HomeMy WebLinkAboutB3-1539 TEMP AGREEMT APPL.PDF(828)465-8399 Office Number P.O. Box 389
(828)465-8962 Fax Number Newton, NC 28658
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CATAWBA COUNTY APPLICATION FOR PERMIT
(COMMERCIAL ONLY)
(Please print or type) Date
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Temporary Electrical Temporary Mechanical
Building Permit No(If Applicable)
Property ID No. -z,,L 0 Use of Structure
Physical Street Address
Owner
'v Telephone
Last First
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State Zip
Subcontractor ' I I-
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-Telephone( 6,q)
(As Listed in License Book)
Subcontractor Address ell <i'A
city State Zip
State License No, classifications G County Account No.
General Contractor L_&tvVeYL 4- Cc Tel ephone (ftq 6 4-
Location of StructL����
ure or Project (Physical Directions, Road Numbers and Names, Etc,)
This agreement between Catawba County and C
or Authorized agent)authorizes temporary (Owner
power/tem�porary �mech�anic'al 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 permits and inspection of work described and agrees to comply with all State, Coulity, codes and laws regulating the work.
Signature of .6,-le tri a
Mechanical Contractor
Si store f �rAg�ent
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B 1ding Code Official
rn to and subscribed
before
me this Z day
Signature of N tary
Official Seal
MY commission expires
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Notary Public
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**This form must be notariz if signed out ;f
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