HomeMy WebLinkAboutBLD2008-00448 TEMP POWER AGREEMENT.TIFCatawba County Building Services Division
PO 8Ox 389, Newton, NC 28858
Permit Center 828 - 465.8399 Newton Fax 828 465 -8975 Hickory Fax 828.322 -6814
n
SERVICE AGREEMENT TEMPORARY ELECTRICITY
NOTE: Each separate meter to be connected lyconsidered a separate request and subject to a separate fee.
Please list the total number of electrical auction to be installed on this projeet
OLD200 V 1 � Job Tide PIN# Bldg# Unit#
We do hereby release and agree to indemnify, save and hold harmkss Catawba Conroy and its employees and Dalai Power
Company from any and all liability due to or arising from Catawba County causing the electrical service to the above,mentioned premises
being disconurctod. Temporary service is issued solely as a courtesy tot 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 ber_ 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 IfVAC and to
'provide lighting for the completion of the finish work. Only those circuits that me 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 eonst,conn purp,cs
will be ground fault interrupt protected, with the exception of lighting circoits in metal conduil. The building will be con =randy supereiced
or will be securely locked when it is not supervised. The electrician, RVAC, and Plumbing contractors are ready for the systems to be
energized as attested below.
The responsible agent for the purpose orsigning this form may be the general contractor or owner. The GC is responsible
for Administrative fees unless otherwise arranged and agrees m set lip a bill account with Catawba County F'mence
Department for renewal of agreement. H seeded. The electrical contractor *4 coordinate tibia inspection with Wilding service
'oGleia4(A CONTIN1,11TY T£SIER SHALL St FURMSM RT SLECTFUrAL CONIT OR AT T IME OF SCHEDULED R"FF4;;F renn,...
I, hereby sooty for temporary use of the permanent amp - f'n� "OS"s'c' ou'r,` AbTg`';Pq
elecarcal service to the structure identified strove. I authorize iv Ry
4 �r
billing of all renewals, if required, to the following active y f If O
Catawba County billing account hmmber t � c
Owner or GC Signntore i i hQ, UJY(Ckd' a , a printed.m d Type Name �9
�f
1A I r n m _. it . Ifl
As electrical contractor, I hereby certify flat the electrical system
( ) is ready ( ) is not ready to be energized. Branch circuits will be
energized as stated above. I I
Electrical Conractor Sliphaturt �./a/r. W //K1�51(
Printed Names T�sfl NJ 1 -S$f Title Ow f\ax
As HVAC contractor l hereby catifythat the RVAC equipment
Date ofaclurowledgment
( ) is ready ( ) is not ready to be placed in service. I ain
aware that the electrical systems will be activated a stated above.
Official signature of Notary
Mecbanical Contractor Signature
Notary's Primed orTyped Name
(Official Seal)
printed Name Title
MY commission expires!
As plumbing contractor l hereby certify that the Plumbing equip.
'( ) is ready ( ) is cut ready in 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 Signore"
Notary's Primed m Typed Name
Printed Name Title
(Ofctal Seat)
SEP -26 -2008 08:56, PM a T &W_PLUMBINC 18284335534
'• - - -
PO Box 388, NePermit t
Pa Center 82646"390 Newton Fax 826-M43376 Nldkory Fax M-322-6 - 322•B Bta
SERVICE AGREEMENT TEMPORARY ELECTRICITY
NOTE: Each eepuraq Mater to be meaected is considered a separate request sad subject to a &%ware tee.
Planve Bat the told uunalm of electrical seters to be Installed on tole pmjatt
BLI 280 &3>OMa job n & Xiie PU4# BMN d UnN p
We do hreby releaw; and agree m Indemnify, lave and hold harmless Catawba County and ins employees and Duke Power
Company from any and ag liability due to or arising tons Catawba County cawing dse electrical service to the abDYe- arMtioMd premise
being disconnected. Temporary service is issued solely u a courmq for the complaints of consbmAlon and the building is not to be
occupied until a certificate ofoccupsmy is issued. Any violation of the above will automatically void temporary service.
The use of the syaleM before A411 inspection is anticipated to be_ days or less. If wilily connection remains in u& beyond
30 days CC will he billed monthly par County Foo Schedule. The temporary we of the system is necessary to operate the HVAC end t
pmvide fighting for the completion of the finish work. Only those circuits that are necessary sndror have been inspected and approved by
the alectriNm and atectrkal trupecta will be enorgimd. Any 125v single -phase chnuits temparmily oncreired Ibr construction purposes
Will be ground fault interfuln prateaed, with the "caption of lighting circuits In maW conduiL The building will be constantly supervised
or will be eecturely locked when It is rot supervised. This eleuvoi :ion, HVAC, ant Plumbing controctors are ready for the systems to be
energized as alsawed below.
