HomeMy WebLinkAboutBLD2007-01499 TEMP ELEC.TIF�01
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.
Please list the total number of electrical meters to be installed on this project
Permit i3L0Z0rl C - 0 / 9 9 Job Title 3 Z 6, l q l PIN# 37qo / '5 0 V.P//7
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
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, 7T g� do hereby apply for temporary use of the permanent electrical service
(Name) (Size of service)
to the structure located at 20 e N. A,� 06
(Address of site) (Building number) (Unit number)
I author'ze billing of all renewals, if required, to the following active Catawba County billing account number
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Ow /General Contrac or signature Date �" f. Permit Specialist or Notar
Please Print Name e,2hL�� I �t_
AID s s TitIerl _ IV `t 1- z' b�j
As ele>d
Electrical
Print Name
6r I hereby certify that the building at
not ready-, to be energized. Branch circu wil be energized as stated above.
b
mjtrac r signature Date Permit Specialist or Notary
050, S" Title �`✓h.�l
As ntractor I hereby certify that the HVAC equipment installed at
( is ready ( s no dy o p ced in service. I am aw re t the electrical systems will be activat as stated above.
VA actor si atur Date Permit Spec• list or Notary
P se Print Name ZOCQ 14 Ctt I Title L[J ,W_4
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
As pl bing contractor y certify that the Plumbing equipment installed at
( is rea ( ) is t ready be placed in service. I am aware that he electrical systems will be activated as stated above.
Plumbing Contractor signature l ate Pe nut Specialist or Notary
Please Print Name A w Aw� Title l I" � °tr'''
' S J
1 July 2004