HomeMy WebLinkAboutbldc-12-09-3375 temp power-gas agreement.tif
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Catawba County Building Services Division
Q PO Box 389, Newton, NC 28658
Permit Center 828-465-8399 Newton Fax 828-465-8962 Hickory Fax 828-322-6814
1 4
i SERVICE AGREEMENT TEMPORARY ELECTRICITY
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! NOTE: Each separate meter to be connected is considered a separate request and subject to a separate fee.
i Please list the total number of electrical meters to be installed on this project
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'~1JB-399 Job Title yls~ PIN# 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.
s 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
6
official. (A CONTINUITY TESTER SHALL BE FURNISHED BY ELECTRICAL CONTRACTOR AT TIME OF SCHEDULED INSPECTION.)
I, hereby apply for temporary use of the permanent O0 amp 3-S - 1
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 account number Official signature of Notary
i
( Owner or GC Signature Notary's Printed or Typed Name
I (Official Seal)
Printed Name/v&/ ?/✓~So Title r r V~ NI My commission expires:
As electrical contractor, I hereby certify that the electrical system
O is ready ( ) is not ready to be energized. Branch circuits will be Date of acknowledgment
energized as stated above.
Q Q Official signature of Notary
Electrical Contractor Signature
Notary's Printed or Typed Name
Printed Name 6 ~L Title (JO CiQ (Official Seal)
M commission expires:
?j--,rte - ~ 0
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
i
aware that the electrical systems will be activated as tated above.
Official signature of Notary
Mechanical Contractor Signature
Notary's Printed or Typed Name
Printed Name Title (Official Seal)
M commission ex ires:
As plumbing contractor I hereby certify that the Plumbing equip. Date of acknowledgment
( ) is ready ( ) is not ready to be placed in service. I am aware
that the electrical systems will be activated as stated above.
Official signature of Notary
s Plumbing Contractor Signature Notary's Printed or Typed Name
Printed Name Title (Official Seal)
M commission expires:
E
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Mar 08 10 07:18a A&K Plumbing 704528-7326 P.1
a~~r,~icnln 1a:5~ tS'L13 32168 1 4 CATAWBA CO PAGE 81/01
Catawba County B uilding Services Division
PO Box 389, iV"on, NC 28558
Permit Center 828455-13399 Nmitan Fax 828-465-8962 Hickory Fax 828-322-6814
SERVTCE AGREEMENT'IEN.IPORARY ELECnUCf.TY
NOTE: Each separate meter to be connected is comMered a separate request and subject to a separate fee.
Icase list the total number of electrical rm:ters to be installed ou this proiect I
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Job Title PrNit. ut - Bldg 4 Unit #l
We do hereby release and agree to indemnify, save and hold harmless Catawba County and it's anployecs and Duke Power
Company from any and all liability one to or arising from Cetawbs County causing the CICCVkarl service to the above-mentioned premises
$ being disconnected. Temporary service is issued solely as a courtesy for the cornpWon of construction acid the building is not to be
occupied until a certificate of occupancy is issued. Any violation of the above will automatically void tempo M. service.
The use of the system before final inspection is anticipated to be days or less. 7f. utility cotmectiou remains in use beyond
30 days GC will be billed monthly per Ctnmty Fee SCItedule, The temporary use of the system is necessary to operate the RVAC and to
provide lighting for the completion of the fmisb work. Only those circuits that are necessary and/or have been inspected and approved by
fir, electrician and electrical inspector will be energized. Any 125 v single-phase circuits temporarily energized for constntction purposes
wilt be ground f Cult intctruptprotected. 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, RVAC, and Plumbing contractors are ready for the systems to be
€ energized as attested below.
The responsible agent for the purpose of signing this form m ay be the general contractor or owner. The GC is responsible
for Administrative fees unless otherwise arranged and agrees to set up a billing account wit]; Catawba County Finance
i Department for renewal of agreement, if needed. The electrical contractor shall coordinate this inspection with building service
official. (A CORTIENILrr'Y TWrCR SHALL, RE VURNiMM I&V ELEGTR ICAO. C.oNTRACrOR AT Timm- Or 30moul.ED rNSt erio3e.)
1, hereby apply for temporary use of the permanent Q420 amp
electrical service to the structure identifled above. I authorize Date of acknowledgment
billing of all renewals, if required, to the following active
Catawba County billing account number Official Signature of Notary
Owner or GC Signature - Notary's Printed or Typed Name
° ► (Official Seal)
Printed NaaieA& Title fkW--rL§4 YIJ lAy commission expires:
As electrical contractor, I hereby ecrtify that the electrical system 5 4 f
Date of acknowledgment _
` is ready is not ready to be energiized. l3ttrn0 circuits will be
energized as stated above. Official signature of Norery
Electrical Contractor Signature .9- Notary's Printed or Typed Name
j Printed Name Gca Tile ~D- "aaeGC (Official goal)
i t'ui commission ices:
t As HVAC contracts 1 hereby certify that the HVAC equipment - Q
( ) is ready { ) is riot ready to be placed in service. I am Date of acknowledgmentp
C aware that the elecuical systems will be activated as tated above.
Official signature of Notary
Mechanical Contractor Signature A d✓`(.~
• Notary's Printed or Typed Name
Printed Name / EurGf Title (Official Scat}
.VI commission ex ires-
As plumbing crmtractor l hereby certify that the Plu+nbing equip. - I it
( ) O faclmowl
is ready ( ) is notready to be placed in service. lam aware: ~
t~ the electrical systems will be activated as stated above,.
O Ic altsignature`of'4
otary ^
Plumbing Contractor Signature ' v ,
Notary's Printed or Typed Name
Printed Name@jYl Title commission cxptes
_
$ Catawba County Building Services Division
PO Box 389, Newton, NC 28658
F. Permit Center 828-465-8399 Plan Review 828-466-5130
° Q Newton Fax 828-465-8962 Hickory Fax 828-322-6814
a
1 4 SERVICE AGREEMENT TEMPORARY HEAT
NOTE: Each separate meter to be connected is considered a separate request and subject to a separate fee.
Please list the total number of gas meters to be installed on this project
B)-OC-IZ- 05 -3375 l ~ 5 ~ 0 ~ E
IwB Job Title PIN # Bldg # Unit #
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I 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
j 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.
a
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 73 - .5 )
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 Signature - Notary's Printed or Typed Name
(Official Seal)
Printed Name ,o Title, r i,vf)kL My commission expires:
As mechanical contractor, I hereby certify that the mechanical - -
i system ( ) is ready ( ) is not ready to be placed in service. Date of acknowledge
Official signature of Notary
j Mechanical Contractor Signature
Notary's Printed or Typed Name
Printed Name f q OLC, ((i Title (Official Seal)
M commission expires: