HomeMy WebLinkAboutB3-1198 TEMP ELEC & HEAT APPL.PDF(828)465-8399 Office Number P,C). Box 38S
(828)465-8962 Fax Number Newton, NC 28656
COUNTY XPPLICATION FOR PERMIT
CATAWBA
(Please print or type)
Temporary Electrical Temporary Mechanical
Building Permit No,(If Applicable)
Properry ID No. Use of StructurejN)U��iAl,_
Ph sica] Street Address C e (C i t'yL11WC-0-
Owner r x Telephone
Last First
owner's Address
City State Zip
Subconiractor Te I e p h o n e,
(As Listed in License Book)
I
Su-bcontractor Address
City State Z - p
State License No. & Classification ✓ County Account No,,___
General Contractor Telephone (Sa5 )—ZNt- �34
—Location of Structure or Project (Physical Directions, Road Numbers and Names, Etc.)-
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This agreement between Catawba County and (Owr
or AUhorized agent)authorizes temporary power/temporary mechanical service to be es,-ablis.-
on the Building for above named project for a _�� day period.
This agreement does not constitute a Final inspection for Electrical Power/Mechan-'c'
Service. we further release Catawba County and its employees from any liability which me
arise from this agreement,
The parties acknowledge that occupancy of a building without a Certificate of Occupancy '
a violation of local and State law and exposes the violator to criminal and civil sancc110r
it occupancy occurs before Final Inspection has been completed and the Certificate c
Occupancy issued, Catawba County Building Inspection will request the power/gas company t
disconnect the main service to the building,
The undersigned makes application for permits and inspection of work de ribed and agrees
In a State,County, codes and laws reg-ulatin or
o
l/M C tr tor
�i �a Contractor Si star of Owner or Agent
m 'y w' 11 of 2 trl
a re lec
Building Code Official S
0
Sworn to and subscribed before me this day of ("-JaWV-1
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Official Seal 0
Signature of Notary Notary Public 7
my commission expires 20 0 (0,
-This farm must be notarized if signed out of office, A%
WT C 0 6��%o %
(828)465-8399 Office Number P.O. Box 389
(828)465-89(72 Fax Number Newton, NC 28658
TCATATeMA COUNTY APPLICATION FOR PERMIT
(Please print or type)
Temporary Electrical _Y/__ Temporary Mechanical
Building Permit No,(If Applicable)
Property ID No. Use of Structured jak.,�
Physical Street Address C
11
Owner Jit C'
_Telephone_�,�
Last First
Qwmer's Address
City State Zip
Subcontractor V C-4 I r Tel ephone (82Z eIZZ4.
(As Liste in License Book) 4
6 4 j Aj
Subcontractor Address
State License No. & Classification
city, State Zip
County Account No,
General Contractor —
LcaAsau:&r.0 T e 1 e p h o n e AAk!_4S,
_Location of Structure or Project (Physical Directions, Road Numbers and Names, Etc,
This agreement between Catawba County and k
J (Owner
Vl
or Authorized agent)authorizes temporary power/temporary mechanical service to be escablishec
on the Building for above named project for a _.:!L_Q_ day period.
This agreement does not constitute a Final Inspection for Electrical Power/Mechanica'
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 is
a violation of local and State law and exposes the violator to criminal and civil, sanction.
If occupancy occurs before Final inspection has been completed and the Certificate C)f
Occupancy issued, Catawba County Building Inspection will request the power/gas company to
disconnect the main service to the building,
The undersigned makes application for permits and inspection of work described and agrees tc
comply w tt� all Mate, Co ty, codes and laws regulating the rk,
regulating
ngt.herK
Sisignature of 1/Mec nical
r
Contractor Si atu of Owner or gent
Building Code Official
w�
Sworn to and subscribed before me this _J f
day o eAy
0
A
Official Seal
Signature of Notary Notary Public
Z
MY commission expires s j 200 :C;
**This form must be notarized if signed out of office.
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