HomeMy WebLinkAboutBLD2007-01172 TEMP POWER APPLS.TIFU1/ LJ/ LUUO 14 : La rAA auas aza Uo un center for Human Srvs . 1¢1 ou
a"- Aj -AUUts 1Z: J UATAWIdA WUNTY 1 828 465 8962 P.0 0in n'JvNi�J(
Catawba) County Building Services Division _�
'
PO Box 389, Newton, NC 28658 n ,'
Permit Center 828.465 -8399 Newton Fax 828-465-0"5 Hickory Fax 828-322-6814 F4*
SERVICE AGIREEMENT TEMPORARY ELKC TRICITY '�'"�"`
NOTE: Each separate natter to be connected is considered a separate request and subject to a separate fee.
Please list the total au><ntber of electrical meters to be installed tbb proje 1
RLD 200 - (� Q Job Title g # Unil # -
We do hereby release and agree to indemnify, save and hold harmless Catawba County and it'i cmployees and Duke Power
Company from any and all liability due to or arising rrom CatawbA County causing the electrical service to the above - m entioned premises
being disconnected. Temporary service is inued solely as a courtesy for the completion of construction and 06 building is not to be
occupied until a certificate of occupancy is inued. Any violation of the above will automatically void temporary scrvicc.
The use of the system Wore fins! inspection is anQeipated to be days or less. If u ility connection remains in use beyond
30 days CrC will be billed monthly per County Fee Schedule. The temporary use of the system is nceem saay to operate the IIVAC and to
provide Iighdng for the completion of the finish work. Only thrssa circuits that arc necessary and/or have been inspected and approved by I
the clectrici to and electrical inspector will be ener6rized. Any 125v single - phase circuitsi lcmporarity energized fnr construction purpose,%
will be ground fault interrupt protected. v4th the exception of lighting circuit. in metal conduit. The huilding will be con.tantly stgp�rvised
or will be securely locked when it is not supervised. The electrician. RVAC. and Plumbing contractors are ready for the systcros to be
energized as attested below.
The responsible agent for the purpose of siming this form may be the general contractor or owner. The CrC is responsible i
for Adminibtrative fees unless otberwkc arranged and agrow to seel up a baling saint with Catawba County Finance
Department for renewal of agrcememt, if needed. The electrical contractor sball coordinate this la tpeefion with bulMing service
official. lA cowm4urry 77.:X7 xR SxALL $ii: Fu aIIsma) BY ELzeri cAL coN'rRArvoit AT Tna of sClt$Dt71 = IIaSnt4
1, hereby apply for temporary use of the permanent SgL amp
Ol 1 2.31 0 6
electrical service to the saructure idc>tt!W above, I auftrize
of ack o Mont
� E
billing of all renewals, if required, to the following ac&*
County billing
oi 'r
NOV A 24,200
' i7F
Catawba account manner
cla auar C) y
r
Owner or GC Signature A4 23
Notary's Printcdor Typed Name
X
Pruned Name ?No A A S A X Lt Tide Owner
T
MY commission ex roes: 1 1 Z}
(official Scat)
og
rvcDl. 'tGIS
Asplecirical contractor, i hereby certify that the elcutrleal system
-�••
Dale of acknowledgment
3-
( to ready ( ) is not ready to be energized. Branch circuits will be
energized as stated above
Official sifmxture of Notary
Electrical Contractor Sipawr.
"' —"—'
Notary's Printed or Typed Nars>e
Printed Narra I�/hN./ri ls�/s~C•�+- -• Title r
(Official Seal)
,;�� �..
MV commission roes:
As HVAC contractor I hereby certify that the HVAC equipment
- � �-- --
Date of acknowledgment
( ) is ready ( ) is not ready to be placed in service. I am
aware that the electrical systems will be activated as smted above.
Official signature of Notary
Mechanical Cpawaetor Signature
I
Nay Printed or Typed Name
Printed Name Title
(Official Seat)
My commission expires;
As plumbing contractor i hereby certify that the Plumbing equip.
—
( ) is ready ( ) is not ready to be placed in .service. 1 am aware
Date of acknowledgment
that the electrical sy.4wmu will be activated as mated above.
Official signaturc of Notary
Plumbing Contractor Signature
Notary's Printed or Typed Name
Printed Name Title
(Official Seal)
Mv commission Tres:
I gA
Catawba County Building Services Division
PO Box 389, Newton, NC 28658
Permit Center 828- 465 -8399 Newton Fax 828 -465 -83 Hickory Fa 828 - 322 -6814
1 SERVICE AGREEMENT TEMPORARY ELECTRICITY
NOTE: Each separate meter to be connected is considered a separate request and subject to a separate fee.
