HomeMy WebLinkAboutBLD2009-01188ELECTAPPLICATION.tif
(828) 465-8399 Office Number Catawba County FAXj~ CALL ❑ WITH ISSUED PERMIT #
(828) 465-8962 Newton Fax Number Application for Permit TO THIS NUMBER (4
(828) 322-6814 Hickory Fax Number
www.catawbacountync.gov
P.0 Box 389 Newton, NC 28658
(Please print or pe)
Type of Permit Electrical El Plumbing El Mechanical El Fire Date e (7'~
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Active Building / Mobile Home Permit # iS LM Witt O 1 $ Property ID # (if known) 3 ?S ) 0 p $ Fyn 0
*If no active Building or Mobile Home permit please list driving directions from a major intersection:
Use of structure: ❑ Mobile Home ❑ Single family ❑ Multi family Commercial ❑ Industrial/Factory ❑ Church Owned ❑ Gov't Owned ❑ Accessory
Physical 911 Address of Project pp
Owner or Business lac fl ~c,..~ A c cr.~ Telephone
Address
Subcontractor TccMl', 'l\- W &S 1n-Nk Telephone 7~y 0Q,-09 St
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Address 5 30t 1 c e 3t v-%r,, FA r,,, fA S~ nAtS .'A License # &618- U,
General Contractor o2W 6?) Telephone
Design Professional Telephone
Address NC Reg #
Power/Utili.ty Company Servicing the hocation: Type of Gas Service (Nat or Propane)
ELECTRICAL (List each panel separately) Panel # 1 Amps Panel # 2 Amps Panel # 3 . Amps Panel # 4 Amps
❑ New Building Wiring ❑ Pole Service ❑ Wire Mechanical unit only (No Svc Chg) Total#
❑ Additional Service (existing bldg) ❑ Service Chg. Amps ❑ Interior Wiring (No Service Change)
❑ Addition of Sub Panel ❑ Load Control ❑ RV Service
❑ Saw Service ❑ Mobile Home Other (List) \0VA uc SP,,n,b.o~~+ bA1r ~ VP
❑ Sign Service ❑ Modular Home Total Electrical Cost $ '1 son 6;i
❑ Service Repair i] Swimming Pool (Size __x_) (work you will perform) _ _Bonding _ Associated Wiring
PLUMBING (Include all future rooms that may be roughed in)
❑ Full Bathrooms Total # installed
❑ Half Bathrooms (Toilet & Sink only) Total # installed ❑ Gas Line/Pressure Test only
❑ Mobile home (new set-up only) ❑ Modular Home
❑ Water Heater (Electric, Gas) ❑ Other (List)
MECHANICAL (Check One) ❑ New Installation ❑ Change out exiting system
❑ Heat Pump or Furnace with A/C Total ❑ Gas Line/ Pressure Test ❑ Other (List)
❑ Furnace (Oil, Gas, or Electric) Total # _ ❑ Gas Logs Total # ❑ Mobile Home
❑ Air Conditioner Total # ❑ Unit Heater Total #
❑ Water Heater (Electric/Gas) Total # ❑ Modular Home
FIRE (Check permit type applicable)
❑ Fire Extinguishing System ❑ Compressed Gases ❑ Spraying & Dipping
❑ Fire Alarm/Detection System ❑ Hazardous Materials ❑ Standpipe Systems
❑ Fire Pumps & Related Equipment ❑ Industrial Ovens ❑ Temp. Membrane Structures
❑ Flammable & Combustible Liquids ❑ PVT Fire Hydrants ❑ Other
"*All fees entered by Permit Center, DOUBLE FEE charged for work started prior to obtaining permit."The undersigned makes application 70r
permits and inspection of work described and agrees to comply with all applicable State, County codes and laws regulating the work.
PRINT NAME \~C C
SIGNATURE
(Subcontractor) se Holder/Owner
G:\BLD\PERMCTR\FORMS-FEES-HANDOUTS\Blank Applications\Building Services\Trade Application New Revised 06-
07.D000reated on 03/23/2006 12:16:00 PM
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