HomeMy WebLinkAboutB3-1538 TEMP ELEC APPL.PDF(828)465-8399 Office Number
(828)465-8962 Fax Number V
CATAWBA COUNTY APPLICATION rOR PERMIT
(COXHBRCIAL ONLY)
(Please print or type)
—Temporary Electrical
C I
I -, '1a ; "')"
'3 , �'� ' Building Permit No. (If Applicable)
P.O. Box 389
Newton, NC 28658
Date
Temporary Mechanical
Property ID No. Use of Structure
Physical Street Address
Owner Telephone(
Last First
Subcontractor
(As Listed it
/40
Subcontractor Address
M
r
License Book)
C t7
it
State Zip
Telephone ( i
E
State License No, & Classification ounty Account No.
Ct General Contractor Telephone(
—Location of Structure or Probe
(Physical Directions, Road Numbers and Names, Etc,)
This agreement between Catawba County and
or Authorized agent)authorizes temporary (Owner
service to be established
on the Building for above named project for a 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 its and inspection of work described and agrees to
'y "'I th all
State, Con codes and laws
comply with all State,Coun codes and laws regulating the work.
of tr�
S i :�a t u r e Electrical/Mechanical ature of E ectrical/Mechanical Contractor Signature of owner or Agent
Building Code Official
11 Sworn to and subscribed before me this day of 20
, of Official Seal
Signature of
I Notary Public
My commission( expir
20(
"This form must be notarized if signed out of office,
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PalftM Carol N 0? Ina
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CATAWBA COUN