BUILDING Application # 10 fro Z5
40
• Each section below to be Stied out Harnett County Central Permittin g
by whomever performing work. PO Box 65 Ll llington, NC 27546
contractor. AddreTosss, , company co
Must owner s 910 -893 -7525 Fax 910 - 893 -2793 www.hamett.org/permits
name & phone must match
Application for Residential Building and Trades Permit
Owner's Name: Royal Oaks Building Group, LLC Date: \ al \01
Site Address: V% P' c4. Cocer OQ.i Phone: 919.2333886
Directions to job site from Llllington: Head South on Main St toward Front St; Turn Right at NC 210 S;
Turn Right on Overhllls Rd; Turn Left on Overhllls Rd; Continue onto Nursery Rd; Turn Right at NC 24W/87N;
Turn Right at Sawyer Rd
Subdivision: Village of Lexington Lot: P,
Description of Proposed Work: Single Family Home # of Bedrooms: 3
Heated SF:1 Unheated SF:1ba Finished Bonus Room? Crawl Space: _ Slab: ✓
General Contractor Information
Royal Oaks Building Group, LLC 919.233.3888
Building Contractor's Company Name Telephone
1210 Trinity Road, Ste 102 Raleigh, NC 27607 kwesterman @royaloaksbg.com
Ad sn Email Address
49775
Si nature df owner /Contractor /Officer(s) of Corporation License #
Electrical Contractor Information
Description of Work Electrical Rough - In and Final Service Size: 200 Amps T -Pole: d Yes No
Imperial Electric 919 363 - 7474
Electrical Contractor's Company Name Telephone
PO Box 162, Apex, NC 27502
Addres Email Address
rte, 19860
Signature of Owner /Contractor /Officer(s) of Corporation License #
Mechanical /HVAC Contractor Information
Description of Work install HVAC and duct system
Stewart's Heating and Air 919- 362 -0387
Mechanical Contractor's Company Name Tel � JJ
2430 Reliance Ave, Apex, NC 27539 CGJ �Tura.4 0 Shagtr1 f L tk. n j 44 qr ( [ u •R
Address Email Address
e / y / ^Q 09308
Signature of Owner/Contractor/Officer(s) of Corporation License #
Plumbing Contractor Information /�
Description of Work plumb single family home # Baths d • 5
Barbour and Pourion - 919533 -0455
Plumbing Contractor's Company Name Telephone
PO Box 934, Clayton, NC 27528
Address / Email Address
10672
Signature of Owner /Contractor /Officer(s) of Corporation License #
Insulation Contractor Information
Tatum Insulation II 919 661 - 0999
Insulation Contractor's Company Name & Address Telephone
*NOTE: General Contractor must fill out and sign the second page of this application.
Residential Building Application 1 of 2 03/10
Homeowners Applying to Build Their Own Home
Please answer the following questions then see a Permit Technician to determine If you qualify for permit under Owners Exemption.
Questionnaire per G.S. 87-14 Regulations as to Issue of Building Permits (Memo available upon request)
1. Do you own the land on which this building will be constructed? _ Yes _ No
2. Have you hired or intend to hire an Individual to superintend and
manage construction of the project? _ Yes _ No
3. Do you intend to directly control & supervise construction activities? _ Yes _ No
4. Do you intend to schedule, contract, or directly pay for all phases of
construction work to be done? Yes No
5. Do you intend to personally occupy the building for at least 12 consecutive
months following completion of construction and do you understand that if
you do not do so, It creates the presumption under law that you fraudulently
secured the permit? _ Yes _ No
I hereby certify that I have the authority to make necessary application, that the application Is correct
and that the construction will conform to the regulations in the Building, Electrical, Plumbing and
Mechanical codes, and the Harnett County Zoning Ordinance. I state the Information on the above
contractors is correct as known to me and if any changes occur Including listed contractors, site plan,
number of bedrooms, building and trade plans, Environmental Health permit changes or proposed use
changes, I certify It Is my responsibility to notify the Harnett County Central Permitting Department of
any and all changes.
EXPIRED PERMIT FEES - 6 Months to 2 years permit re -issue fee is $150.00. After 2 years re -issue fee
is as . r current f= - schedule.
a Sa /2./0 Cd
SI: ature o 0 r`"' .'rector /Officer(s) of Corporation Date
Affidavit for Worker's Compensation N.C.G.S. 87 -14
The undersigned applicant being the:
;\ ✓ General Contractor Owner Officer /Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s), firm(s) or corporation(s) performing the work
set forth in the permit:
✓ Has three (3) or more employees and has obtained workers' compensation insurance to cover them.
_ Has one (1) or more subcontractors(s) and has obtained workers' compensation Insurance to cover
them.
/Has one (1) or more subcontractors(s) who has their own policy of workers' compensation insurance
covering themselves. .
Has no more than two (2) employees and no subcontractors.
While working on the project for which this permit is sought it is understood that the Central Permitting
Department issuing the permit may require certificates of coverage of worker's compensation insurance prior
to issuance of the permit and at any time during the permitted work from any person, firm or corporation
carrying out the work.
Company or Na • e: Royal Oaks Building Group, LLC
Sign w/fltle:1 u_ %.- - 44NA &Lf1 Date: 12 . (O . /0
Residential Building Application 2 of 2 03110
J
Plan Box Number IQ 7 Job Name ey sok
Date: /It- a- /C)
Required Inspections for SFA/SFD
Appl. # lO- 57:562S7W/t
Valuation /S/ r„y3
Sq. Feet 2 3'? LI
Sequence
10 R* Bldg. Footing
10 -30 R* Elec. Temp Service Pole
20 R* Building Foundation
20 Address Confirmation
30 -999 Open Floor
30 -999 ;/ R* Bldg. Slab Insp. 'rt vut
30 -999 R* Elec. Under Slab
30 -999 ✓ R *Plumb. Under Slab
40 ✓ Four Trade Rough In
40 Four Trade Rough In> 2500
40 Three Trade Rough In
40 Three Trade Rough In> 2500
40 Two Trade Rough In
40 Two Trade Rough In> 2500
40 One Trade Rough In
40 One Trade Rough In > 2500
50 ✓ R* Insulation
60 A✓ Four Trade Final
60 Four Trade Final > 2500
60 Three Trade Final
60 Three Trade Final > 2500
60 Two Trade Final
60 Two Trade Final > 2500
60 One Trade Final
60 One Trade Final > 2500
999 Envir. Operations Permit