HomeMy WebLinkAboutPERMITS yes _ uu I -
Certification of Work Performed fD O
By Owner/Contractor
- D Contractor Information / ' /
work on the project or
I, IKZFo~, Z-LK !%/t~ai l complete the l~
(Name) (Trade)
structure herein described. My state license number is . All work shall comply with the
State Building Code and all other applicable State & Local law, ordinances and regulations.
Company Name: 467
Mailing Address: y' C-
Street Address: vE L~~E C
Business Phone: Email Address: A L 6z%'~~`t/hz~e,c
'Company name, address, & phone must match information on license.
Job Information
Land Owner's Name: fj Phone
Tenant/Building Owner(if different): Phone:
Construction or Site Address: /Z ~x /GL< ae ~i`~~yr~✓~G✓O-®~
PIN or Parcel # from GIS:
S ecific Dir lion t ob from L~lin ton: 2 - ~ v~i~
Ah
c
Descr tion of work to be done: z_ (J(J/ j~/its{ J L~~Job Cost: 70
echanica • New Unit With Ductwork _ New Unit Without Ductwork ✓Gas Piping -
ec 200 Amp _ <200 Amp _ Service Change _ Service Reconnect _ Other _
Plumbing: Water/Sewer Tap _ Number of Baths _ Water Heater _
Permit Cost
Permit Fee: $ (calculated from fee schedule)
Mail In Processing Fee: $3.00 oer application
c)
Total Enclosed: $ z
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
PO Box 65
n Lillington, NC 27546
Contractor's Signatur Date: ®Z d
DO NOT SEND CASH. C L TE APPLICATIONS WILL NOT B PR CESSED.
ioroe
GIS Public: Powered By Freeance 4.3.2 - TDC Group Inc. Page 1 of 1
p«, to- Ili , pI~~~~, { `G fi ('pJ1 ]I+' J E
t
~~~!II1W~i6iI:iI~IJiII',
L `5
IN,
Mom
"yc z ;t a 9 Search
i ~y< 507` 3 1 y w All Selections
4 /
ns Clear, ~f
Is Feature
^!lB2B¢Opl ( , '~a~. Lion c6
SCHROY ROBERT R &
' r$,. 1 1 'r#i't1j SCHROY YONG C &
AD
DDS 477 LAKERIDGE V01 'N
9 ` E r P } `II]'++ 1- _ CAMERON
iNC '
283260000
' I'7 IN fi u '9565-79 3821 000
J1 Hr t . 477 C 1 995660
10001 14
.al
3
N El 88
TGAS LT#9 000477 X
{ 8 MIRE BRANCH
1~ $ ESTATES
a A e. AL _2I J ESTATES
D~UNITS•.
f i fl
2AC
ItIs ( f r , ,It ~~If~
tliPv 'x 'Tk x ° C1+C ~ES~ 0.68219816
ion
41 DB K 01018
6I, +3' ; 0"' 0727
EMI 3 3rr ; ~ V D - a
s..-:b Mi ....c, r.
rte Information
I
I
stIPID PIN ILEQALt LEOAL2 11099566019665-79- MIRE SC#4 ~LAKERIDGE 062 01018 0727 91500129190
000114 3821000BRANCH PC#Fl86D DR 000477 X
'
ESTATES
LT 152
u+u in, tin, w zr s.e.~ i ;kl naita~au
http://gistools.hamett.org/Freeance/Client/PublicAccess1 /index.httnl?appeonfg=publie 1 2/18/2010