HomeMy WebLinkAboutB4-191 TEMP ELEC APPL.PDF�,A6f-Az
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Catawba + . • Services 11
•
'* Box 389, Newton,:«
Plan Review # 828-466-5130
Newton Fax 828-465-8375
separateI' �*� �" do hereby apply for temporary use of the permanent
(Name) —electrical service
to the structure located at (Size of service)
(Addresslof site) (Building number) (Unit —number)
<NOTE: Each t considered
request
We do hereby release and agree to indemnify, save and hold harmless Catawba County and it's emaloye_e
i subject to a separate
fTom Carawba I 'ounty causing the electrica service to the above -mentioned premises beinE
disconnected.
be
The use of the system before final inspection is anticipated to be — days or less. If utility connection remains in use beyond 30
occupied until a certificate of occupancy is issued. Any violation of the above will automatically void temporary service,
MV9"QM"97v-wffrpld1ion of M—efi`msh work. Only those circuits that are necessary and/or have been
inspected and approved by the electrician and electrical inspector will be energized, Any 125v single-phase circuits temporarily
energized for
The building will be constantly supervised or will be securely locked when it is not supervised. The electrician, HVAC, and Plumbing
contractors are ready for the systems to be energized as attested below.
Please Print Name
rr
9
responsibleThe Purposef this form may be the general
i i. i.. building i
contrshall y • electrical
with
service official. (A CONTINUITY TESTER i
ELECTRICAL CONTRACTOR AT TIME OF SCHEDULED 11-1,SPECTMIJ I
f FURNISHED
By
______________®_-----__________-_______-_______-_
r I hereby certify that the HVAC equipment installed at____________®________________________________________________®_
( ) is re d ( } ` of rea to he placed in service. I am aware that the electrical systems will be activated as stated above.
HV C Contractor
Please Print Name Title Witness 1 Notary
____________________________________________________________________________________________ _ __ _______
As plumbing contractor I hereby certify that the Plumbing equipment installed at - - - - -
____________________________
( ) is ready } not re to- in service. I am aware that the electrical systems will be act' as stated above.
Plumbing Contractor
Please Print Name ""'� i k ,fir Titter p' Witness t Notary
This agreement is in effect until
GENERAL CONTRACTOR IS RESPONSIBLE FOR ADMINISTRATIVE/FEE UNLESS OTHERWISE R NEED.
Fee
PIN # PERMIT G
____ Hoods stem '
Y smoke Duct Detector system _Fire Alarm System..
15 March 24