HomeMy WebLinkAboutB3-2187 TEMP ELEC APPL.PDFCatawba County Building Services Division
PO Box 389, Newton,86
Plan Reviewi ••s
Newton+•
Hickory. 828-322-6814
i
`VICE A E NT TEMPORARY ELECTRICITY
considered_J do hereby apply for temporary use of the permanent electrical servic
(Name) (Size of service)
to the structure located at JAA-0—
_L�(A�ddress �ofsite)����� —(Building number) (Unit —number)
<NOTE: Each separate meter to be energized is R • subject to a separate fee>
CatawbaWe do hereby release and agree to indemnify, save and hold harmless Catawba County and it's employees and Duke Power Compai
from ano and all liabilitp due to or arising from
occupied until a certificate of occupancy is issued. Any violation of the above will automatically void temporary service,
disconnected. Temporary service is issued solely as a courtesy for the completion of construction and the building is not to
energizedThe building will be constantly supervised or will be securely locked when it is not supervised. The electrician, HVAC, and Plumbir
contractors are ready for the systems to be as attested below.
Please Print Name
Owner/General Contractor
The reslonsibIL "tent for the ose of siglii" this torm map be
shall coordinate this inspection with building service official. (A CONTINUITY TESTER SHALL BE FURNISHED BY
ELECTRICAL CONTRACTOR AT TIME OF SCHEDULED INSPECTION.)
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As electrical contractor I hereby certify that the building at
( v'} is ready ( ) is not ready to be energized. Branch circuits will be energized as stated abo e
Electrical Contractor Witness f Notary
Please Print Name °Title G%
_______________®____ ______ ___________4_________________________6__________-____ _®______ _____m_______ T -_____
As HVAC contractor I hereby certify that the HVAC equipment installed at
( �rea�(l t re to be placed in service. I am aware that the electrical systems will t1V
atp as stated above.
HVAC Contractor Witness / Notary
Please Print Name d J Pt Title
_____-____A__9_®_________®____®__e______a_________®_______4____________®________________®______________________ _ _____ _ _ _____________
As plumbing contractor I hereby certify that the Plumbing equipment installed
( `s read ( is not ready to be placed in service. I am aware that the electrical systems will be activl as stated above.
umbing Contractor Witness J Notary
Please Print Named Title �-
_____________pa________®_________a________________________________-____________a________________________________________-.__________________-_
This agreement is in effect until: 6 Fee $ 1 `�
GENERAL CONTRACTOR I RES NSIBLE FOR ADMINIST TIVE FEES UNLESS OTHERWISE ARRANGED,
PIN # _ PERMIT '+4- ZL
4-7
Hood System Smoke Duct Detector System Fire Alarm System
15 March 2004