HomeMy WebLinkAboutBLDC-3-10-5370 TEMP ELECTRIC.pdf
\ Catawba County Building Services Division 1 PO Box 389, Newton, NC 28658 Permit Center 828-465-8399 Newton Fax 828-465-8962 Hickory Fax 828-322-6814 I SERVICE AGREEMENT TEMPORARY ELECTRICITY
NOTE: Each separate meter to be connected is considered a separate request and subjeeTto a separate fee. Please list the^oJaLnumbjer of electrical meters to be installed on this project
yJ -l(rOT0 Job Title \Kc3^SWflm# 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 3 Q 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 £ a electrical service to the structure identified above. I authorize billing of all renewals, if required, to the following
active Catawba County billing account number Owner or GC Signature 1fa*« K< jjfrc Printed Name JtA./>e~fr-b*cf*S> Date of acknowledgment ____ r^S^ Official signature of Notary Notary's
Printed or Typed Name My commission expires: (Official Seal) As electrical contractor, I hereby certify that the electrical system J^/is ready ( ) is not ready to be energized. Branch
circuits will be energized as stated above. ^~~~p h t\ fj Electrical Contractor Signatup^ Printed NameP ^ t As HVAC contractor I hereby certify that the HVAC equipment (t-^is ready (
) is not ready to be placed in service. I am aware that the electrical systems will be activated as stated above. Mechanical Contractor Signatur/A*? /y^>2 ^2*^~ Printed Namef,Wi S ft^&itle
UJ JmfiJf Date of acknowledgment Official signature of Notary Notary's Printed or Typed Name (Official Seal) Mv commission expires: Date of acknowledgment Official signature of Notary
Notary's Printed or Typed Name (Official Seal) As plumbing contractor I hereby certify that the Plumbing equip. ( ) is ready ( ) is not ready to be placed in service. I am aware that
the electrical systems will be activated as state/above. Plumbing Contractor Signature C-: * Printed Name , fj\ \SL\i\^ Mv commissi«i\expires: Official signature of Notary \ Notary's
Printed or Typed Name Mv commission expires: (Official Seal)