HomeMy WebLinkAboutBLD2009-01349 TempElecMech Agreement.tif
F~- Catawba County Building Services Division ,bn \ OS
ati PO Box 389, Newton, NC 28658
Permit Center 828-465-8399 Newton Fax 828-465-8962 Hickory Fax 828-322-6814
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SERVICE AGREEMENT TEMPORARY ELECTRICITY
NOTE: Each separate meter to be connected is considered a separate request and subj o a separate fee.
Please list the total number of electrical meters to be installed on this project
BLD 200"A- ~ 3A"\ Job Title ~Or) a PIN# ST NE Bldg # Unit #
We do hereby release and agree to indemnify, save and hold harmless Catawba County and it's employees and Duke Power
Company from any and all liability due to or arising from Catawba County causing the electrical service to the above-mentioned premises
being disconnected. Temporary service is issued solely as a courtesy for the completion of construction and the building is not to be
occupied until a certificate of occupancy is issued. Any violation of the above will automatically void temporary service.
The use of the system before final inspection is anticipated to be days or less. If utility connection remains in use beyond
30 days GC will be billed monthly per County Fee Schedule. The temporary use of the system is necessary to operate the HVAC and to
provide lighting for the completion of the finish work. Only those circuits that are necessary and/or have been inspected and approved by
the electrician and electrical inspector will be energized. Any 125v single-phase circuits temporarily energized for construction purposes
will be ground fault interrupt protected, with the exception of lighting circuits in metal conduit. The building will be constantly supervised
or will be securely locked when it is not supervised. The electrician, HVAC, and Plumbing contractors are ready for the systems to be
energized as attested below.
The responsible agent for the purpose of signing this form may be the general contractor or owner. The GC is responsible
for Administrative fees unless otherwise arranged and agrees to set up a billing account with Catawba County Finance
Department for renewal of agreement, if needed. The electrical contractor shall coordinate this inspection with building service
official. (A CONTINUITY TESTER SHALL BE FURNISHED BY ELECTRICAL CONTRACTOR AT TIME OF SCHEDULED INSPECTION.)
I, hereby apply for temporary use of the permanent pd amp 10 + O n
electrical service to the structure identified above. I authorize Date of acknowledgment
billing of all renewals, if required, to the following active
Catawba County billing ac ount number Official signature of Notar
Owner or GC Signatu Notary's Printed or Typed Name
Printed Name tle My commission expires: (Official Seal)
As electrical contractor, I hereby certify t at the elect r' al system 11- 0 q
( ) is ready ( ) is not ready to be ener ' d. Branch i uits will be Date of acknowledgment
energized as stated above.
d-Lt - -L" LOCI 1) $ Official signature of Notary
Electrical Contractor Signatur
Notary's Printed or Typed Name
Printed Name Title (Official Seal)
My commission expires:
As HVAC contractor I hereby certify that the HVAC equipment
( ) is ready ( ) is not ready to be placed in service. I am Date of acknowledgment
aware that the electrical systems will be activated as stated above.
Official signature of Notary
Mechanical Contractor Signature
Notary's Printed or Typed Name
Printed Name Title (Official Seal)
M commission expires:
As plumbing contractor I hereby certify that the Plumbing equip.
(~eady ( ) is not ready to be placed in service. I am aware Date of acknowledgment
that the electrical systems will be activated as stated above.
Official signature of Notary
Plumbing Contractor Signature
Notary's Printed or Typed Name
Printed Name & tK a 6itle (Official Seal)
M commission expires:
F~t
SBA • Catawba County Building Services Division
Q. PO Box 389, Newton, NC 28658
F Permit Center 828-465-8399 Plan Review 828-466-5130
u Newton Fax 828-465-8962 Hickory Fax 828-322-6814
1.8 4' SERVICE AGREEMENT TEMPORARY HEAT
NOTE: Each separate meter to be connected is considered a separate request and sub' to a separate fee.
ll Please list the total number of gas meters to be installed on this project 1
BLD200P~- I,3"1 Job Title ~o S', c,' Ad S PIN # S% o? NC~ S~ Bldg # Unit #
In an effort to assist contractors in completing construction projects, this office will implement the following policy. The utilization of
permanently installed gas heating equipment to maintain environmental conditions necessary to facilitate the installation of
environmentally sensitive materials, or finishes in accordance with manufacturer's instructions is permitted by the North Carolina State
Administration and Enforcement Code with the following local requirements. The owner, general contractor, and mechanical contractor
must sign this request form for temporary utility connections. The form must be filled out completely.
