HomeMy WebLinkAboutBLD2007-02361 TEMP ELEC.TIFJul JVL-IO iA vc ,.�....... .... �.... /� P.1
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Catawba 8`�ounty Building Services Divislof�
PO Box 369, Newton
Permit Canter 82946S.8399 Newton Fax 828-465-8962 Hickory Fax 828 - 322.6814
SERVICE ACRFHMENT TEMPORARY ELFCTRICITY
NOTE. El eh separate teeter to be Connected is considered a separate request and eubjert to a separate i.e.
please IM the loll viu mbest of irAA hr he italailnd nn is prajScl�.
)ILL) 28UV7 -0-4361 Job l'itle . Ux M'N9 lodge l none
We do hereby releame and .agree to indcmniry. save and lnld Bono less Camwha Chun, and 'it, employees mxl Ovke Power
Conquny fawn any and ill liablbry due vi or arising from Catawba Qmnly causing Ow electrical wav'icc hl the uhrvc.menlionW premises
being disconnalwd. Temporary service is issued solely as a courtesy for the complerian of coaslructiaA no the bu8ding is not to be
occupiW umil a evru6cate of oceopaney is issued. Any viulinum of the shoe will amamatically void manpunry service.
The uisof the system before final inspection is anticipated to be__ days m less. If utility connection remains in use hcyond
30 days GC will he billed monthly per County Fee Schedule. The temporary use of the system is necessary to operate the HVAC and In
pmvidc lighting for the Nmpldkm or the finish wok. Only thou circuiaa that are netesxxy and1w have been impacted and approved by
the electrician and electrical impactor will be energized. AM 125 vsingle- phnsoekcuiutempormilyeaagized Cmcoiul tionpur;Ks
will be ,ground fault interrupt prolu:tal, with the exception of lighting circuits in metal cautious. The huiiding will be constantly suervised
or will be securely led:ad when it is net supervised. The electrician, HVAC, and Plumbing contrietum are medy for the systems m he
cncridzal as afstal below.
The responsible agent for the purptue ofsignins: this form may be the general am tract rt or owner. The OC is responsible
Poe Administrative fare unless otherwise arlRngod and a grees to sty up a billing retained, with Catawba County Finance
Deportment for renewal of agrerneny if needed. The electrical contractor shall eeordinnte this inspection with building service
omCial. to CONTOMTY IltSTEn attAll LLE YUtaVlglrl/ RY gYC1lltCAt. C(MlRSCTOR AT TRAY.OY x(TiRlnn.tin mSIT.r.TION.I
I hereby for t useof the Naneat a
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electrical sIXVlce to (lie 5lrudurt Identified AbtivC. I aathanxe
Meant. Wllx(^ment
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billing of an renewals. if required, in the fnllnwintg active
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Catawba County billing au number-
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Nmary's Printed or Typed Name
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My commission eMpircv: MARCH /3 ab // art PrH CPa
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As datrical cpmracror.l hereby certify that the w elaaiical system
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()0 is ready () is not ready to be energized. Branch circuits will be
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cragizcd'as stated show;.
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(W irlisibmatureor Notary = NotoN =
Electrical Contractor Signals.
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Nola(y's Printed or Typed Name
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As HVAC cootrattm[ hacby certi(Y that the HVAC equipment
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(") is vady ( ) u mst ready m be placed in service. ....
aware that the ele<ujcal systems will be activated as a abrrve-
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Mer1uM(al Contractor Signature
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Notary's Priaaed m Typed Name
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As plumbing contractor I hereby certify that the Plumbing.quip.
Date of
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`` JPUVOnC U ,pit i
ready m be placed in service.
( ) is ready ( ) u not I am swore
that the electrical systems win be a above
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Plumbing Camases" Signaler
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