HomeMy WebLinkAboutB3-2096 TEMP POWER APPL.PDF(828)465-8399 Office Number
(828)465-8962 Fax Number W�4'
P.Q. Box 389
Newton, NC 26656
CATAWBA COUNTY APPLICATION FOR PERMIT
(Please print or type) Date 1 w7 -f
r\_Temporary Electrical Temporary Mechanical
Property ID No.
Physical Street Address
Owner
Last
Use of Structure
W
M
Telephones2LLL—
owner 's Address
City State Zip
Subcontractor, Telephone(
(As Listed in License Book)
Subcontractor Address D
—ILL
City 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 temporary power/temporary mechanical service to be established
on the Building for above named project for a —3_Q_ day period,
This agreement does not constitute a Final Inspection for Electrical Power/mechan_;all
Service, We further release Catawba County and its employees from any liability which maarise 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 CF
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 cc
comply with all State, County, codes and laws regula,ing th
s IS:, e Elect ic 9� a - J oOf f
cgnatur of Owner or Agent
Building Code Official����
Sworn to and subscribed before me this day of
20
Official Seal
Signature of otary Notary Public
my commission expires 20
**This form must be notarized if signed out of office,