DOCUMENTS Jun. 12. 2018 1 :52PM CHARLES TART PROPANE INC. No. 3212 P. 11/1
Application# <K R0OL f(1)43
Harnett County Central Permitting
PO Box 55 Lillinglon,NC 27546 - Ph:910-893-7525 - Fx:810.893-2783 - www.hamod.org/pemils
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: H�„K.H Grw. N..h a.l SIc,,I ✓ Phone: 4310814alSz
Owner(s)Mailing Address: Po tom quo
O2sY
Land Owner Name(s): Phone:
Construction or Site Address:
PIN# / Parcel#
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Job Cost: )BOO Description of Work to bedone
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fl o s 1;. C C v-r� $b L(s e� GLAt i �v:gAe.\ li� LLc--(:,v1,-
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Mechanical: New Unit With Ductwork_ New Unit Without Ductwork Gas Piping.Other_
Electrical: 200 Amp_X200 Amp_Service Change_ Service Reconnect_ Other
'For Progress Energy customers we need the premise number
Plumbing: Water/Sewer Tap Number of Baths Water Heater
Specific Directions to Job from Lillin�oton:
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Subdivision: Lot#:
I C.Vw,t .TejF Orae- will provide the rwtsb.w.es,.l labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is a\1 aY which entitles me to
perform such work on the above structure legally. All work shall comply with the Slate Building Code and all
other applicable State and local laws,ordinances and regulations.
Y10-r124- .4-- por-x. Flo BAA- o. \r
Contractor's Company Name Telephone
70-\ '?1c...;.-. AasCZ f.�po.4 . w
Address ail Address
;1\ 215 CP;c.
License#
Structure Owner/ ontrac r Signature: rr— Date: V -rt- I Y
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 18-50044243 Date 6/12/18
Property Address 1100 MCKAY PL
PARCEL NUMBER 10-0569- - -9000- - -
Application type description CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning LILLINGTON
Owner Contractor
HARNETT COUNTY OF OWNER
PO BOX 759
LILLINGTON NC 27546
Applicant
HARNETT COUNTY ANIMAL SHELTER
PO BOX 960
LILLINGTON NC 27546
(910) 814-2952
--- Structure Information 000 000 GAS LINE
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE GAS LINE
WATER SUPPLY UNKNOWN
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc
Phone Access Code 1246792
Issue Date . . . 6/12/18 Valuation . . . 0
Expiration Date . 6/12/19
Special Notes and Comments
T/S: 06/12/2018 02 : 14 PM JBROCK ----
1100 MCKAY PLACE
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 18-50044243 Date 6/12/18
Property Address 1100 MCKAY PL
PARCEL NUMBER 10-0569- - -9000- - -
Application description . . CP STANDALONE TRADE - RESIDENTIAL
Subdivision Name
Property Zoning LILLINGTON
Permit RESIDENTIAL MECHANICAL PERMIT
Additional desc .
Phone Access Code 1246792
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 COUNTY CAS: RELtWrS
*** CUSTOMER RECEIPT ***
OpeT: IEROCK Type: CP Drawer: 1
Date: 6/12118 52 Receipt no: 387532
Year Humber Amount
2018 50044243
1100 MCKAY PL
LILLINGTOH, NC 27546
El BC - PERMIT FEES
460.00
GAS LINE
TART PROPONE
lender detail
CP CREDIT CARD 460.00
Total tendered 860.00
Total payment 460.00
Trans date: 6/12/16 lime: 14:15:12
** THANK YOU FOR YOUR PAYMENT **