HomeMy WebLinkAboutB3-1992 TEMP HEAT APPL.PDF(828)465-8399 Office Number
P.O. Box 3E
(828)45-8962 Pax Number
Newton, NO 286c
CAT AWBA CO
APPLICATION FOR
PERMIT
( Please ,print or type)
Date
Temporary Electrical
—Tempoeary
Mechanical
Ll__J_�Building
Permit No, (If
Applicable)
Property ID No,
Use of Structure
Physical Street Address
Owner—
Telephone(-'east)-:S7L7,74�
Last First;
Owner's Address
city
State 2-,
Subcontractor seC�f
Tele
(AS Listed in License Book)
`v
Subcontractor Address .5-,F
MrA
scare License No. & Classification
Coustty Account No,
■
General contractor F e-u Vf,o Telephone {'704) 1-74-k
—Location of Structure or Project (Phy8_i_c`a1D_T_re`ct�ions
Road Numbers and Names, �Ecc,)
This agreement between Catawba County and
or Authorized agent)authorizes temporary power/temporary mechanical service to be es—cablisn
on the Building for above named project for a 2L_o day period,
This agreement does not constitute a Final , Inspection for Electrical Power/Mechar_,t�
Service. we further release Catawba County and its employees from any liability which m�
arise from this agreement,
The parties acknowledge that occupancy of a building without a certificate of Occupancy:
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 0
Occupancy issued, Catawba County Building Inspection will request the power/gas company C
disconnect the main service to the building,
The undersigned makes aPPlication for permits and inspection f work described and agrees c
r 'b
e
comply with all State, County, codes and laws regul�atin e work,
f 0
;ature of &WAN444004/ S store Owner Agent
and agrees
Building Code Official
Sworn to and subscribed before me this _ day of 20_
Signature of NotaryOfficial Seal---- Notary public
My commission expires 20 1
"This form must be notarized if Signed out of office,
__T