HomeMy WebLinkAboutB3-1245 TEMP ELEC-HEAT APPLS.PDF(828)465-8399 Office Number
(828)465-8962 Fax Number
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P.O. Box 389
Newton, NC 28656
(please print or type) (COMORCIAL ONLY) Date
Temporary Electrical Temporary Mechanical
)wilding Permit No.(If Applicable)
Property ID No. Use of Structure
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Physical Street Address it (04 '". k.�.:b2� �J
Telephone
Owner— 12A cl,
Last First
Owner's Address
City State Zip
Subcontractor-�E6'���
(As Listed
Subcontractor Address
I I ON I." -! � 1, N1
a
_Telephone 6 7L
City 7 State Zip
State License No, & Classification County Account No.
General Contractor —Telephone( 4 16 -/0
—Location of Structure or Project (Physical Directions, Road Numbers and Names, Etc.)
This agreement between Catawba County and — (Owner
or Authorized agent)authorizes temporary power/tem ary mechanical service to be established
on the Building for above named project fc.- -- day period.
This agreement does not constitute a Final Inspection for Electrical Power/Mechanical
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 of
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 to
comply with all State, County, codes and laws regulati-11, 2 the work,
Sign tore of Jflectr-ical/Mo0k**i*&1 Contractor Signature of Owner or Agent
--e(c vial 1 Building Code Off
Sworn to and subscribed before me this day of -11-VAI 200
�la4t
mm Ca
t 7
�e r Agent
0
Official Seal
Signature of Notary
Notary Public
My commission expires----.-\--,--,-, 2 O_L_y
1 14.
**This form must be notarized if signed out of office. ...... ....
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(828)465-8399 Office Number P,O. Box 389
(828)465-8962 Fax Number Newton, NC 28658
TA ,A COUNTY APPLICATION FOR PERMIT
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(Please print or type) RI Y)
AL ONLData
Temporary Electrical /,~''� Temporary mechanical
61- P Z01-13 - C,1 1,—V5_Building Permit No. (If Applicable)
Property ID No. Use of Structure
Physical Street Address
0
Owner La Telephone(
Last First
Owner's Address 11J2L6 -
city State Zip
Subcontractor (As Listed in License Hook)
TelephoneL����
Subcontractor Address
City State Zip
State License No. & Classification County Account No.
General Contractor 5
PA /_ L. Telephone JLL3_)2J�L'
—Location of Structure or Project (Physical Directions,
�8, Road Numbers and Names, Etc.)
This agreement between Catawba County and
P L6_L._, (Owner
or Authorized agent)authorizes temporary power/temporary mechanical service to be established
on the Building for above named project for a aLO day period.
This agreement does not constitute a Final Inspection for Electrical Power/Mechanical
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 of
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 to
comply with all State, County, codes and laws regulating the work,
Signature of Tilililiffitimpil! _� a
1/Mechanical Contractor Si gnaturr�eof or Agent
W
N4, E
C
Sworn to and subscribed before me this day of �C;
%
Official Seal
0
Signature of Notary
Notary Public >:
MY commission expires XA
1 20y.
**This form must be notarized if signed out of office. (JSLIC
Pwr
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