HomeMy WebLinkAboutBLD2007-00631 TEMP ELEC APPL.TIF(_H 1 F4wG5m 4L1
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Catawba County Building Services Division
PO Box 389, Newton, NC 28658
Permit Center 828- 465 -8399 Plan Review 828- 466-5130
Newton Fax 828- 465 -8375 Hickory Fax 828 -322 -6814
SERVICE AGREEMENT TEMPORARY ELECMCITy
NOTE. Each separate meter to be connected i4 considered a separate re"est and subject to a separate fee.
Please rrlbtt the total number of electrical meters to be installed on this project
Perteitlb �d ZOc)J — IJ3ILLJI Job Title PIN#
We 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
dam. Temporary service is issued solely as a courteey for the completion of construction and the building is not to be 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 tune beyond 30 days
general contractor will be billed monthly per Coun Fee Schedule. 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 arc necessar 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 securely locked when it is not supervised. The electrician. HVAC, and Plumbing
contracture are ready for the systems to be energized as attested below.
The responsible agent far the purpose of spniug this form may be the general contractor or owner. The General Contractor is
responsible for Admimdtrative fees ankss other wise arranged and agrees to set up a billing account with Catawba County
Fbuanre Department for renewal of agreement, if needed. The electrkal contractor shah coordinate this inspection with building
so.kr e f vial- to CONTINUiTY TESTER SHALL BE FURNISHED BY ELECTRICAL CONTRACTOR AT TIME OF
SCHEDULED INSPECTION.)
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d o hereby apply for temporary use of the permanent electrical service
(Name) / / (Size of service)
to the structure located at x ` /�`J /�"
(Address of cite) Z; 7 3 (Building number) (Unit number)
1 aolhA . bilOng of t r , it required, to the following active Catawba County biilimg account rsurnber,
__ 7
1
i Cott for ss ture Date Permit 5 list
Please Pnnt Name n ` { l/ �`J Title X _n\dqla 2(i,Z
--------------------------- - --- -- - -- -- - - - -- --- �----------
As electrical contractor I hereby certify that the building at
( ) is ready ( ) is not ready to be energized. Branch circuits will be energi Mai
Electrical Contractor signature Date t Specialist or Notary
Please Print Name Title
As HVAC conwiLtor I hereby certify that the HVAC equipment installed at
( ) is ready ( ) is not ready to be placed in service. I am aware that the electrical systems will be activatal as stated above.
HVAC Contractor signature Date Permit Specialist or Notary
Please Print Name
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 electricil systems will be activated as stated above.
Plumbing Contraettx signature
Date
Permit Specialist or Notary
Please Print Namc
I July 2004
JAN 04,2009- 10:33A 8283226814 page 1