DOCUMENTS Application# / T - to V 7 7rzer
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 8 phone must match
Owner's Name: 1-yok flu-t ll -f )tc`r Date: q-1f —y0
Site Address: /2-2-7 Gr'f -1- L(tI 'I. /z/P-- 271 1= Phone: 7i 337 CJ 1 U
Directions to job site from//Lillington: Q
Subdivision: Nl� Lot:
Description of Proposed Work: fr/4-4",i (o"-i 71Yc.c-f p-- #of Bedrooms:
Heated SF2Y '12— Unheated SF: 89411 Finished Bonus Room? yea Crawl Space: L------Slab:
General Contractor Informatio
c9w3 c�.-1 y�n-C. c/ t 317 03 70
Building Contra or's Company Name Telephone
oO. (jolt CO 0/1144/ mac, .7--h4
Address Email Address
16 71Y
License#
Electrical Contractor Information
Description of Work , w .C- 0_9., Service Size: //PO Amps T-Pole: Wes No
t,..-,,_01k j- c"`.t 6C/I.c c.("✓cL G /9-y)t(r(39 Sec
Electrical Contractor's Company Name Telephone
6/07 V / -eJ 7r-C, LI, ,C. rd NL )72JZ
Address Email Address
/Low 7- LA
License#
Mechanical/HVAC ContractorInformation
Description of Work Sri /&i1 i S 'ice �/ l2,2--C �'Cv-``'rc"'-'
ltvIFK 0 9/o— 3 4- - 3)23
Mechanical Contractor's Company Name jelephone
? z0( Itc- 211 de<w,/vC, 237/)
Address Email Address
3 7Licensee#
/)plumbing Contractor Information
Description of Work Ivy Y I i'-'+-4 / #Baths 3
6- /6v+ 0 4V (--‘), 7/0 -2-ly— /27Y
Plumbing Contractor's Company Name Telephone
113F Tit-StyAl. 6,— AA--
Address Email Address
l44z-1
License#
Insulation Contractor Information
Tri - Cl i 1 ?/o - `166 -fS s-
Insulation Contractors 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 my 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.
r- /9—(OK
Signature of Owner/Contractor/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. �7 TT
Company or Name: Ly„,, j -iccer. X✓`C'
Sign w/Ti ' r�j ri Date: 4' �/F g
Appointment of Lien Agent:Details-LiensNC Lien Service hops://apps.liensnc.com/scr/filing/details.html?entryNumber-837364
DO NOT REMOVE!
Details: Appointment of Lien Agent Filed on: 04/19/2078
Entry #: 837364 Initially filed by: Lyonbuilders
Designated Lien Agent Project Property Print & Post
First American Title Insurance Company 1227griffinrd p�'W❑
Lton,NC 27545 7
Online:www Sununu COM:mo...•II„.... Harnett Comity
Andras:l9 W.Hvgm St.,Suite 5071 Weigh,NC
31601 Co etracIor3:
nom 880.690-7384 Property Type Please post this notice on the Job Site.
Da:DS-489-5231 Suppliers and Subcontractors:
und1:wnWn(rvfiwnccom i..o•wr+ne...ma Scan this image with your smart phone to
1-2 Family Dwelling view Nis filing You can then file a Notice
to Lien Agent for this project.
Owner Information Date of First Furnishing
Lyon builders
P o box 569 04/23/2018
Olivia. NC 28368
United States
Email:Lyonp70 a@gmail.com
Phone;919-353-0370
View Comments(0)
Teehnkal Support IloNne:(888)690-7384
I of 1 4/19/18,2:00 PM
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call: (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50043528 Date 4/19/18
Property Address 1227 GRIFFIN RD
PARCEL NUMBER 13-0519- - -0103- -03-
Application type description CP NEW RESIDENTIAL (SFD)
Subdivision Name
Property Zoning PENDING
Owner Contractor
LYON BUILDERS INC LYON BUILDERS INC
PO BOX 569 PO BOX 569
OLIVIA NC 28368 CAMERON NC 28326
(919) 498-2074
Applicant
LYON PAUL
PO BOX 569
OLIVIA NC 28368
(919) 353-0370
--- Structure Information 000 000 55X61 4BDR 3 . 5 BTH W/GAR CRWL FNSH BONUS
Flood Zone FLOOD ZONE X
Other struct info # BATHS 3 . 5
# BEDROOMS 4 . 00
PROPOSED USE SFD
SEPTIC - EXISTING? NEW SEPTIC
WATER SUPPLY COUNTY
Permit BLDG,MECH, ELEC, PLB, INSU PERMIT
Additional desc .
Phone Access Code 1233915
Issue Date . . . 4/19/18 Valuation . . . . 0
Expiration Date . 4/19/19
Special Notes and Comments
T/S: 03/13/2018 09 :58 AM LLUCAS ----
OLD US HWY 421 NORTH - LEFT ON GRIFFIN
RD - BESIDE BOONE TRAIL SCHOOL
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 18-50043528 Date 4/19/18
Property Address 1227 GRIFFIN RD
PARCEL NUMBER 13-0519- - -0103- -03-
Application description . . CP NEW RESIDENTIAL (SFD)
Subdivision Name
Property Zoning PENDING
Permit BLDG,MECH, ELEC, PLB, INSU PERMIT
Additional desc .
Phone Access Code 1233915
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 / /_
HARNETT COUNTY CASH RECEIPTS
•** CUSTOMER RECEIPT aw*
Oper: 7EROCK Type: CP Drawer: I
Date: 4/19/18 52 Receipt no: 328191
Year Number Amount
2016 50043528
1227 GRIFFIN RD
LILLINOTON, NC 27546
81 EP - PERMIT FEES
81260.00
SED
PAUL LION
fender detail
CK CHECK PAYMEN 9048 $1260.00
Total tendered 41260.00
Total payment $1260.00
Trans date: 4/19/18 Time: 13:58:54
** THANK. YOU FOR YOUR PAYMENT **