HomeMy WebLinkAboutBLDC-10-09-1784 Temp power agreement.tif l S
�� Catawba County Building Services Division
d ,� '' PO Box 389, Newton, NC 28658
F� 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 subject to a separate fee.
Please list the total number of electrical meters to be installed on this project .1�.
BLD(, 61 1')`S Job TitleO 0 M PIN# Bld g # 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 100 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 CC 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 CONTINurry TESTER SIIALL BE FURNISHED BY ELECTRICAL, CONTRACTOR AT TINIF Or SCHEDULED INSPECTION.)
1, hereby apply for temporary use of the permanent asQU ant
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electrical service to the structure identified above. I authorize Date' f adflowledgment
billing of all renewals, if required, to the following active
CC
Catawba County billing account number O 1 ial signature o ota NOTARY
Owner or CC Signature 7�/ Notary s Printed or Typed Na
Printed Name I'rett _GJ; #<M_ Title & id c f t'lo er My commission expires: of /( 7/ 2e 13
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As lectrical contractor, I hereby certify that the electrical system t' b �`�•`0�P OGS•.
(4 ready ( ) is not ready to be energized. Branch circuits will be ate of ttcknowle men tn9
energized as stated above. - r
fficial sig re o N ry A
Electrical Contractor Signaw -� ' .S e r jfelL��r
Notary's Printed or Typed Name •� ��A �.
Printed Na Titled pis' , �" @,C��.`��
My commW �� ��•
As /VAC contractor I hereby certify that the HVAC equipment ---- - 0 -
/ s read y P Date j cknowledgrn at
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} ' ( ) is not read to be laced in service. l ant < <
aware that the electrical systems will be a tivated as stated above. JOYCE A KESSLER Official signature of Notary NOTARY PUBLIC
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Mechanical Contractor Signature T CATAWBA COUNTY TE OF NOi�i WCAROtI
(( Notary's Printed or Typed N
Printed Name F 1 ;o tle 1cia ea
My commission exp ices: C7dt�i 3
As �umbing contractor I hereby certify that the Plumbing equip.
{/} is ready ( ) is not ready to be placed in service. I am aware D ofacknowledUrnent JOYCE A KESSLER �'
that the electrical systems will be activated as stated above. `'` ' " NOTARY PUBLIC
O cial signature of Notary WAWBACOUNTY
Plumbing Contractor Signature ` < e c �' BTA�'E OFNOIRTH CAROLINA
Notary's Printed or Typed Name
Printed Name Sit MF V qvzy Title OWNZt-
(Official Sea])
My commission expires: 7/ i 3
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