Please list the total number of electrical meters to be installed qn this project 1
BLD 200J - 0 Job Title A a IN # Bl dg # A Unit #
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 days or less. If utility connection remains in use beyond
30 days GC 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 b1lildin2 gill he cnmt;uitlV suherV iced
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 GC is responsible
for Administrative fees unless otherwise 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.)
1, hereby apply for temporary use of the permanent _A0P__ amp
electrical service to the structure identified above. I authorize
Date of acknowledgment
billing of all renewals, if required, to the following active
Catawba County billing account number
Official signature of Notary
Owner or GC Signature
Notary's Printed or Typed Name
X
(Official Sea[)
Printed Name Title
My commission expires:
_bk
As lectrical contractor, I hereby certify that the electrical system
Date of acknowledgment'`
-l0
(✓is ready ( ) is not ready to be energized. Branch circuits will be
energized as stated above.
Official signature of Notary
Electrical Contractor Signature 1 . 1 ���
Notary's Printed or Typed Name
Printed Nam / /i.� K� �sf +�-' Title 'Gl�t� 6� -�
(Official Seal)
My commission expires:
As HVAC contractor I hereby certify that the HVAC equipment
Date of acknowledgment
( ) is ready ( ) is not ready to be placed in service. I am
aware that the electrical systems will be activated as stated above.
Official signature of Notary
Mechanical Contractor Signature
Notary's Printed or Typed Name
Printed Name Title
(Official Seal)
My commission expires:
As plumbing contractor I hereby certify that the Plumbing equip.
( ) is ready ( ) is not ready to be placed in service. I am aware
Date of acknowledgment
that the electrical systems will be activated as stated above.
Official signature of Notary
Plumbing Contractor Signature
Notary's Printed or Typed Name
Printed Name Title
(Official Seal)
My commission expires:
JAN- 23-20UH 14 9 U1 UATAWdA CUUNTY
1 W2U 4bb UUbL F.UUa
CaMwb a County Building Servioes Division
PO Box 389, Newton. NC 28658
Permit Center 828. 465 -8395 Plan Review 828466 -5130
Newton Pax 828 Hickory Pax 828- 322 -8814
SERVICE AGREEMENT TEMPORARY ELECMCITY
NOTE: Each separate meta' to be connected Is asndelered a separate request and subject so a apatnte Lee.
Plow list the total number of electrical meters to be installed on tits project
1'crereiCl� t`nG a .boa 7 iqW Z Job Title PINYlt
We do hereby release and agree to indemnify, save and hold harmless Catawba County and its employees and Duke Power Company
from any and all liability due to or arising from Catawba County causing the electrical st m= to the above•mcntiottod V=ins bang
disconnected. Temporary servke is imoW achy as a cmateay for the e0ftVk iao of eonstzuctice and the building is not to be oeaupied
until a certificate of oecupmcy is istned. Any violefi m of the above will aotoa mdcaily void temporary goyim.
The use of the system bd'are fmal inspection is mvidpatad to be days or less. If utility connection remains in use beyond 30 days
ge mal corms will be billed monthly per County Pee Schedule. The temporary use of the system is tr to opcxate the HVAC
and to provide lighting for the conopledon of the fudsh work Only those circuits that are necessary and/or have bees hapeated and
approved by the eleecrw= and elec=4 inspector wM be osno Vud. Any 125v single-phase eirattits temporarily energized for
construction Purposes will be g found fanh tnu mot pr , with the exception of lighting ck-ub in metal conduit
The building will be corotmtly superAsed or will be securely locked when it is not supervised. The electrician, I4V AC. and Plumbing
a=actots are ready for the systems to be enmVize d as amened below.
The reaponatbk for the purpose of skalm Ibis forar may be eke general cona for or owner. The General Comasopr in
eapondble for Adminla:lrat he 2m aches other wive arranged and op es to set rep a blift moor t r►Bb Catawba County
Finant`c Deparbout for . amwal of sgreears1,1<netded. Tian decUW toetrad er aball amrdlnate, this Inspection wkh builds
scrvicc owi iaL. (A CONTINUITY I EST SHALL BE FURNISM SY Rl<.F3C'll'IUCAL CONTRACTOR AT TEKE OF
SCMDULE,MSPEC'I'LON.)
