HomeMy WebLinkAboutB3-1158 TEMP HEAT APPL.PDF(828)465-8399 Office Number P.0 Box 389
(828)465-8962 Fax Number Newton NC 2665BCATAWBA COUNTY APPLICATION FOR PERMIT
sPle;,ase print or type) mate
Temporary Electrical Temporary Mechanical
7( Building Permit No,(If Applicable)
Property ID No,
Use of Structure
Physical Street Address (fit ) ;k`0
m
1,11
Telephone( (1
Last First
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O wn e r' s Address d'"C 9, + »,-,. ..,. ,»r'
city State
S booms actor � Telephone( c
Led in License Book
Subcontractor Address ,�L� �6� ; „
��... citySate Z .F
State incense No, & Classification � � ( � —County Account No,
General Contractor � . � C. L_ UM r) Telephone( )
Location of Structure or Project (Physical Directions, Road Numbers and names, Etc
`his agreement between Catawba Count} and Owner
or A ithorized a ent) authorizes temporar-y power/temporarypower/temporary mechanical service to be esta.hlishe
on the Building for above named project for a day period,
h i s agreement does not constitute a Final Inspection for Electrical PQwe11/Mechar_ca'
Service- We further release Catawba County and its employees from any liability which may
arise from this agreement.
.the parties acknowledge that occupancy of a building without a Certificate of occupancy i
a violation of local and Mate law and exposes ,the violator to criminal and civil sanctions
If occupancy occurs before Final Inspection has been Completed and the Certificate of
Occupancy issued., Catawba county Building Inspection will request the power/gas company to
discomnect the main service to the building.
The undersigned makes application for permits and inspection of work described and agrees tc
do mil; with all Mate o codes and laws regulatingthe work,
Signature of e arzical contractor Signature of owner or Agent
8-lilding Code Official
Sworn t..1 a TS d subscribedbe f C. e' t fi,. day CJd'..M',.^' `+,r'Y.e �,.'`.. a�,.`��,
Official Seal r p
Sgnature of Notary Notary tic rI
my commission expires 20—)
*This form must be notarized if signed out of cfftc �