The following requirements will also apply:
1. All heating units to be placed in operation shall have the following items inspected for compliance if applicable.
a. Vent system (Products of combustion)
b. 'Appropriate amount of combustion air is provided.
c. Gas lines shall be pressure tested and inspected.
d. Water lines shall be pressure tested and inspected if geothermal or coil supplied by a hot water heater.
e. Condensate traps and lines in place and inspected.
f. Electrical circuits installed with appropriate disconnect, over-current, equipment grounding, conductors and raceways.
g. Refrigeration lines shall be inspected with appropriate pressure certification tests.
h. All gas tubing shall be labeled per gas code prior to temporary heat inspection.
i. Approved temporary electrical power is a prerequisite for temporary heat. (This can be scheduled simultaneously with
temporary electrical.)
2. No occupancy of any kind (persons, furnishings, etc.) shall be allowed during this period, without prior approval of the Code
Enforcement Official.
3. The use of the system before final inspection is anticipated to be days or less. If utility connection remains in use beyond
30 days general contractor will be billed monthly per County Fee Schedule.
4. If there is any violation of this agreement, this service shall be disconnected without prior notice to the participants. This shall be
done without any obligation of responsibility on the part of the Code Official or Catawba County.
5. All processing fees are applicable as set forth in the Catawba County fee schedule.
I have read and agree to this procedure and guidelines as set forth by Catawba County and will abide by the conditions and qualifications
under which it is issued. I further agree that failure to comply with the procedure may result in disconnection of gas, revocation of permit,
and/or the refusal to consider further requests for temporary gas. I also agree to have a billing account set up with Catawba County
Finance Department so that any renewal fees of temporary service can be automatically billed if needed.
I do hereby apply for temporary use of the permanent heating \ h - ) - Q q
system located at the structure identified above. I authorize billing Date of acknowledgment
of all renewals, if required, to the following active Catawba
County billing account number Official signature of Notary
Owner or GC Signatu Notary's Printed or Typed Name
I~ t 1 (Official Seal)
Printed Name i~itTc1 y commission expires:
As mechanical contractor, I hereby certify that the mechanical e°(;] .jl
system ( ) is ready ( ) is not ready to be placed in service. Date of acknowledgment /V /y
QLmlk . Official signature of Notary
Meehan Contractor Signature t
,4 v / Notary's Printed or Typed Name
Printed Name A,1 k J 14644 rr/PZTitle (Official Seal)
My commission expires:
Nov 18 09 09:18a Cory Corditions 338 817 0923 p.1
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Cozy Conditions, Inc.
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I Fax Transmittal Form o'~ 3
To: Catawba County From; Ba'sim Shabazz
j CC: Date: 11/7 6/2009
Fax: (828) 322-6814 Pages: 2 (including Cover)
ti V/ 0 9- Ga►JUuQ
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1001 E. W.T. Harris Blvd. Suite P226
Greensboro (336) 740-2078 Charlotte (704) 361-8611
Nov 16 09 09:16a Cozy Conditions 338 617 0923 p.2
• ' Catawba County Building Services Division bb Y10.i 0's
PO Box 389, Newton, NC 28658
A Penrlit Center 828.4554399 NLvtan Fax 920.455.8962 Hickory Fax 828-322.6814
SERVICE AGREEM115V'll' TEbP()R&RX Ii1_F.CrRIC'ITX
NOTE: Each septrratt near to be corurecied is c9a5 mercd a separate rte crest and sah'
Pleam- list Ore total no ~ J R separate fee.
