UDO Administrative Manual - Currituck County Government

Contractor of RecordContractor of RecordBuilding Contractor Name NC License #AddressPhoneCity/StContact NameElectrical Contractor Name NC License #AddressPhoneCity/StContact NameMechanical Contractor Name NC License #AddressPhoneCity/StContact NamePlumbing Contractor Name NC License #AddressPhoneCity/StContact NameInsulation Contractor Name NC License # Not RequiredAddressPhoneCity/StContact NameGas Contractor Name NC License #AddressPhoneCity/StContact NameMoving Contractor Name NC License #AddressPhoneCity/StContact NamePool/Hot Tub Contractor Name NC License #AddressPhoneCity/StContact NameOther Contractor Name NC License #AddressPhoneCity/StContact NameOWNER CONTRACTORAs owner of the property, I intend to retain the finished project exclusively for my own use and will occupy theproperty for at least one year following the completion of construction. I understand that it is myresponsibility to obtain workers’ compensation insurance, if necessary. I will contract with a North Carolinalicensed electrical, plumbing, mechanical, and gas contractor for this project unless otherwise noted. As ownerof the property, I will complete the following:□ General □ Electrical □ Mechanical □ Plumbing □ GasSignature of Property OwnerDateAdministrative ManualPage 2.19Residential Building Permit ApplicationPage 3 of 7