DOCUMENTS Application#
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.hamen.orglpermits
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: ' mock) c.43t (.4 Date:
Site Address: \3\ SCOtt3 LY\ ' \QX NC Phone:
Directions to job site from Lillington: ri-50\
Subdivision: Lot:
Description of Proposed Work: #of Bedrooms:
Heated SF: Unheated SF: Finished Bonus Room? Crawl Space: Slab:
General Contractor Information
dud p4\edq CI k(1\ 153 34 \
Building ontractors Company NN.
pme Telephone
Address
Eli
Email Address
License#
Electrical Contractor Information
De cription of Work Service Size:_Amps T-Pole: Yes No
'pT
Electrical ontractors Company Name Telephone
Address Email Address
License#
MechanicallHVAC Contractor Information
Description of Work
Mechanical Contractor's Company Name Telephone
Address Email Address
License#
Plumbin, Contractor Information
Dir cription of W• • d #Ba -
rCA 0 �— A s '� 3 r''"-)
PI ��®- elephone er
AddrW Wr Email Address
License#
Insulation Contractor Information
Insulation Contractor's Company Name&Address Telephone
*NOTE: General Contractor/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 mi 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.
)
Signature of Owner/Contractor/Officer(s)of Corporation Date
Affidavit for Wor is 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.
1 as 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: ,
(/Sign w/Title: e Date: 9 - (2- (8-
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call: (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50043673 Date 7/12/18
Property Address 131 SCOTTS LN
PARCEL NUMBER 04-0672- - -0108- -13-
Application type description CP GARAGE/CARPORT RESIDENTIAL DETACHED
Subdivision Name MEADOW BROOK
Property Zoning RES/AGRI DIST - RA-30
Owner Contractor
RUEDA REYNALDO & LOPEZ CLAUDIA OWNER
131 SCOTTS LANE
ANGIER NC 27501
Applicant
LOPEZ CLAUDIA
--- Structure Information 000 000 20X20 COV PATIO/POOLHSE W/SHOWER&SINK
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE COV PATIO
SEPTIC - EXISTING? EXISTING TANK
WATER SUPPLY COUNTY
Permit RESIDENTIAL BUILDING PERMIT
Additional desc . WORK DONE W/O PERMITS-DOUBLED
Phone Access Code 1236256
Issue Date . . . 7/12/18 Valuation . . . . 0
Expiration Date . 7/12/19
Permit LAND USE PERMIT
Additional desc .
Phone Access Code 1236272
Issue Date . . . 7/12/18 Valuation . . . . 0
Expiration Date . 1/08/19
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1251313
Issue Date . . . 7/12/18 Valuation . . . . 0
Expiration Date . 7/12/19
Special Notes and Comments
T/S : 03/28/2018 01:47 PM BPETRICH --
131 SCOTTS LANE ANGIER 27501
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 18-50043673 Date 7/12/18
Special Notes and Comments
MEADOW BROOK #12
T/S: 03/29/2018 10 : 06 AM BPETRICH --
UNDER SLAB PLUMBING IS ALREADY DONE,
SLAB IS POURED, AND COVER IS PARTIALLY
BUILT. PERMIT FEES DOUBLED. CUSTOMER
SAYS ELECTRICAL WORK WILL BE COMPLETED
LATER SO NO ELEC PERMIT IS PULLED NOW.
T/S: 06/06/2018 11 : 23 AM BPETRICH --
OPERATIONS SIGN OFF REQUIRED PRIOR TO
CO - PERMITS NOT SOLD AND I CANNOT ADD
THE STEP UNTIL THAT IS DONE.
T/S : 07/12/2018 04 : 14 PM JBROCK ----
CUSTOMER CAME IN TO GET PERMIT AND SAID
THE PLUMBING WAS BEING TAKEN OUT
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call: (910) 893-7525 Fax: (910) 893-2793
Page 3
Application Number 18-50043673 Date 7/12/18
Property Address 131 SCOTTS LN
PARCEL NUMBER . 04-0672- - -0108- -13-
Application description . . CP GARAGE/CARPORT RESIDENTIAL DETACHED
Subdivision Name MEADOW BROOK
Property Zoning RES/AGRI DIST - RA-30
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
Permit type . . . . RESIDENTIAL BUILDING PERMIT
999 103 B103 R*BLDG FOUND & TEMP SVC POLE / /_
999 111 Bill R*BLDG SLAB INSP/TEMP SVC POLE / /_
999 101 B101 R*BLDG FOOTING / TEMP SVC POLE / /_
999 131 R131 ONE TRADE FINAL / /_
999 125 R125 ONE TRADE ROUGH IN / /_
999 229 R229 TWO TRADE FINAL / /_
999 225 R225 TWO TRADE ROUGH IN / /_
1
1
IefNErrt OUP/
uatr 1f**f CN870>Eir.'1DT*^p,�
- 7,02c008 5@ _Y`•e: r , D..awa..
deceapt rs:
'ear ErNbe,
iGSEti
Tri ^COT7 "BdJ3n75 Fnc.
NNOIE,i & �'nt
SiGOld' NC 27561
DN - PF44.7_ __
COU PA710 7 P00L RIRSE K370,OB
REYNALDO .RbEP4
Ender ce.ai-
CP CREDIT CORD
iotTotal tenderer
Total oa,vnent 5778,GO
Fa e,0O
7r'ans date: 7/42i1E $330.30
•N THANK 'Nit, FOR YOGE ?grs�-,me« 6:11:35