q _ ~ ~ A tabor of ctccl*1Cal meters b he installed on this project_- ,
Bf.D2M, aq" Jttb titleL~o17 PRNtI~ QNa ST
)31dg Llnit # _
We do hcraby relesse and ngrec to indemnify, save and hold Ilium ICM Catawba County anti it's ernployews and Duke Pawe•
fompnny from any and all I•abirity due to OF wising from Catawba County 4nusieg tiro electrical service to the above-mentioned premises
being disconnected. Term-mry service 4 issued solely as a courtesy for the completion of construction and the hugding is not to be
occupied until a certifrcate u • acouMney ix i.Saued, Any violation of the above will autotm6eally void tempos v
The usa of the systc nl before final inspection is andcipared to be _ clays or less. if utility connec~a Irrksinc in use beyond
30 dnyS W. will be hilled rr.onthly per County ree Scltcdulo, the temporary use of the system is necessary to i1pernte the I;VAC and to
prnvido lighting fcbr the comlilction of the finish work. Only those circuits that arc necessary and/or have been inspected and approved by
the electrician and electrical inspector will be enerLIMW. Arty IZ5v single-phase circuits tenrpo,Rtuily energized t)m. construction pwposes
will be groundfault inton•upt protoetcd, with the exception of lighting circuits in metal conduit. The building will be am4tantly supervised
or will lx securely l9ckod Ahcn it is not supurvrsetl, The electrician. HVAG. gall Pittmbin cuntraCtors are ready for tht
cnorAizec) as attested below. y systems la be
The r""mnsihlle agent for Ide Purpose Of signing this form may be the aenerai ctmtrrrctbr or owner. The GC is irespmnslble
for Ad rninistraative fees unl, M otherwise arranged and agrees to set up a billing ■ceeaat with Catawha County F lbaaabee
I iDepartnrerat for renewal of agreement. if needed. Tile electrical contractor shall coor djn&te thi4 hwpeetioe with twliillitng servict
oiTicia! to CON RNIIITY'1 FZn 6R SIiALL It Y.1r RJDt M, W nv>~,k-rTRTCA r, ct' +raxt r C1~R ,~x rn►12 caF tsar nut.rto rrtsr~~rrttn l
1, hcrchy apply for temporary w- of the pctmancnt rump
electricAl service sty the strum jr. identified above. I nutlmrixe Date of acknowledgment
billing of au renewnh, if required, to the following active
CRtawha Ceranty billing bunt ntmm^ Official signature; of Ntrta
Owner or GC Signaga I Notbry'c Printl or Typed I`arnc
Printed Nrrtm6 _ ~r My commission expires: (Of ciul Sea[)
A5 elcotrical contractor. I heft-by certify that the 0lectrical xrstem -
Is ready ( ) is riot ready to be energized. Beanch circulte: ill ba Date of Aci mModgrncnt
energized as stated above.
Official ::ienaurnt: of Notary
,>Elcctriat I Contractor Signal ore _
Ncrtnry'sPointCd or Typed Name
Printed NAak . Title (Official Seal)
M commisAion cx fires;
As HVAG cprrtrta:tor 1 hereby certify that the HVAC equipment _
( ) is ready ( ) is nut ready to be placed in service. I a n Hate of 0Cknow1cdg,tx:nt
aware that the clceiri"l &ystc,"s will be activated s above.
Official Fignature of Notary
Meclrauical Contractor Sigi idrrt j__QA21 I .
Notary's Printed or Typed Namo
Printed Norse R'M A 141074 Mile C A (Official Seat)
M commini(m cx irm:
As p1h1rg1)in&contractor'I here} y cerliry shat the Plumbing equip.
