HomeMy WebLinkAboutB4-37 TEMP ELEC APPL.PDF(828)465-8399 Office Number P.O. Box 389
(828)465-8962 Fax Number V Newton, NC 28658
CATAWBA COUNW APPLICATION FOR PERMIT
(COMMERCIAL ONLY)
(Please print or type) Date
Temporary Electrical Temporary Mechanical
u C, Building Permit Flo, (If Applicable)
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Property ID No. Use of Structure
Physical Street Address 0 7 5<*";
Owner c",
/ I/ `fie le hone ( 1"PJ) 9
Last Fi at
owner's Address 7 �5v In
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City F State zip
Subcontractor 611"r-0
Telephone
(As Listed in License Book)
Subcontractor Address
City State Zip
State License No, & Classification V County Account No,
7C"l 777777—
General Contractor C/(_Ii* Telephone f
SLLLL'�
—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 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 inspectionQf work described and agrees cc
comply with all State, County, codes and laws regrulatingx.fie p r k
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grature"of Elect 'cal/mechanical Contractor _SiWa_tu_rsof _0=_r_0r A' —gent
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BU ding Code Official c N F, Y ', y, "P
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S, rn to and subscribed before me this day of
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Official Seal
Signature of Notary q
Notary Public S e,
MY commission expires 14 20 ---------------------- -
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**This form must be notarized if signed out of office. "** 4
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