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Home My WebLink AboutBLD2007-02030.TIF• Catawba County Building Services Division PO Box 38'9, Newton, NC 26658 Permit Center 828. 465 -8399 Newton Fax 828 - 465 -8962 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� - tot ' al number of electrical meters to be installed on this project BLD 2W1 Job Ti tle1j IN# 5421 - ZD Y �� Bldg # 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 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 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) I, hereby apply for temporary use of the permanent amp Z 0 L N CIJL Z`6Zibq 2> electrical service to the structure identified above. I authorize Date of ackitowledgment _� billing of all renewals, if required, to the following active Catawba County billing account number Official signature of Notary Owner or GC Signature `N Notary's Printed or Typed Name (Official Seal) Printed Name '7/' 7 Title jZ a My commission expires: Z los Asplectrical contractor, I hereby certify that the electrical system f le ( ready ( ) is not ready to be energized. Branch circuits will be e act ow men energized as stated above. tci s gnature Qf Nota M P" We" Electrica Contractor Signature .� C t` (') ' i Notary's Printed or Typed Name /� Printed Name �k�df�l�c 8y°r ✓°� Title R i �� 0 (Official Sea!) M commission expires: As RVAC contractor I hereby certify that the HVAC equipment Date of acknowledgment (. 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 Signatu - '1� - Notary's Printed or Typed Name Printed Name TiJ9G'yliG o /1/d O/7GL1G� (Official Seal) M commission ex ires: As plumbing contractor I hereby certify that the Plumbing equip. 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 Plumbing Contractor Signature e Notary's Printed or Typed Name Printed Name Jai /� {L'a� � Title Q)7WlaT rmy (Official Seal) commission expires: 0 Catawba County Building Services Division PO-Box Newton, NC 28658 Permit Center 828- 465 -8399 Newton Fax 828- 465 -8962 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 -010 BLD 2 001 -010 Title a rt lJ+^ PIN # Z� -ZD "► Bldg # 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 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 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 -'B amp 17, 1 Z. d IU Q-CL - ZM C VS electrical service to the structure identified above. I authorize Date of ack owledgment 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 Printed Name Ti ?!pff . a (Title IZ-'n t My commission expires: (Official Seal) As electrical contractor, I hereby certify that the electrical system Date of acknowledgment ( ) is ready ( ) is not ready to be energized. Branch circuits will be energized as stated above. Official signature of Notary Electrical Contractor Signature Notary's Printed or Typed Name Printed Name Title (Official Seal) My commission expires: As HVAC contractor I hereby certify that the HVAC equipment 17 1 1 14 O s (*J`is ready ( ) is not ready to be placed in service. I am Date of acknowledgment aware that the electrical systems will be activated as stated above. //��jj Official signature of Notary I\{ Jt\ Mechanical Contractor Signatu �l _ Notary's Printed or Typed Name Printed Name T_1 2g7GG� Title O/Nx a (Official Seal) My commis ion expires: As plumbing contractor I hereby certify that the Plumbing equip. ate f ac nowledgment (, rs 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 Plumbing Contractor Signature Notary's Printed or Typed Name Printed Nam to jLy�ne Title _ CANCf (Official Seal) My commission expires: