HomeMy WebLinkAboutDOCUMENTS c' 117 Application# 1 - ham ) 0 )
Harnett County Central Permitting
PO Box 65 Lillington,NC 27546 - Ph:910-893-7525 - Fx:910-893-2793 - www.hamettorg/permits
Certification of Work Performed By Owner/Contractor
//.� (Individual Trade Application)
Owner(s)of Structure:(cert` 7etnnPr Phone: 41Q- 1521- t-lora%
Owner(s)Mailing Address: a' 'SS NC. 4}r.,, 55 13e rF
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Land Owner Name(s): }7r P. 7-e-tnne-r Phone: qlq--t$3-- 40(0)4
Construction or Site Address: We_$f c� as-3
JobULD t ••-• — .�0`tls ' anal# oLo L l c) a
Joobb Cost: aJ.QQs Description of Work to be done in�Stalt 2 a 4-� heti-
f p
Mechanical: New Unit With Ductwork_ New Unit Without Ductwork Cok. 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
Soecific Directions to Job from Lillington:
Pfr4Qset dearit, Mr gin Mo. - fraM' Kari W,Nrnotl;14 C.b&ne,r* avrt- -run
tCC+ cin AY,-,:t(Nf.11.?• .'+I i,h+ r1,-,{ht rm .cW S4.v+ Stl Ak:.DI --fr.m I.4* snip
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Subdivision: Lot#:
r L1ana 14a4t�4..,%4.r�-
I g)t'vrt P.v_Dress will provide the F\VfIC.S labor on this structure.
(Contractbrs Name) M (Trade)
I am the building owner or my NC state license number isr'aflatc _, 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.
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Contra8dttor's Company Name Telephone
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Address EmailA ressCry,�.,yy1
LicenseAiDn#tL
Structure Owner/Contractor Signature: l r ‘birtki-Cnn1 tkj a II, Date: ` &JI I I
By signing this application you affirm that you have obtained permission from a 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
Application#
Harnett County Central Permitting
PO Box 65 Ullington, NC 27546 - Ph:910-893-7525 - Fx:91D-893-2793 - www.hamett.org/permits
Certification of Work Performed By Owner/Contractor
(Individual Trade Application)
Owner(s)of Structure: (Pr Ze)n et- Phone: SEQ-153- 40(04
Owner(s)Mailing Address: j� � NC 1}Wy .si,'L Was+
l'co-}s MC- 153t
Land Owner Name(s): Casae 7vlv�e,r � �w� � Phone: lac-'1S'S- 401 'F
Construction or Site Address: a SS NC "'t""1 �.� LOPS-
PIN# Parcel#
Job Cost: ale QS. eDescription of Work to be done ()Sall n a `itn heti-4
PtIL
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
S ecific Directio to Job from Lilli
c.nder be Mr'Krnv+, fla.>y rrsre Fri W.('nrrwl:uP&u&-41a n
talk t n NC:xtIn1P xtr-- r6k4 rcrrk�ti+ rcn c 1 G!PW,.r+ 5-1 Ak..rl — -tuor, ke 1 nnta
N. fhrtrdf. t SF NC- Si +vrn s r t as5c Mi tkiewru.l c: Coats AX.
Subdivision: Lot#:
mirkea-i,."Cud
I JX(lex+ IAL.fYPS54will provide the C1eckirCre..Q- labor on this structure.
1I((Contractors ame) (Trade)
am the building owner or my NC state license number is E. I tp4aP ,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.
1—y De if 4- d-y.pre.cs QlQ-laZ(¢- a
Contrattors Companyy''Name Telephone
PD. Pntr '3C 'a4e.* &1ro14 QSKev.-.t es< .
Address Email Address RCE.1 yy1
I lg
License#
Structure Owner/Contractor Signature h4Q 4,t4APCL1 y)i Date: S(36111
By signing this application you affirm that you have obtained permissidh 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