TRADE MECH 02/09/2011 10:40 9104833056 D PAGE 01/01
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. Application
Ina n
Pltasa now [Misapplication Harnett aunty Central Permtting
it parr of a job in progress PO Box 85 L11Angton, NC 27646 • - -1. r.\ r . "Tit dye'
with opts psneira. 910. 893 -7525 Fax 910.893 -2793 1 '' j r 1r i •
www.hamettorg/pennite 1w � "
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Cedt N reUhn (ndMApplication)
dual Trade /Contractor
Contractor Information
I DOUG NEW will complete th ELECTRICAL - HVAC work on the project or
(Name) (Trade)
sbuctur'e haretn described. My state license number Is et 194) , All work shall comply with the State Buadin0
Code and all otter applicable State & Local law, ordinances and regulations. •
Company Name The WAY ELECTRIC COMPANY
Mew Address: P.0 BOX 53591, FAYETTEVILLE, NC 28305
Street Address: 608 CAPE FEAR AVE„ FAYEfTEVILLE, NC 28303
Business Phone 910483.1110 Erna Address: WA
'Company name, address, b phone must match Inlo/madon on license.
Job Information
Land Owners Noma:
DOUGLAS ESHENSAUON ph one: 064
SAME
Tenant/Building Owner (If different); SAME Phone:
Consbuodon or at Address; 218 BRANDYWOOD CT., CAMERON, N0 28326
PIN or Parcel /I fiom GIS: 9584414064.000
§saaM Directors to Job from Lillea4aa: MAi rt-et r 1 4 .QI) " )1 01, , a r
Desorption of work to be done: 2 TON SPLIT HEAT POMP Job Com
Mechanleat New Unit With Ductwork _ New Unit Vt6thout Ductwork _ Gas Piping _
Electrical: 200 Amp _4200 Amp — Service Change _ Service Reconnect Oster
Plumbing: WaterfSewer Tap — Number of Bathe — Water Heater
Permit Cost
Permit Fee: $ 50.00 (calculated from tee schedule)
Mail In Processing Fee: f3.80 Der Iola For Electrical Permits with Progress Energy we
need the premise number provided.
Total Enclose& 5 E84°
Make check payable & Mail completed application form to: H Box 85 County Central Permitting (HOCP)
LIINngton, NC 27548
Conlreetors Sig natur Date: 44$
"DO NOT SEND CASK INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED'"'
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