HomeMy WebLinkAboutBLD2007-00914 TEMP POWER APPL.TIF�84ti
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 ELECTRICITY
NOTE: Each separate meter to be connected is considered a separate request and subject to a separate fee.
��pp Please list the total number of electrical meters to be installed on this projec
Permit# D1S00 60 ?-Q(9 1 q Job Title Dawe.0 &&A m tux 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
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 violation of the above will automatically void temporary service.
The use of the system before final inspection is anticipated to be _b_ days or less. If utility connection remains in use beyond 30 days
general contractor will be billed monthly per County 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 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 securely locked when it is not supervised. The electrician, HVAC, and Plumbing
contractors are ready for the systems to be energized as attested below.
The responsible agent for the purpose of signing this form may be the general contractor or owner. The General Contractor is
responsible for Administrative fees unless other wise arranged and agrees to set up a billing account with Catawba County
Finance Department for renewal of agreement, if needed. 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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I, �...�-E>row - ) L! � fLS 4� do hereby apply for temporary use of the permanent 0 electrical service
(Name) (Size of service)
to the structure local at ' 11 2 4 1 &- V V_ i% ) U) /_ A,, I V ° _
(Address of site) (Building number) (Unit number)
I authori illing o all r wals, if required, to the following active Catawba County billing account nu
ner /Gene ntraM signature ate Permit Specialist or Notary
Name
LFo.)ll� '�.,) iLSt _ . n ,��1111111�,.
s electrical contractor I hereby certify that the building at ' 3
( is r ( ) is not ready o be energized. Branch circuits ill be energized as stated
e rical Contract signature Date
Please Print Name 1 ✓ Q1 d Title U
PermZSpecialist or lrta>y V
As HVAC contractor I hereby certify that the HVAC equipment installed at ° 0 M1 L I II oW
( ) isready is not ready to be placed in service. I am aware t t the electrical . 1 i s t e.
HVAC Contractor signature Date t a r I Sar
t i
Please Print Name k L �a _t 9 ' 5 4 W et Title
- -- - -- -- - - - - -- -- - - - - --
As plumbing contractor I hereby certify that the Plumbing equipment installed at
( ) is ready (yj' s not r ady to a placed in service. I am aware that the electrical systems will aced as s d a ove.
1.71 Plumbing Contractor signature Date Permit Specialist o Notary
Please Print Name Gg r a5, . ti �'/e Y Ta
1 July 2004
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NOTARY PUBLIC
Mecklenburg County
North Carolina
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