HomeMy WebLinkAboutBLDC-3-10-5117 Temp power agreement.tif L o •�, S rw&c
$ Catawba Count Building Services Division -�
Y 9
Q PO Box 389, Newton, NC 28658
Permit Center 828 - 465 -8399 Newton Fax 828 - 465 -8962 Hickory Fax 828 -' > 14
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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.
S' Please list the total number of electrical meters to be installed on this jroect
.5 (, o w % S od S ST t4__ Fj 004- P
BLD -- 3 ` -1 — Job Title 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.
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 B OF CHEDULED INSPECTION.)
I, hereby apply for temporary use of the permanent amp //–
electrical service to the structure identified above. I authorize Date of acknowlement
billing of all renewa , if required, to the following active
Catawba Count illing Owne account umber Official signature of Notary
r o GC Si nature Z Notary's Printed or Typed Name
g7
Q (Official Seal)
Printed Name 9)6 � /�_KQ Title/ My commission expires:
As electrical contractor, I hereby certify that the electrical sys in
( ) is ready ( ) is not ready to be energized. ranch circui w 11 be Date of ackfi ledg lent
energized as d above. Official signature of Notary
Ele ical Contractor Sign ture
Notary's Printed or Typed Name
Printed Nam RS mcFa__0 04_0%-xQ_r (Official Seal)
My commission expires:
As HVAC contractor I hereby certify that the HVAC equipment
f acknowledgment
( ) i ready ( ) is not ready to be placed in service. I am Date o
aware hat the electric systems will be activated as stated above.
Official signature of No
Mechan a1 Contractor Sig ure
tarys Printed or Typed Na
'
Printed Na a Title (Official Seal)
M com fission expires:
As plumbing con ctor I hereby certify that th lumbing equip. \
( ) is ready ( ) is t ready to be placed in sery I am aware Date of acl wledgment
that the electrical syste s will be activated as stated above.
Official signature f Notary
Plumbing Contractor Sig ture
Notary's Printed or T ed Name
Printed Name Title fficial Seal)
My commission expires: