HomeMy WebLinkAboutCONTRACTOR INTERNET--HOLLIDAY HEATING.TIF02/25/2009 11:48 7047329238 HOLLIDAY HEAT & COOL PAGE 01
22/21V2889 89:54 8293226514 CATaWd.1 Co PAGE 81/8:
CATAWBA COUNTY 0 -0 -ON 3"
BUILDINO SERVICES K&-* W, Nc atom
Fit Number (a2a) 46r, Nnutpn onkii
PERMIT CENTER FR Numbv(aat)322- 014'j4i oft,
Vrice Me" Number (224) 465-
Contractor Information for Internet access
N applicant holds multiple Ike NM a saParate GPPIICetlon must be subml Md for each license.
ALL f19LOS MUST BE CQMPLETEp OR M APPUCArM WILL BE REJECTED
Company nerve as listed on state license;
License holders P.2me as listed an State License;
((f diflefentfrom Campsny name) (First Name) ► M) (Last Name)
Lice Number. 2-2L4 oI
Address:
Lit, Expiration Date: —s () I V
'or-% N G 28
L- -mu address: r� r�k. Z's 1 �e,1
v •-
(E -mail addresses w►!I be used for notification)
Telephone ' - — i 3 • g 7 s s
Fax Number: - 10 (4 — - 7 3 2 Q 1 4 , 49
Mobile Cell: - 7 0 4 - L0 - 303
NarnNs) of any other Quallfler listed on the license:
Name(s) of any other perw that i4 authorized to sign for a permlt with Cal.wba County;
Signature of applicant:
Z " , Uau: 2'
ay signing this opplicstio ou agree to me intair, the security of the l and password.
Password securky will be the full responslblllty of ttq applicant.
The Issuance of a logdn and password will sliew a Pom" to achedule Inspections for all projects they
are listed on M a contractor. Your User name and temporary paiesword wlli be sent to the emai
address You pitwidad above eftar the b0tirmatkm an this farm is verified. This farm can be mailed to
the add# or eithar of 04 ft nambers hated sbw.
22 ;M091