I, do hacby apply for temporary use of the perm aw electrical service
(A ms) (Siu of service)
to the stractute locatod at
(Address of site) Building rnnaubw) (Unit number)
I authorize billing of aR renewals, K ropme4 to the bflowing acthe Catawba Comfy b ifs aceoust cumber
Owner/Gotctal CAt "ctor sip et wo
Date ' Permit Specialist or Notary
Please Print Name Title
As electrical contractor I hereby certify that the bails M at
( ) is ready ( ) is not ready to be energized. Branch cirauis wM be enarginod as stated above
H1e:Mt W C sigtatm t Date
Permit specialist oe Notary
Please Print: Name
Title
As HVAC aosvactor I hereby certify dwt dat I W AC egt4mw instalted
at M o r a
t+; A z L I k
U �
f ;�A, is ready ( is not ready to be placed In wvtce. I aoa a
I wee
dial the elemics �
be voted ! �/ a
M �-4:
_ �\ �
14a- K- �--- -�
I- 3 3 -D_ �' _
S -
HVAC Coottact�or signature
Ike
Permit Permit Specialist or
\ — ®L�'
PICO=PnntName t6, 'S.S���
Tide C,% l- ��+r•ec`1�ru' \ D
aa�.eG4 ��....�
Ire
P ilo
As plumbing contractor I hereby cw* ON the Plumbing equiMem installed at -
( ) is ready ( ) is not ready to be placed in scevioe. I am aware that the electrical systems will be activated as stated above.
plumbing Contractor sigmturc Date: Permit specialist or Notary
Please Print Narm
i J uly 2004
Title
TOTAL P.002
8 'd 1090 'ON b1V I HUM NI331H Md Z:L 8001 U '°pf
JAN GJ -4VVU 14:01 GATAWr16 cauunrx 1 tiZtt 4" aubz r.UUI
Plant Review 828.4t39-'S130
Hickory Fax t3M - M-W14
S18;RVICE AGREEMENT T EMMRARY HEAT
NOTE. Each separate meter to be connected is considered a separate regnQ4 nod object to a separate f1w.
Perttrit # lh G �ia'i - [i l 1 � � !ob Title PIIQ p
In an effort to assist Wwaetars in eo WIctiag cow ruction pr*=. that office will implement the following policy. The utilization of
permanently (NWIod heating equipment to maintain e:tviromo W aoaditions neoatstry to facilitate the installation of
cnviroomegtelly satsitive materials, at Sm:hes is accordance, with manuffiatm n instructions is pontifted by the North Carolina State
Administration and Eeferconmt Code with the following local requirements. The owner. gemW contractor, and mechanical
contractor must r+gn this request fwm for tonporary 41ity co mections. Thor farm most be filled out completely.
The following requirentub will also apptr:
1. • All heating units to be plaid in operation shall have the following iftm iuspected for compliance if applicable.
a. Vent system (Predltcts of combustion)
b. Appropriate amount of combustion air is provided
e. Gras lines shall be pressras tested and inspected.
d. water lima Shen be yzmure orated and inspected if geot etwal or coil supplied by a hot water how -
e. Condensate tarps and lines in place and Inspected.
L klecaical cimufta inatalled with appropriate diaoom,eck ova - current, equipment grounding, conductors wad
receways.
g. Refrigeration lines shall be inspected with appropriate pressure catificstion tests:
h. All gas tubing shall be labeled per gm code prior to temporary hoot inspection_
L Appnovad temporary doceical power is a prcoquWta for temporary heat: (This can be scheduled aimultwnaously
with temporary diutacrical.)
2_ No occupancy of any kind (pawns, faraiabings, etc shall be allowed during this period, without prior approval of the Code
EnIbrccmcnt Official.
3. The use of the system before final inspection is kaficipated to be days or I= If utfl ty conngtion remains in we
beyond 30 days general Contra= will In billed monthly per County Fee Schedule,.
4. If tbar a is any violation of this agreement, this SwAce shall be diaoonne W without prior notice to the pwicipsats. This
stun be dorle without any obligation of rrsporustbiliiy on the part of elk Code Official err Catawba County,
S. All processing fees are Oppftcatble as se, fth in the Catawba Cotmtyfee schedule.
I have read woad agree to this ptocadue and guidelines as sat Ecth by Catawba Coctity and will Abide by the conditions and
gitaliltcatsons under which it is issued. Ifurtber ague that faihwe tD epinply with the procedure may ressrdt in disconnection of gas.
revocation of peanut, an&or the rdasd to consider fwdxr requests for temporary gas.
