DOCUMENTS 1 Ur I I $ Application# I 5t`t 3(ny(-{
P I Harnett County Central Permitting
PO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.harnett.org/permits
Certification of Work Performed By Owner/Contractor
(Individual Tra.rr- f{IPlic-tion) �f � [�� /I
Owner(s)of Structure: / / PA _= 1 (17/ one: r I I p 10S& III-11 I /�
Owner(s)Mailing Address:.-,.2-?i / //) S 'Ad
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Land Owner Name(5): ' na J� eAJ. 4tlft Phone: 9(9 - g ��� M.Q/)
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Construction or Site Address:
PIN# Parcel# '
Job Cost: Description of Work to be done 1 Vl"a
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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 cu mers we need the premise number
Plumbing: ewer Tap ( Number of Baths Water Heater
Specific Directions to Job from Lillinoton:
Subdivision: Lot#:
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providehid labor on this structure.
(Contractors Name) (Tr e)
I am the building owner or my NC state license number is BWYThBQ ,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.
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Contractor's Company Name k Teleph ne ^I
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Address Email Address _/ rr�l/CdN)
License#
Structure Owner/Contractor SignatureV y.1/1 Li 2)I V N r 4i D . Ma Ia 4/Z-ti '3
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
+vuuvnii wuNEI CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50043644 Date 3/26/18
Property Address CHRISTIAN LIGHT RD
PARCEL NUMBER 05-0632- - -0015- -01-
Application type description CP SEWER/WATER TAP
Subdivision Name
Property Zoning RES/AGRI DIST - RA-30
Owner Contractor
GILCHRIST RANDALL WAYNE OWNER
223 ROLLINS RD
FUQUAY-VARINA NC 27526
(919) 552-4161
Applicant
GILCHRIST RANDALL
223 ROLLINS RD
FUQUAY-VARINA NC 27526
(919) 656-1476
--- Structure Information 000 000 WATER TAP HOOK UP
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1235571
Issue Date . . 3/26/18 Valuation . . . . 0
Expiration Date . 3/26/19
Special Notes and Comments
T/S: 03/26/2018 04 :16 PM JBROCK ----
2966 CHIRSTIAN LIGHT 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 18-50043644 Date 3/26/18
Property Address CHRISTIAN LIGHT RD
PARCEL NUMBER 05-0632- - -0015- -01-
Application description . . CP SEWER/WATER TAP
Subdivision Name
Property Zoning RES/AGRI DIST - RA-30
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1235571
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 305 M305 R*PLUMB SEWER CONNECTION
999 307 P307 R*PLUMB WATER CONNECTION / /
999 309 P309 R*PLUMB UNDER SLAB %/
999 131 R131 ONE TRADE FINAL
999 125 R125 ONE TRADE ROUGH IN %/
999 315 P315 R*PLUMB HW HEATER /--/--
HARNETT COUNTY CASH RECEIPTS
wam CUSTOMER RECEIPT ***
Oper: JBROCK Type: CP Drawer: 1
Date: 3/26/18 52 Receipt no: 299298
Year Haber Amount
2018 58843644
CHRISTIAN LIGHT RD
81 BP - PERMIT FEES
$40.88
PLUMBING
RANDALL N GILCHRIST
Tender detail
CR CHECK PAYMEN 3250 $40.00
Total tendered $40.80
Total payment 840.08
Trans date: 3/26/18 Time: 16:21:34
** THANK YOU FUR YOUR PAYMENT am