DOCUMENTS Application# ( O SCO 41.4SM5a_
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 Trade Application)
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Owner(s)of Structure: Rath .i--L C�(i T✓,,, 6, phone: q/q• 6(7, 7/ 0 9
Owner(s)Mailing Address: 2099 Sler, FF ?ahns ` AA
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Land Owner Name(s): 54 n-e- AS n/3n v'0-- Phone: 5°-E- w' 0,Ra✓e----
Construction or Site Address: 20 2 01 5L2r,'FP Te 1-.‘5-ON a
PIN# 06(/71-$2-y'I32 pools Parcel# 11069 ( oo93 of
Job Cost: S71S 6e0' Description of Work to be done I-I uric SVS-lcrr CIna ny n_ eLi-F-
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Mechanical: New Unit With Ductworkx New Unit Without Ductwork_ Gas Piping_Other_ 4is correct
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Electrical': 200 Amp <200 Amp Service Change_ Service Reconnect_ Other
'For Pro ress Energy customers we need the premise number
Plumbing: Water/Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillin!ton: r�
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Subdivision: n �I I A /V Lot#: /0'c
I gmrk I t/ Are l P will provide the Mr c key.,i a (-- labor on this structure.
(Contractors Name) 1!(Trrade)
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I am the building owner or my NC state license number is 18 b 6 , 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.
130.4--_ ClO f'12C1-0.rcr6AL / SnC - 4{Ic1i $6'8 a .33SY
Contractor's Company Name Telephone
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Address / Email Address
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License#
Structure Owner/Contractor Signature: . fes. ^c Date: 5// 221 g
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 .... - ----..
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HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Application Number 16-50044052 Date 5/17/18
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
BAKER RANDELL I & BAKER TAMMY BAR CO
2029 SHERIFF JOHNSON RD PO BOX 65
LILLINGTON NC 27546 FUQUAY-VARINA NC 27526
(919) 669-7109 (919) 868-3354
Applicant
BAKER RANDELL I & BAKER TAMMY
2079 SHERIFF JOHNSON RD
LILLINGTON NC 27546
(919) 669-7109
--- Structure Information 000 000 HVAC CHANGE OUT REWORK DUCT SYSTEM
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE MECH
WATER SUPPLY UNKNOWN
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code . 1243302
Issue Date . . . 5/17/18 Valuation . . . . 0
Expiration Date . . 5/17/19
Special Notes and Comments
T/S: 05/17/2018 04 :14 PM JBROCK ----
2079 SHERIFF JOHNSON 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 18-50044052 Date 5/17/18
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning UNZONED
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1243302
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 _/_/_
HARNETT COOKY CASn RECEiPTE
*** CUSTOMER RECEIPT ***
Open IBAOCK Type: CP Drawer:
Date: 5/17/18 52 Receipt no: 361720
Year Humber Amount
2018 50044052
91749 TECH 2
LILLIHOTON, NC 27546
E1 BP - PERMIT FEES $90.00
MECH
DAVID PUTTER
lender detail 490.B0
CP CREDIT CARD $90.80
Total tendered $90.80
Total payment
Trans date: 5/17/18 Time: 16:15:39
** THANK YOU FOR YOUR PAYMENT **