HomeMy WebLinkAboutB4-1083 TEMP HEAT-ELEC APPLS.PDFCatawba CountyBuilding Services Division
ReviewPO Box 389, Newton, NC 28658
Plan s •r• 1
Newton Fax # 828-465-8375
Hickory Fax # i + i a.
SERVICE AGREEMENT TEMPORARY
r
..do hereby apply for temporary use of the permanent Nelectrical service
(Name) (Size of service)
to the structure located atL_,�_ �_
(Address of site)' (Building number) (Unit number)
<NOTE: Each separate meter to be energized is considered tseparate
violationWe do hereby release and agree to indemnify, save and hold harmless Catawba County and it's employees and Duke Power Company
from any and all liability due to or arising from Catawba County causing the electrical service to the above -mentioned premises being
disconnected, Temporary service is issued solely as a courtesy for the completion of construction and the building is not to be
occupied until a certificate of occupancy is issued. Any
The use of the system before final inspection is anticipated to be days Or less. If utility connection remains in use beyond 30
a s general contractor will be billed monthly per County Fee SchFdule. The temporary use of the system is necessary to operate the
HVAC and to provide lighting for the completion of the finish 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 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
attestedcontractors are ready for the 0- stems to be ener i ed as
f
Owner, cnc�
al c
The responsible agent for the purpose of signing this form may be the general contractor or owner. The electrical contractor
shall coordinate this inspection with building service offlcial. (A CONTINUITY TESTER SHALL BE FURNISHED he Title
ELECTRICAL CONTRACTOR AT TIME OF SCHEDULED INSPECTION.)
aig
tractor I hereby certify that the building at T a, - __
Branch circuits will be
al Cantr for
Please Print Name < ` Title c
HVAC Contractor
Please Print Name
as stated above.
Witness / Notary
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
As plumbing contractor I hereby certify that the Plumbing equipment installed at
N is not ad y t e pla edin servtceam aware that the electrical systems will be actin ted as stated above.
�Plumb ng ContractorWitness I Notary
Please Print Na6Title
This agreement is in effect until: Fee $-,--
GENERAL CONTRACTOR IS RESPONSIBLE FOR ADMINISTRATIVE FEES UNLESS OTHERWISE ARRANGED.
PIN # PERMIT #tA&t
____ Hood System Smoke Duct Detector System Fire Alarm System
15 March 2004
V7_ (�1@4jel
Catawba County Building Services Divisi_on 3ZZ 6<81+
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
apply for temporary use of the permanent ____electrical service
(Size of service)
to
(Building number) (Un772—mber)
<NOTE: Each separate meter to be energized is considered a separate request and subject to a separate fee>
harmless Catawba County and it's employees and Duke Power Compan)
•
om unty causing the electrical service to the above -mentioned premises bein�
I f disco rtesy for the completion of construction and the building is not to bt
occu tion 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 Y
days general contractor will be billed monthly per County Fee Schedule. The temporary use of the system is necessary to operate tht
HVAC and to provide lighting for the completion of the finish work. Only those circuits that are necessary and/or have beer
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 Plumbing
contractors are ready for the systems to be energized as attested below.
Please Print Name Title__
Owner/General Contractor
k&-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.)
---------------------------------------------------------------------------------------------------------------------------------------------------------------
As electrical contractor I hereby certify that the building at
( ) is ready ( ) is not ready to be energized. Branch circuits will be energized as stated above.
Electrical Contractor Witness / Notary
Please Print Name Title
-------------------------------------------------------------------------------------------------------------------------------------------- --------- -----------
As HVAC contractor, I hereby certify that the HVAC equipment installed at
)11 e a e
1 2:111 11, ip"eady to be placed in service. I am aware that the electrical systems will b d a tat d ab e.
HVAC Conti ctor I n ss 1 y
Please Print Name?Title�
----------------------------------------------------------------------------------------------------------------------------------- -----------------------------
As plumbing contractor I hereby certify that the Plumbing equipment installed at
is ready ( ) is not ready to be placed in service. I am aware that the electrical systems will be activated as stated above.
Plumbing Contractor Witness / Notary
Please Print Name Title
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
This agreement is in effect until: Fee $__
CQUIVICTOV, IS RESPONSIBLE FOR ADMINISTRATIVE FEES UNLESS OTHERWISE ARRANGED.
PIN # PERMIT #
— Hood System Smoke Duct Detector System Fire Alarm System
15 March 2004