DOCUMENTS v1 i a\ 1 Y Application# I WSO0-1C-4J r
Harnett County Central Permitting
PO Box 65 Lillington,NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamett.org/permits
Certification of Work Performed By Owner/Contractor
JJ (Individual Trade Application)
Owner(s)of Structure: R,4 Cat 74241/ Phone:
Owner(s)Mailing Address: /`J Ye NC 27
L.//.ay <d„ .dc z-7s46
Land Owner Name(s): Phone: 910 fBY -6912
Construction or Site Address: 2328 7,4%1 d etJ . get
PIN# Parcel#
Job Cost: Description of Work to be done /LC [c*.-ea
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 customers we need the premise number
Plumbing: Water/Sewer Tap Number of Baths Water Heater
SSecific Directions to Job from Lillin tan:
Subdivision: Lot#:
I A')1 Cads-y.)4-7' 4ec4 will provide the {>G -:� labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is 211/7 - ,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.
110 170. /f cJ,2:r 606- gray- 67?
Contractor's Com Name Telephone
/9Ye Alt w e <,4 4,
Address Emai ,ddre s '
2/ 7/7 — (Al_
License#
Structure Owner/Contractor Signature: 7 Date: 6 -72.-
By
7a-By signing this application you affirm that you have ained PbT mission 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 18-50044237 Date 6/12/18
Intersection
Property Address 2328 TITAN ROBERTS RD
PARCEL NUMBER 10-0578- - -0010- - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20R
Owner Contractor
GREGORY RODNEY A R A GREGORY ELECTRIC
1948 NC 27 W 1948 NC 27 WEST
LILLINGTON NC 27546 LILLINGTON NC 27546
(910) 893-6650
Applicant
GREGORY RODNEY A
1948 NC 27 W LILLINGTON, NC
27546
LILLINGTON NC 27546
(910) 984-6932
--- Structure Information 000 000 ELE RE-CONNECT - NO WORK
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE ELE-RE CONNECT
WATER SUPPLY UNKNOWN
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1246685
Issue Date 6/12/18 Valuation . . . . 0
Expiration Date . 6/12/19
Special Notes and Comments
T/S: 06/12/2018 09: 27 AM JBROCK ----
TAKE ROSS RD TO TITAN ROBERTS 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 18-50044237 Date 6/12/18
Property Address 2328 TITAN ROBERTS RD
PARCEL NUMBER 10-0578- - -0010- - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20R
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1246685
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 211 E211 R*ELEC ABOVE CEILING —/—/-
999 217 E217 R*ELEC RECONNECT —/—/-
999 205 E205 R*ELEC UNDER SLAB —/—/
999 215 E215 R*ELEC. UND. POOL —/—/
999 213 E213 R*ELECTRICAL UNDERGROUND _/_/-
999 131 R131 ONE TRADE FINAL —/ /
999 125 R125 ONE TRADE ROUGH IN _/ /
HARNETT COUNTY CASH RECEIPTS
xam CUSTOMER RECEIPT a«r
Oper: JBROCK hoe: CP Drawer:
Date: 6/12!10 52 Receimt no: 367236
Year Hamner Amount
2016 50044237
2326 TITAN ROBERTS Ru
LILLINGTON, HE 27546 __
Bi BP - PERMIT FEES
$60.00
ELE PERMIT
R A GREGORY
lender detail IB0.00
CA CASH PAYMENT g$100.00
Total tendered 0.00
Total payment 46 460.00
Change
trans date: 6/12/18 Time: 9:36:59
+N THANK YOU FOR YOUR PAYMENT as