HomeMy WebLinkAboutB4-206 TEMP ELEC & HEAT APPLS.PDF(82'8)465-8399 office Number P.Q. Box 389
(828)4'65a8962 Pax Number �W;l Newton, NC 28658
CATAWBA COUNTY APPLICATION FOR PERMIT
(CORUIRCIAL ONLY)
(Please print or type) Date
Temporary Electrical Temporary Mechanical
Building Permit No. (If Applicable)
Property ID No. Use of Structure
Physical Street Address
Last IFirst
Telephone( )
Owner's Address
City State Zip
CS,bcontractor
contractor Telephone( ) ,�
(As Lfited in bicenae Book)
Address tCity State Zip
te license No, & Classification
General Contractor Ali Telephone( }
Location of structure or Project ( hysicl Directions, Road Numbers and Names, Etc.}
°Phis agreement between Catawba County and (owner
or Authorized agent)authorizes temporary power/temporary mechanical service to be established
can the Building for above named project for 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 conTpany 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 regulating the work.
� ore of Ele ri �
/ l Contractor 4gnature of Owner or A ent
Build' g Code official
Swot o and subscribed before me this day of
�a
c�, o
Official Seal
Signstore of Notary �l Notary Public
m
My co fission a fires E 20 �#' p
°*This fo must be notarized if si ed out of office, �,
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(8 8`)465- 399 Office Number P.O. Box 389
(828)465m8962 Fax Number Newton, NC 28658
CATAWBA COUNTYP I TION FOR PERMIT
(CO)MRCI ONLY)
(Please print or type) Date�
Temporary Electrical Temporary Mechanical
" ' Building Permit No,(If Applicable)
Property ID No, Use of Structure
Physical street Address -SI
Telephone{ }
Last First
Owner's Address
�- City State Zio
Subcontractor /(
Telephone( )
_ ---- -- (As Fisted in License Book)
--
Subcontractor Address tsA r c �C-A-
u% ! u /
-- City State Zip
State License No. & Classification
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 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 inspection of work described and agrees to
com th all State, County, codes and laws regulating the work,
i ature of Electrical echanica Contractor i4a ure of Owner or Agent
R Ai
Bui ng Code Official
io
Sw to and subscribed before me this Cit L
day of
Official Seal n 9 1Q "�
Si ature of Notary NotaryPublic .aW,+Z
"dW®4p
My commission expires 20����T.
**This formmust be notarized if signed out of office. 1110111441ae�, ®`
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