DOCUMENTS Application# I D 56.0044'4Lis `v
t9 Harnett County Central Permitting
offPO Box 65 Lillington, NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamett.org/permits
t Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: air2e,.4 ,0FCC 0 ir' ('ArIrlaY-kone: 9i / lig-9-C, Z2/
Owner(s) Mailing Address: 70/ ML'/07y 162G-1 ti PI
'vr,i/%n/A/r, 1532 ,
Land Owner Name(s): ---244;:: Phone: 0 m
ra
Construction or Site Address:
PIN# Parcel# //''��
Job CosDescription of Work to be done �V\le l.1 p
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 cust ers we need the premise number
Plumbing: Water/ er Tap Number of Baths Water Heater
Specific Directions to Job from Lillington:
Subdivision:l� 71 ,,1 Lot#:
I l �sUV^+. will provide theabor on this structure.
(Contractors Name) ,•^^ (Trade)
I am the building owner or my NC state license number is v•
(. _ ,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.
Contractor's Company Name Telephone
Address Email Address
OC Lik a, ---
License#
Structure Owner/Contractor Signature .� <,f Z, Date; 7-/7 - .41-1By signing this application you affirm th you have obtained permission from the above listed lidense 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, 8 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 18-50044470 Date 7/12/18
Property Address 701 MCKOY TOWN RD
PARCEL NUMBER 09-9555- - -9000- - -
Application type description CP SEWER/WATER TAP
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20R
Owner Contractor
CHURCH OF GOD IN CHRIST JESUS OWNER
OF ANGIER
PO BOX 1121
ANGIER NC 27501
Applicant
CHURCH OF GOD IN CHRIST
701 MCKOY TOWN RD
CAMERON NC 28326
(919) 499-6231
--- Structure Information 000 000 WATER TAP HOOK UP
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1251222
Issue Date . . . 7/12/18 Valuation . . . . 0
Expiration Date . 7/12/19
Special Notes and Comments
T/S: 07/12/2018 11 :40 AM JBROCK ----
701 MCKOY TOWN 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 18-50044470 Date 7/12/18
Property Address 701 MCKOY TOWN RD
PARCEL NUMBER 09-9555- - -9000- - -
Application description . . CP SEWER/WATER TAP
Subdivision Name
Property Zoning RES/AGRI DIST - RA-20R
Permit RESIDENTIAL PLUMBING PERMIT
Additional desc .
Phone Access Code 1251222
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
999 305 M305 R*PLUMB SEWER CONNECTION / /
999 307 P307 R*PLUMB WATER CONNECTION / /
999 309 P309 R*PLUMB UNDER SLAB / /
999 131 R131 ONE TRADE FINAL
999 125 R125 ONE TRADE ROUGH IN /--/--
999
/999 315 P315 R*PLUMB HW HEATER / /
•
HFMNETT COUNTY CASH RE.133:"3
*** CUSTOMER RECEIPT ♦**
Doer: SHOCK Type: CP Drawer: i
Date: 7/12/15 52 Receipt no: 16007
Year Humber Amcemt
2018 50044470
701 MERCY TG'MN SD
CAMERON, NC 26326
Bl E" - PERMIT FEES
$40.00
PLUMBING PERMIT
CHURCH OF COD
Tender detail
CK CHECK PAYMEN 2150 648.00
•
Total tendered $40.00
Total payment 540.00
Trans date: 7/12/l8 Time: 12:46:30
** THANK YOU FOR YOUR PAYMENT **