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TRADE Mar.15. 2011 12:22PM Carolina Comfort Air, Inc. No.22489 P. 2 AppllcaUcn# C 1 5 26 757 Harnett County Central Permltting PO Box 65 Lillington, NC 27546 910-893-7525 Fax 910 - 893 -2793 www. h arnett.org /permits Certification of Work Performed By Owner /Contractor (Individual Trade Application) Owner (s) of Structure: _ a' is 01 # •_ _ _ Phone: is. se g Owner (s) Mailing Address: a . • ! re L t. C u •_ _ - • i A • Land Owner Name (s): S. ( Phone: Construction or Site Address: clef 11 3f,A�G PIN or Parcel # from GIS; ..9 i 29 3 /• 3 Job Cost: Description of Work to be done G /o 3 tt,n Spilt + H'1 Tr - ne _ - ne c-1 - f� t' Zgtllon T• . 4- • New Unit With Ductwork is ew Unit Without Ductwork _ Gas Piping Electrical': 200 Amp _ <200 Amp 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 LNlinoton: Subdivision: Lot #: I 6Apd;na. CODAS Mv'It* will provide the AVM. labor on this structure. (Contractors Name) (Trade) I am the building owner or my NC state license number is , 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. Structure owner(s) signatt Date: t / Company Name: (411311:14 t Aoi4vkn'A• Inc. Phone: 91 i • {L� Address5g1a 11.S H.W V'7 w . County: Contractor's License #: aab11 Email Address: hi , fee l Contractor's Signature: 151 01,140.4.12. 11 .t Date: 3 - 1 r *Company name, address, & phone must match information on license. Individual Trade Application 1 of 1 06/10 Mar. 15. 2011 1 :48PM Carol ina Comfort Air, Inc. 1 No.2494 P. 2 Lr Application Y 1 1 600 Qbd 6 Harnett County Central Permitting PO Box 65 Llllington, NC 27546 910- 893 -7525 Fax 910- 893 -2793 www.harnettorg/permIts Certification of Work Performed By Owner /Contractor (Individual Trade Application) Owner (s) of Structure: , ... Q s Phone: 41 - 71 Owner (s) Mailing Address: \ ! . . .! + as e i . "r i a, _ Land Owner Name (s): Phone: Construction or Site Address: PIN or Parcel # from GIS: Job Cost: Description of Work to be done Mechanical: New Unit With Ductwork New Unit Without Ductwork ` Gas Piping _ Electrical': 200 Amp -_ <200 Amp _ Service Change _ Service Reconnect _ Other • For Progress Energy customers we need the promise number Plumbing: Water /Sewer Tap — Number of Baths _ Water Heater _ Soeciflc Directions to Job from Lillincton: • Subdivision: Lot #: I 1 :,r \- 41cuse "stai r .win provide the _5..„4 r a 4 ` labor on this structure. (Contractors Name) (Trade) I am the building owner or my NC state license number is .r9rQ gEr7 , 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. Structure owner(s) signature; Date: Company Name. '�-k(�@ IS 0 ( (*Yr. Phone: 1 Address;QQ F ( C r County: 0( - Ora Contractor's License #:..� _ . Email Address: J. Contractor's Signature: T r ir..- r. Date; S`18 j • *Company name, address, & phone must match Information on license. Individual Trade Application 1 of 1 08110