HomeMy WebLinkAboutB3-1631 TEMP ELEC & HEAT APPLS.PDF(828)465 8399 Office Number
(828)465-8962 Fax Number V
CATAWBA COUNTY APPLICATION FOR PERX17
(Please print or type) (CONMRCIAL ONLY)
Temporary Electrical - Temporary
i,, Lo -2-0 () 3 -- I �o 3 ) Building Permit N0,(lf Applicable)
Property ID No,
Physical Street Address 4-c
P,O. Box 389
Newton, NC 28658
Date t
Oise of Structure
_EL__ �� �
In
Owner
Telephone
Last First
Owner's Address
M
Subcontractor %Tel
(As Listed in License -Book)
Subcontractor Address 2,5)L/
State License No, Classification L)
General contractor (ICDU
Tel
Location of Structure or Project (PhysicalDirections, Road Ni
State Zip
e (W SO 9 - 6 11
-A / 1_/ b"
------------- _
State Zip
ty Account No,
nelli4g)
to and Names, Etc.)
This agreement between Catawba County and
(Owner
or Authorized agent)authorizes temporary power/te Fary mechanical 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 Cer'
a violation of local and State law and exposes the violator to crim'
it occupancy occurs before Final Inspection has been completed
Occupancy issued, Catawba County Building inspection will request t
disconnect the main service to the building.
The undersigned makes application for permits and inspection of work
comply with all State, County, codes and laws regulat-i-W,, t�# wozy.
Lure of E-17ectri
Buitll�dng Code Official
Sw, to and subscribed before me this 6day of (V\
Official Seal
SignatureofNotary
MY commission expires Notary Public
200(o
"This form must be notarized if signed out of office,
ificate of occupancy Is
nal and civil sanction.
xnd the Certificate of
to power/gas company to
Jescribed and agrees to
711
Z
(828)465-v399 Office Number
(828)465-8962 Fax Number W
CATAWBA COUIM APPLICATION FOR PERMIT
(CO)MRCIAL ONLy)
(Please print or type)
Temporary Electrical Temporary
Building Permit No. (If Appl'!cjbl:e)
Property ID No,
Physical Street Address Ira 4-r,
P.O. Box 389
Newton, NC 28658
to
Use of Structure —&i-t
Owner
Tel
Last First
Owner's Address
city
Subcontractor
Tele
(As Listed in License Book)
Subcontractor Address 360,L 5 0,1e I A) (;6
City
State License No, & Classification C GA
15 �5( Col
General Contractor /I
—Location of Structure or Project (Physical Directions, Road Numt
This agreement between Catawba County and
or Authorized agent)authorizes temporary power/trary mechanical se
on the Building for above named project for a 70c) day period,
This agreement does not constitute a Final Inspection for Elect
Service. we further release Catawba county and its employees from a
arise from this agreement,
The parties acknowledge that occupancy of a building without a Certi
a violation of local and state law and oses exp
if the violator to crimin
occupancy occurs before Final Inspection has been completed at
Occupancy issued, Catawba County Building Inspection will request the
disconnect the main service to the building.
The undersigned makes application for permits and inspection of work d
comply - with all tate, County, codes and laws regulating th work
M
ME
N
State Zip
a (VY) Z� - 4t;.2 q
State Zip
ty Account No.
to and Names, Etc,)
(Owner
ice to be established
ical Power/Mechanical
y liability which may
irate of Occupancy is
1 and civil sanction
i the Certificate of
power/gas company to
scribed and agrees co
%
Si attire Electr
� a t
cal/Mechanical Contractor S gnat re of Owner 0 Agent.
uiy ing Code Official
SwOrAn to and subscribed before me this )i day of
�.
%
signature o .. �o Official Seal YfnNotar
tg Notary public
200(1 ,
t ;f office.