(Printed Name of General Contractor)
systr,, located at
do hereby apply for temporary use of the perrti at heating
cf&eitype system)
(Address of site) (Building number) (Unit number)
I authorize bihling of all renewals, it nquhmd to flue foaowing active Cahwrba Coady bil log a000utr<t ttamba
Owncr/Ge=al Contractor sipatme. Dale Permit Specialist or Notary
Please Print Name Title
I r` C hereby apply for ternpurary use of the permantau otiliry serviea idectifiod above -
(Printed Name of HVAC Co )
HVAC Contractor:sipaarsv 1 pate Permit Specialist or Notary
Please Print Name %A k
I July, 2004
�r�AtlaLi 2
Catawba County Building Services Division
PO Box 359, Newton, NC 28658
Permit Center 825-485 -8899
Newton Fax 828- 4854337S
Z 'd 1080 'ON HIV I JNIAD NIJJAD AdIZ '-L 8002
WI- r-w-cfOod 11:42 ALAN JERKINS PLUMBING 7048271512 PAGE1
Csowba County Building Services Division
PO Box 308, Nswlon, NO 28859
Permit Cenler a2bA&S Plan Review m 486-St90
Newton Fax 8084884W6 hllCkAty Rex 828.322.8814
MmVICR AGR13EMM T' N"It"Y BUT
NOTE: Race aep�trd A metetr to ibe aawkeded is Pond' as a aepmrate regm nt and s■iiloet to a aopeaste few
Pawodt 8 -
- ow l job Job T 'V Q li Q — - MN 8
In an edfort to at" 1:oMraetots in oot *song aodepe mdw pe *=. (his odloo will nWwmm the =owing policy. The adimamn of
AemRMendy ltesAM h=ft cguipmenc to =iataia ltd OOttdidats osowray vo 6cllim dw lnstalkdw of
mranome ay ssmdtive "OWiglc ar fhalSbW IA 4COOF4000 M& WAMACIOW raUuadotta Lt pam?M d by the Npth Coollm Sun
Adtnwmtlea 20 Bafotae:�OW Coda With 11e following 1OW nepW ms, The owber. 2oomd coantim, and mecbmmmW
conaactor must sitar this regooat dorm for Omporsty utility wmo Bona. The form map bo NOW out omVIetmly.
The to WAN s+ayttie+saa m Wm des appkm
L .All badng odte sO be placed In opa dit sbsri have the foilovAng i om inspected for oomplisnee if appOmble.
L vcnt sym m (lb odem of cmabusd*
, b. Approprim amoaat of aombusdm sa is p r&WOod.
- C. Oae'liaae shall be pamaure tamed and impacte&
d. dab tines shall be p mvxo tasted ad inspected it Saothamal or oat supplied by a hot water hteaur.
e. CoodeomW bW and Titter in place and Inspected.
f Plecalcal tip bt MW with spPropriate diNOOneoct, Over cwmt, O*dpmaat pvmWlo& coadmem and
rstxways.
& Pafdpsndm Maas d all be b apoeted with app mpida preasme osrtifiadm *#t1L
IL All gas tubing shall be labeled per on cods prior io tempoatty bm imfema&
1 . Appmed o eloetrW pow is a pr apblm for mvVorvy Item. CM an be sued simultaneously
with Wmporary eletA IML)
2. No ocr4mtKy of my ldod (pataCeNi, fiaroieltinps6 ttie.) shall be sAowad dutfitg Britt >>OKA wlthm pdw app owl of cite Coda
Rnfcremncnt OfftW.
3. The use of tht: symem b*m And hapecOm b aedclpated to be. --dep or lase. If utility comeation remains in usC
beyond 30 days pastel comamor will be billed monthly Per Coamy Pee Schedule.
4. If that�a Is day vinladfla of char ee+rtasr, die mvice Od be d boomMd withoat prior ttotloe m dw paodcipaaa. This
shall be dom witbout an oblipadon of ampawa tlr on the Wn or dw Code Of kdal or Catawba CmW.
S.- All prooesseing fees we applkabis m net Axth in the Caawba Cm aty he aa6edahe.
I have read and ages to this prooedwe and golddiam as set fmtb by Cmwba County and will dm& by the cmilfftm and
goallficadom under whkh it is issued. i fiwdw agree #sac Where to coWly arltb efts piaaadems may teach is diwoaawdon of bas.
is mdm of pazd4 anther ezlbW to aomlderlmdw tmipmm I m m Womy pas.
I beating
Nam af¢aoera>. ts+saltype ayste�
�m at
(Addnee of alts) (atdmi number) (the number)
l astthsrlae Cadwba Cmmfy biv g aosesset weber ,
Owm dGcaaAi ConincW44ma re DW PW it SpeciaiW or Notary
h?laese PrMe Nat>b Tidaa
I f' I, A N , [,C( L, l de hsaaby apply ft tee @ftwy tae of ells pammnab vWity Sal else
(hhinted Ntuas ai'I! ! cm&amw)
b j. � Cortaat: } oor segoatt>ra 1 Date Penitit
Pl a Print Manta +G ry Je rl� ArJ 5 Z i r Al A
I July, 2004 - , �•�;�' NoMry Public
C ounty,
(S "�
&O"m Jan. 1
2012
01 - 23 - MB 15:27 ALAN JERKINS PLUMBING 1512 �✓►��•