644 PO BOX 1225 DUNN NC 28334 DUNN NC 28335 (910) 890-2160 Applicant GODWIN SONNY --- Structure Information 000 000 48X43 3BD 2BA CRAWL FUT DECK,GAR,ADDITIO Flood Zone FLOOD ZONE X Other struct info # BATHS 2 # BEDROOMS 3 . 00 PROPOSED USE SFD SEPTIC - EXISTING? NEW TANK WATER SUPPLY COUNTY Permit BLDG,MECH,ELEC, PLB, INSU PERMIT Additional desc . Phone Access Code 1229772 Issue Date . . . 3/09/18 Valuation . . . . 0 Expiration Date . 3/09/19 Special Notes and Comments T/S: 02/16/2018 01 : 38 PM BPETRICH -- 421 TOWARD DUNN - TAKE 301 TOWARD BENSON - RIGHT ONTO HOBSON RD - PROPERTY IS ACROSS THE STREET OF WHERE HOBSON DEAD ENDS INTO LANE RD. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX PERMIT INCLUDES BLDG, ELEC,MECH, PLUMB INSULATION AND LAND USE. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX Work must conform and comply with the STATE BUILDING CODE and all other State and local laws, ordinances & regulations 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 18-50043329 Date 3/09/18 Property Address 17673 *UNASSIGNED PARCEL NUMBER 02-1527- - -0142- - - Application description . . CP NEW RESIDENTIAL (SFD) Subdivision Name Property Zoning RES/AGRI DIST - RA-30 Permit BLDG,MECH,ELEC, PLB, INSU PERMIT Additional desc . Phone Access Code 1229772 Required Inspections Phone Insp Seq Insp# Code Description Initials Date 10-30 814 A814 ADDRESS CONFIRMATION _/ / 10 101 B101 R*BLDG FOOTING / TEMP SVC POLE / /_ 20 103 B103 R*BLDG FOUND & TEMP SVC POLE _/_/_ 30-999 105 B105 R*OPEN FLOOR —/ / 40-50 129 I129 R*INSULATION INSPECTION _/ / 40-60 425 R425 FOUR TRADE ROUGH IN _/ / 40-60 125 R125 ONE TRADE ROUGH IN _/—/- 40-60 325 R325 THREE TRADE ROUGH IN _/ / 40-60 225 R225 TWO TRADE ROUGH IN _/—/_ 50-60 429 R429 FOUR TRADE FINAL —/_/— 50-60 131 R131 ONE TRADE FINAL —/ /— 50-60 329 R329 THREE TRADE FINAL _/ /_ 50-60 229 R229 TWO TRADE FINAL _/—/_ 50-60 209 E209 R*ELEC TEMP POWER CERT /_/_ 999 H824 ENVIR. OPERATIONS PERMIT /_/_ T COUNTY CASH EIPTS NA*rnTCUSTOMER RECEIPTC*** Oper: 3DROCK Type: CP Drawer: 1 Date: 3/39/18 52 Receipt no: 281829 Year Number Amount 2818 58043329 17673 *UNASSIGNED 81NN, NC 263 IT- PERMFEES 34 81 4768.88 SED GODWIN SONNY Tender detail CK CHECK PAYMEN 1676 $760 88 68.88 Total tendered $760.88 Total payment Trans date: 3/09/18 Time: 13:11:82 ** THANK YOU FOR YOUR PAYMENT ** HARNETT COUNTY CASH RECEIPTS xH CUSTOMER RECEIPT m+a Gper: 78ROCK Type: CP Drawer: 1 Date: 3/09/18 52 Receipt no: 282351 Customer Location Name Amount 223707 17673 GODWIN SR, SONNY R UB UT-WATER TAP FEES $800.08 223787 17673 GODWIN SR, SONNY R U9 UT-WATER CAPACITY FEES $1200.80 223707 17673 GODWIN SR, SONNY R UD WA UTILITY DEPOSIT $25.00 Tender detail CK CHECK PAYMEN 1676 $2025.00 Total tendered $2025.88 Total payment 42925.00 Trans date: 3/09/18 Time: 13:19:49 ** THANK YOU FOR YOUR PAYMENT **