( ) IN ruidy ( ) is mil ready rte be pInced in servim 1 am aware Date of acknowledgment
that the electrical systems will ?c acdvated as swcd Above,
official signatur n'tNLKary
Plumbing Contractor Sieruhrsc
No4',ry's T'rinttxl or Typed Name
Printed Name Title (Official Seal)
My c~mm ;Won mires:
Nov 16 09 10:44a Cozy C,orditions 336 617 0923 p.2
11 1 b1 Yt717y I7d: 5~ ozoazdtola I AWUA W t•'Aut;, G] / bl
Cat2wba County Building Services Division
PO Box 389, Nemon, NC 28658
Permit, Center 828-4658399 Plan Review 828-486-5130
Newton Fax 828465.8962 Hickory Fax 628-322-6614
SERYICS AGREEMENTT)EMMRARY HEAT
NOTE Fitch separtate nieitu lobe eomneeW is cmddere$ a impamte v"vmet and stab' ti, P separate fRL
6 Please Ilst tba total lsnmber of gas nwtm to be iinatatled on this project R!
SLV200 t- ISM Job Title ~►oti C):5 _ PIN A
- °7•I`~ ST A E $1dF tt Unit 4
In an effort to ae i st crmtrecttxhs it, completing ei)nstructiDn projects, this office will implement the following policy. The utilization OF
permanently installed gas heating aquiprnentto maintain envirohmental conditiotm nacenary to facilitato the in5t8llati0n of
envimnmentally sensitive materials, or finishca In accon6vee with manufacturer's instructions is permitted by the North Carolina State
Adrrnlnisuition end Enforcement Code with the fallowing local roquiremerits. The owner, general contractor, and rneclatnical contractor
must sign :his request form for temporary utility contxmtions. The form must be filled out complual y.
The folk►Wine requirements will also apply:
1. All heating units to be placed in operation shall leave the following iteMs inspected for compliance if applicable.
a. Vent system (,Products of combustion)
b. Appropriate amount of combustion air in provided.
c. CYa< lines shall be prtxo vm trwted and inspected.
d. Water lines shall be presstmc tasted and inspected if geodminrial or coil supplied by a hot water heater,
c, Condensate trope and lines in place and.impectad.
f. Elturical circuits installed with appropriate cl xoitrrect, Oyer-current, equipment grounding, conductors nod riceways.
g. liefrigeration titres shall be inspected with appropriate pressure cetdfication testa.
h, All Pas tubing shall be labeled per gas cede prior to tomporory cheat inspection.
i. Approved terttporet'y ebectrieal power is a prerequisite for bsnmorary heat. ('t'his can be scheduled sirrhultanoously with
temporary electrical)
2. No ocettpaney of any kind (pcwr*, furnishings. etc.) shall be aliovmd daring this period, without prior apprvval of the Code
D*Kernent Official.
1, The use of die system hcfore final inspection is anticipated to be dnye or less. If util ity connection rcmaim in use beyond
30 days general contractor will be billed monthly per County 15-to Schedule,
4. If than is any violation of this,lgreWe t. this service shall be disconnected without prior notice to the participants. This shall be
done without any obligation of responsibility on the part of the Code Official or Catawba Cotxlty.
5. All processing fete are applicable ns set fartlh in the Catawba County fey schedule,
1 have rend and agree to stns proceclure and CoWchries as set forth by Catawba County and will abide by the corAtions and gualifcatioos
under which it is issued. l further ague that f3i lure to comply with,the procedure may result in disconnection of gas, revocaition of permit,
and/or the refusal to consider further requests for temporary gas, t also agree to have a billing account tot up with Catawba County
Finance Dcpartn=t so that any renewal ftxs of temporary service can be automatically biped it'theeded.
1 do hereby apply far temporay use of the permanent heating N - J-- 0
system located at the stiveove identified above. I ant1wrize lilting Date of ackuowledgrocnt
of all renewnlsy if required, to the fdlowWig active Catawba
Coinity billing account nurnher Official signature of Notary
Owner or CC Sigmiti r Notary's Printed or Typed Name
ry (Official Scal)
Friated Nori+r! t7~1 ~W~,A y Commission expires.
As mechanical contractor, i hereby certify that the mechanical *ji
system is ready t ) is not ready to be placed in service, t7a aelrno t l , 1A• L~►R.,$
Olfio 1 signature of tart- NOt
Meclranicnl Corhtraelor 5igsia L !!t• d`7 c r toke c s ~ S~
(l Notary's x'rinted or Typed Name A . 5-*,
ft coffu Mated Norm Doi ) 4~ a r',<1e I , i 0K& SCRYW.2j.2013 C
M commission expires:
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