HomeMy WebLinkAboutB4-80 TEMP HEAT APPL.PDF(828)465-8399 Office Number P.O. Box 385
(828)465-8962 Fax Number W Newton, NC 28656
CATAWBA COUNTY APPLICATION FOR PERXIT
(CON=RCIAL ONLY)
(Please print or type) Date
— Temporary Electrical Temporary Mechanical
bU) 2-bt —Building Permit No, (If Applicable) 90 0L. 're-3 T1 H N 6
Property ID No, -�--7 0 7- - r—' i lk I
Use of Structure IT -
it T11
Physical Street Address 10 t
Owner P!
Telephone
Last First
Owner's Address 10s,
City State Zip
Subcontractor '
A6 IA /C/ Telephone
(As Listed in License Book)
Subcontractor Address _w6"� 5"fl�dkll'
City State Zip
State License No. & Classification 20 �7 County Account No,
General Contractor
f
—Location of, Structure or Project (Physical Directions, Roada Nuephonembers_nd Names, Etc.)
This agreement between Catawba County and
or Authorized agent)authorizes temporary e (Owner
' pow r/
on the Building for above named project aor a cal se ice Co be tablished
This agreement does not constitute Final
Service, We further release Catawba Coun y and chanical
arise from this agreement. which may
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
If occupancy occurs before Final sanction.
Occupancy issued, Inspection has been completed and the Certificate of
Catawba County Building Inspection will request the Power/gas compan
disconnect the main service to the building. y to
The undersigned makes application for permits and inspection of work a cribed and agrees to
Comply with all State, County, codes and laws regulating the work.
5 7-c4 r 5
Signature of ft2.ffz*MftW1/Mechanical Contractor Signature Of Owner or Agent
Buildi g ode official
Sworn to and .subscr bed before m this day of
2 OD
Signature of N tart' Official Seal
MY commission xpire Notary Public
20_.
OFFICIAL SEAL
**This form must be notarized if signed out Of office.
aro NOWY Public • N�Orth C lifta
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CATAWBA COUNTY
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