HomeMy WebLinkAboutB4-270 TEMP ELEC APPL.PDFCatawba County Building•
Services Divisio
PO Box 389, Newton, NC 28658
Telephone # 828-465-8399
Plan Review # 828-466-5130
Newton Fax # 828-465-8375
Hickory Fax # 828-322-6814
0 XA -5 6 fQ _1�
SERVI� AGREEMENT I*MPORARY ELECTRICITY1
I(- --**do hereby apply for temporary use of the permanent 119aelectrical service
r (Name) (Size of service)
to the structure located at _166-rle-
(Address of site) (Building number) (Unit number)
<NOTE: Each separate meter to be energized is considered a separate request and subject to a separate fee>
We do hereby release and agree to indemnify, save and hold harmless Catawba County and it's employees and Duke Power Compan
from anN and all liability, due to or ser : I OTMEbm
disconnected. Temporary service is issued solely as a courtesy for the completion of construction and the building is not to b
occupied until a certificate of occupancy is issued. Any violation of the above will automatically void temporary service,
The use of the system before final inspection is anticipated to be:� days or less. If utility connection remains in use beyond 31
days general contractor will be billed monthly per County Fee Schedule. The temporary use of the system is necessary to operate thl
HVAC and to provide lighting for the completion of the finish work, Only those circuits that are necessary and/or have beei
inspected and approved by the electrician and electrical inspector will be energized, Any 125v single-phase circuits temporaril,
energized for construction purposes will be ground fault interrupt protected, with the exception of lighting circuits in metal conduit. '
The building will be constantly supervised or will be securely locked when it is not supervised. The electrician, HVAC, and Plumbin€
contr ctors are re y for the systems to be energized as attested below.
crors
04
Owne General Please Print Name
Title
w er
ne General Contractor
The responsible agent for the purpose of signing this for may be the general contractor or owner. The electrical contractor
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 1 -5 1 �P F" Y tzr 'S E
is r ady is not ready to be energized. Branch circuits will be energized as stated above
Electrical Contractor Witness / Notary
Please Print NamejlTitle-- C�_
----------------------------------------------------------- — ---------------------------------------------------------------------------------------------------
As HVAC contractor I hereby certify that the HVAC equipment installed at i 5 1 lq S -P), \j E S1f-
�teady it of ready to e placed in service. I am aware that the electrical systems will be ivAted as stated above.
HVAC Contractor Witness J Notary
Please Print Name
--,E �e 5�— Title C,
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As plumbing contractor I hereby certify that the Plumbing equipment installed at ) t�7 ) 1# f:�V S L—_
( aced in service. I am aware that the electrical systems will be activate stated above.
_11Aarly is n t ready o
i
Plumbing Co actor
Print
t Witness Notary
Please Print Name ljlt Title Q,
--------------------------------------- -------- ---------------------------------------------------------------------------------------------------------------
This agreement is in effect until: Li Fee$ NONE7
GENERAL CONTRACTOR IS RESPONSIBLE FOR ADMINISTRATIVE FEES UNLESS OTHERWISE AR
PIN# 3T) ' 6 6 311 �03 PERMIT #
— Hood System Smoke Duct Detector System Fire Alarm System
15 March 2004