HomeMy WebLinkAboutB3-1542 TEMP ELEC APPL.PDF04/27/2004 10:01 70448922R7 LAKE ELECTRIC CO PAGE 01
Apr 27 04 03:17a City of Hiekortj
8293237474 p,1
(829)465-5359 Office Number •� �)
P O Box 369
[829) 465-84G2 Fax Number
Newton, NC Ze65®
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CATAWBA COVWTY "PLTCATTON
FOR PERMIT
Pease print or types
Date "T b
Temporary Electrical
Temporary Mechanical
Building Permit No (If Applicable)
Property rD No.
Use of Structure C rN G
/ / /
Physical Street Address _rjf Ale /L�Lti1
��Fi
(city) �Q�y
Owner U lGr(�r d71' /c C•cQ/--li '
Telephones i
Last First
/JJ )
0vr,er s Address `TLnf� lid(° Alt
// %n
� 'diZ /"� to0
—
Subccntractor G-4 L rl jyi
City State 2:I
--Telephone( %1��i ) (JGv
_ [As Llated in License Book)
_—
Sul>contractcr Address-
Z�NVev Ace 26f0—?7
—
city State Zlp
State License No L Claasifieation County Account No,
General Contractor y?�
j�yryj¢ TelephoneLocationof gr z�zaf^?les—
erro4^ire�cte—,tNLbere d N� �C
Etc
Q0-ofI
Th)s agreement between Catawba County and
or Autnorized agenc)authorizee temporary power/temporary/
me anical se ice o be eSLabl_s,.ec
on the Building for above named project for a 0 day period,
This agreement does not constitute a Final Inspection for Electrical Power/Mechanic,,:
Sefvi:'e. we further release Catawba County and its employees. trom any liability which ta,
arise from Chia agreement
^'he parties acknowledge that accupancy of a building vithouC a Certificate of occupancy :S
a violaLl.;n of local and State law and exposes the violator to criminal and civil s�ncr,_or
jf occupancy occurs before Final Inspection hat been completed and the Certificate o!
Occupancy ;saued, Catawba County Building Inspeetion will request the powerlga9 compc.ny tc
d;sconnecr, the main service to the building.
rye undersigned makes application for permits and inspection of work described and agrees CO
comp1 Nlthltcla Ctalte, County, codes and laws rey-� latirg the work.
l- (,1 L te�rr,� \%►tr. [ 7i,4 e
gn cctrical echanical Contractor Signature of Owner or Agent
Building code Official
Sworn rc and subscribed before me this wx..
day of �+► 20
Signature of Notary flffi:Seal
Notair f �tH4RY. s
My Commi98ion expires' t
' ;. Th=3 form mu9be notarized if 20
ed out ai 9n t of office. PUBOO :2
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