TRADES Nov, 2. 2010 12:32PM 72 Degree Heating /AC No. 3079 P. 2
Application*
Please note i if ths appliratlon Mail In application
oft job f progress Harnett County Central Permitting /61 JO 0
is pan
with o ofajob PO Box 65 Lillir►gton, NC 27546 �� �7
910- 893 -7525 Fax 910 - 893 -2793
_yen — no www.hametLorg/permits .
• Certification of Work Performed•by Owner /Contractor
(individual Trade Application) • . " '
Contractor Information . 1
I, i/l j ij.S m GL eo l will complete the f ht°.ritom i cegi work on the projector
•(Name) (Trade),
structure heroin described. My state license number is (98 Ala& . AU work shall comply with the
State Building Code and all other applicable State & Local law, ordina / and regulations.
Company Name: i2 N eS tend rw 1 4112- GOnh4D/4 4 y
Mailing Address: r2�l) RZk+tL.SDn v S 4/UN, o
Street Address: &rrPDtei i A) le d /33 2
Business Phone: 1 I c i - l e -,9. Email Address; U Vic g (' kG1l.Q.i n ✓1L, C4 K.
'Company name, address, & phone must match lMormation on Iicensa
Job Information
Land Owner's Name: ftN n ( adn6e Phone: ctiD - -$S &?
Tenant/Building Owner(If different): Phone;
Construction or Site Address: A3 1(p A tia1•1, e ki uer Ina 1 -ril n34
PIN or Parcel #from GIS: 6 b 4o -4 '7 -Still, noo
S•e icD' atio •Job . II ,••n:
•111.421 7IC._. ! : , - on us _ S nu' t 1a[ At , , f ti-Gek
Description of work to be done: Qa Ia.tt 'i5 J an i f Job ost 85(7O-
Mechanical: New Unit With D _ New Unit Without Ductwork Gas Piping
Beetled: 200 Amp <200 Amp _ Service Change _ Service Reconnect _
Plumbing: Water/Sewer Tap _ Number of Baths Heater
Permit Cost '
Permit Fee: $ �0' Da (calculated from fee schedule)
Mall In Processing Fee: 53.00 per application For Electrical Permits with Progress Energy
we need the premise number provided.
Total Enclosed: $ 4 T Da
Make check payable & Mail completed application form to: Ha aunty Central Permitting (HCCP)
.___,4g2P LillirgWn, NC 27648
•
Contractors Signature' Date: 11 J a at D
D0 NOT SEND CAS . INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
TRADE 4/08
Nov. 2. 2010 12 :32PM 72 Degree Heat ing /AC No, 3079 P. 3
Application # '
Mall In application
Please none if this application Harnett County Central Permitting
is part °ra job in progress PO Box 65 Lilington, NC 27546
with open pamits. 910 -893 -7525 Fax 910 - 893 -2793 .
yea _no www.hamett.orglpermits , .
• Certification of Work Perforrnedby Owner / Contractor . •
(Individual Trade Application) " " • .
Contractor Information - . . 1
•
1, 'Rtr r 1/ neriS will complete the ebeglateeil work on the project or
(Na (Trade)
structure herdin described. My state license number is / 70Q7 ,, All work shall comply with the
State Building Code and all other applicable State & Local law, =finances and regulations.
Company Name: 910ndy kW/5 F./MA/eta &Pv / !SS
Mailing Address: I tiff &181'x'3 J,t k1 'Road
Street Address: .a ad, la N7 9.3 3.2
Business Phone: 119 -777 -Cal/ Email Address:
'Company name, address, & phone must match information on license.
Job Information
Land Owner's Name: fn n /1. cn4rcttt Phone: e l ID- HB1 - $f27
Tenant/Building Owner(if different): Phone:
Construction or Site Address; 2390 5n r fie. ?flea, LiiliAO inn
PIN or Parcel # from GIS: 000-t1 ' -Szfq• boo
u
•ecl c a'uso • Job •m In, ot:
u -�� i . _ llnrit< c'72?7:T'!1tMi7itir Dashetiff_7t1!» f i,
Description of work to be done: Pt-Cartn trf Job Cost; 300' °D
Mechanical: New Unit WO Ductwork _ New Unit Without Ductwork Gas Piping
Electrical: 200 Amp _ Service Change Service /
ce Reconnect Other
Plumbing: Water /Sewer Tap Number of Baths __ Water Heater
Mast •
Permit Fee: $ SO.DD (calculated from fee schedule)
Mail In Processing Fee: $3.00 per application For Electrical Permits with Progress Energy
we need the premise number provided.
Total Enclosed: $ cCDl°D
Make check payable & Mail completed application form to: Harnett County Central Permitting (HCCP)
:;Box 65
n 6 NC 27546
Contractor's Signature: d� � Date:_ //1a /aato
DO NOT SEND CASH. MPLETE APPLICATIONS WILL NOT OE PROCESSED.
TRADE 4/08
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