DOCUMENTS 31P%
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No rn Application# 4 D 5C-1-) 3 toot(
U Harnett County Central Permitting
PO Box 65 Lillington,NC 27546 - Ph:910-693-7525 - F c 910-893-2793 - www.hametorglpennits
Certification of Work Performed By Owner/Contractor
^^ �r (ln[dividual Trade Application) /� f� /� /y �jf
Owner(s)of Structure - (�,.7}�{�./ '-�Sr�,-Cr�� 'r( ;GJ -hone:g)() _( (wtf'2� :J
Owner(s)Mailing Address: / 5I f'I/,{ (l� [-(
Ccurrr , Mc 2_8-772.1.0
Land Owner Name(s): _ w_ _* l i 1 �- �L�--��� q
vone:_
Construction or Site Address: � 1 111 4677
PIN# Qt Sfr5 el a (_n ,rono Parcel ft b ` Ss cc s oto O otc2. 10
Jeb Co t:JP (U/) Description 4of Work to be done ill(11 " lit" 0x
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A1 ;S-I. ] <7) • nark, p,
51 , VD$ wiry; , i ulpim (1 sr,: Ct S 4t(., A' Lona«
Mec anise]: New Unit With DuctworkX— New Unit Without Ductwork Gas Piping_Other -. (u&i'
Electrical*: 200 Amp <200 Amp)( Service ChangeService Reconnect X Other_
*For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillingtan:
Subdivision: Lot#:
/n�r'�y9_ooLiafi(Ug�, jt'�� _ Maid
i`-arrpat�Ar`e - YI it r jade the latz labor on this structure.
(Contractors Name) 2 f�,� r�a7d�ee)) r
I am the building owner or my NC state license number is J(iU"J72056,,which entities me to
perform such work on the above structure legally. Al)work shall comply with the State Building Code and all
other applicable State and local laws,ordinances and regulations.
thn al- r r&' [1k t gl(F -771 I
Contractor's Company Name Telephone
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Address )2/15(0 /�7d�`-i
7 mail Address I 03
icense# LLicense
�
Structure Owner/Contractor Signatu e: 4!i ' ;/ ",(f/fyy ' Dater
By signing this application you affirm t yo 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 CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50043664 Date 3/28/18
Intersection
Property Address 251 HAYDEN LN
PARCEL NUMBER 09-9565-06- -0282- -10-
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name RICHMOND PARK 4&5 86 LOTS
Property Zoning PENDING
Owner Contractor
GRANILLO SCARLET M CAROLINA COMFORT AIR INC/CLAYT
251 HAYDEN LANE PO BOX 190
CAMERON NC 28326 CLAYTON NC 27520
(919) 550-7711
Applicant
GRANILLO SCARLET M
251 HAYDEN LANE CAMERON, NC
28326
CAMERON NC 28326
(910) 964-2989
--- Structure Information 000 000 HVAC CHANGE OUT 1.5 TON
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE MECH / SLE
WATER SUPPLY COUNTY
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1235993
Issue Date . 3/28/18 Valuation . . . . 0
Expiration Date . 3/28/19
Special Notes and Comments
T/S: 03/28/2018 08 :37 AM JBROCK ----
251 HAYDEN LANE
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 18-50043664 Date 3/28/18
Property Address 251 HAYDEN LN
PARCEL NUMBER 09-9565-06- -0282- -10-
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name RICHMOND PARK 4&5 86 LOTS
Property Zoning PENDING
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1235993
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 —/—/—
HA**% CUNTY CASH
TCUSTOMER RECEIPTC***TS
Oper: JBROCK Type: CP Drawer: 1
Date: 3/26/16 52 Receipt no: 300015
Year Number Amount
2016 50043664
251 HAYDEN LN
CAMERON, NC BP FEES
61 $90.00
MECH
CAROLINA COMFORT
Tender detail 9B.60
CP CREDIT CARD E$90.00
Total tendered $90.00
Total payment
Trans date: 3/26/16 Time: 0:40:30
** THANK YOU FOR YOUR PAYMENT **