HomeMy WebLinkAboutBLD2007-02659 TEMP POWER AGREEMENT.TIFPA
Catawba County Building Services Division
PO Box 389, Newton, NC 28658
Permit Center 828 - 465 -8399 Newton Fax 828 - 465 -8375 Hickory Fax 828 - 322 -6814
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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 num ber of electrical o meters to be installed on this project P
BLD 200 00�1l� Job Titl .�r.r _ PIN #� NatIF3 Bldg # ��� thril•#
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 30 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 MIIBNISDED BY ELECTRICAL CONTRACTOR AT TIME OF SCHEDULED INSPECTION.)
1, hereby apply for temporary use of the permanent #Da amp
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electrical service to the structure identified above. I authorize
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billing of all renewals, if required, to the following active
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Catawba County billing a e nt number
Official gn lure of Notary
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Owner or GC Sign _ b4AaEr /A 1CP
Notary'skrinted or Typed Name
(Official Seal)
Printed Name Ta.J Title S4U4 r
My commission expires:
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As electrical contractor, I hereby certify that the electrical system
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O is ready ( is not ready to be energized. Branch circuits will be
energized as stated above.
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Official sig ttJ�e of Notary
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Electrical Contractor Signature CMf/Ot.- OQa'rrK�.
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Notary's rvirand or Typed Name
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(Officrd Sea!)
Printed Name Tit
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My commission expires: Q In
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As HVAC contractor I hereby certify that the HVAC equipment
Datte of acknowledgment
( is reedy ( ) is not ready to be placed in service. I am
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aware that the electrical systems will be activated as stated above.
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sig f ary Not I
Official tore o
S s re t Not ry
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Mechanical Contractor Signalure cw, ���
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Notary's Pr led or Typed Name
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Printed Name M tti� Title -A5
(Offieial Seal)
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As plumbing contractor I hereby certify that the Plumbing equip.
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Da f ackilowled men
( ) is ready ( mot ready to be placed in service. I am aware
that the electrical systems will be activated as stated bo
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Offi,4al_ natur of Notary
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Plumbing Contractor Signature
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Notary's P ted or Typed Name
(Officml Seal)
Printed Nam yx Title E'a _
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M commission ex ires: rn0.Y(:N ad 10