BUILDING Application# � U �,?�L a
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)
Owner(s)of Structure: Phone:
Owner(s)Mailing Address:
Land Owner Name(s): Phone:
Construction or Site Address:
PIN# Parcel#
�9Description / G�
Job Co �� S�� �Work to be donee., �T (Q,� //�� U -
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
Specific Directions to Job from Lillinpton:
Subdivision: Lot#:
I R,c t-4/4 will provide the > z� labor on this structure.
(Contractors Name) (Trade)
I am the building owner or my NC state license number is Z KIZOr"' , 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
License C 1V S
ense#
..� /rte
Structure Owner/Contractor Signature:%_it z Date: i CV j /5"
y
By signing this application you affirm that you '.ve 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
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call : (910) 893-7525 Fax: (910) 893-2793
Bldg Insp scheduled before 2pm available next business day.
Application Number 13-50030362 Date 11/18/14
Property Address 26 LITTLE FARM CIR
PARCEL NUMBER 04-0663- - -0051- - -
Application type description CP FARM BUILDING/ETC.
Subdivision Name CAROLINA LAKES
Property Zoning RES/AGRI DIST - RA-40
Owner Contractor
CROSS JERRY C & LAURA M SULLIVANS ELECTRICAL SERVICE
26 LITTLE FARM CIRCLE 20 ADAMS POINTE RD
ANGIER NC 27501 ANGIER NC 27501
(919) 639-4827
Applicant
HUTCHINS ERIC
108, TOWER DR
ANGIER NC 27501
(919) 207-1681
--- Structure Information 000 000 50X24 BARN / FARM BLDG
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE BARN / FARM BLD
SEPTIC - EXISTING? EXT
WATER SUPPLY COUNTY
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc .
Phone Access Code 1062108
Issue Date . . . 11/18/14 Valuation . . . . 2500
Expiration Date . 11/18/15
Special Notes and Comments
T/S : 01/04/2013 03 : 23 PM JBROCK - ---
210 N L ON JAMES NORRIS RD L ON WHEELER
DR L ON LITTLE FARM CIR