HomeMy WebLinkAboutB3-2096 TEMP HEAT APPL.PDF$W-4i I �4'1�P.O. Box 389
(828)465-8399 Office Number U "� U 1� e
Newt 1 NC 28658
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(828)465-8962 Fax Number '
CATAWBA COLTNTY APPLICATION FOR ERMIT
(Please print or type)
Late
Temporary Electrical —Temporary mechanical
d::XZ_Cn, 916
Building Permit No.(If Applicable)
Use of Structure
Property ID No.
Physical Street AddressIT(Citv) �
14, '�' Telephone (0 _W)
owner
First
a t
owner's Address
Subcontractor-
0
_i&e'nse Book)
(As Listed in L
Subcontractor Address
City State Zip
M
Telephone(
State Zip
State License No. & Classification County Account No.
General Contractor Telephone(
—Location of Structure or Project (Physical Directions, Road Numbers and Names, Etc.)
This agreement between Catawba County and —,(Owner
or Authorized agent)authorizes temporar-y power/temporary mechanical service to be established
on the Building for above named project for a :�L� 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, County, codes and laws regal -ing the, r
�i-tra17Mechanical Contractor ignatu of Owner or Agent
Building Code Official
Sworn to and subscribed before me this day of 20
Signature of Notary Notary Public
My commission expires 20 — •-This form must be notarized if signed out of office.