The teapoeAble agent too the purpose of algsbg 11115 form racy be the Natural cosdrector or owow. The GC Is reepene"
for AdminWrative gee asks o4erwW arranged rind Arm to ad up a bmaEg acoouat with Catawba County Monte
Depaemnmt for renewal of agrmmasf, R eaoded. The electrical toatneor AM oenskabe this hnpectloe with ba8dkg serria
VMS" UCOIV1fgUJTY TafINA MAI.a, eSTtlelt181®1P iL8Cre1L'AL C0M%AVMAT7Ia40PfiCU]d ajXDM1aPZ0l%M
I, hereby apply for temporary we of the perrrema amp
electrical service m the sawoure idlentified above. I saloon&
Date of ackmwledgmant
HIMPI of an ranewak, if ""trued, to tle "o rkq sews
CWwbe Cowq bob" ercou" ncmbm
oMcW signature of Notary
Otmerer GC Sagsatara
Notary's Primed w Typed Name
(Official Basil)
Pcts tad Name Title
My commission expires:
As electrical contractor. I herby certify lbet the electrical system
Dgte of acknowledgment
( ) is ready ( ) is am ready m be energized. Branch circuits wig be
co roved a aloud above.
Oi&cW signature of Notary
Maxer sai Contractor Blowouts
NtXay'a Ptbttedm Typed Name
Priow Name TUN
(Official Sup
my eommiesiaa exp ires!
As HVAC contractor I hereby caaly that the HVAC equipment
Dose of acknowledgment
( )ieready( )laaotmWy tobeplscalkovrviee. Intl
aware that the electrical syoocrm will be activated as skW &bore.
Official signature of Notary
modow twl Contractor Bigtrlum
Notary's Priatad m Typed Name
Proceed Nam This
'm
(Official
M W
As plumbing contractor I hereby cardfy that the Plumbing equip-
��� en
00-M
sw \A U�
�S' �
(to) is ready ( ) is so ready m be placed in mrvice. I tan lware
���
that do, electrical ayaums will be acdv `too
Cifl ypW of o
Plumbing Contractor Blgwtare
Plumbing
Notsry's Rimed m me Typed Na
�� '' //��A� �r, .J
Printed se atS,2.Li Trek
M commiaion ex trea qL1jGl('
crsl Saul) V'
'
IB /T0 3M.1 KX%D 3AIV lSIdgo PZ2896906 4 t tr0 0002; CLlL --
Catawba County Building Services Division
X PO Box 389, Newton
Permit Center 020456 -0300 Newton Paz 82 9"465.8375 Hickory Fax 828. 3226814
SERVICEACREEMENT TEMPORARY ELECTRICITY
NOTE: Each separate mater to be connected is considered a separate request and subject to a separate fee.
Pkaw Oct the total number of electrical meters to be installed on "praject
BLD 200 III99MQ Job Titl d0UjS['ILYf V PJNO__ Bldg B Udt g
we do hereby mkase and agree to indamaify, save and hold harmless Catawba County and it's employees and Duke Power
Company from any and OR Imbility due to or arising from Catawba Cowry 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 acorti0cote of occupancy is issued. Any Violation of the above will automatically void temporary serviax
Them of the system before anal inspection is anticipated to be___ days or lane. If utility connection remains in use beyond
30 days GC will be billed monthly per County Fee Scheduk. The temporary use of the bystem a necessary N operate the HVAC and to
provide lighting for the wmplation of the finish work Only those circuits that are necessary ampor have been inspected and approved by
the electrician and electrical inspector will be energized. Any 125v single -phase circuity 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
w will be securely locked when it is not supervised. The electrician, HVAC, and Plumbing contractors am ready for the systems to be
energized as attested below.
The responsible agent for He purpose of elgaing this form may be the general contractor or owner. The CC is responsible
for Adndmislruid a fees i nlem otherwise arranged and agrees to set up a billing account with Catawba County Fhatu lie
Department for renewal of agreement, N needed. The electrical motractor $hall coordinate this inspection wltb building $ervke
official. (A COMINUf1Y TMFR SHALL BE FURNISM BY ELECTRICAL COIKFVA('POR AT TNIB OF SC/IE'nULJM INSPECTION.y
1, hereby apply for temporary use of the permanent amp -
-
electrical service m the structure identified above. I authorb a D
Date of eaknowkdgment
billing of all renewals, H required, to the following active
Catawba County billing account number O
Official signature of Notary
Owoar or GC Sigmature __ ,.._ N
Notary's Printed ov Typed Name
(Official Sell)
Printed Name Title M
My eormnoi an expires:
As electrical Contractor, I hereby certify that the electrical system D
Date of acknowledgment
( ) is ready ( ) is not ready m be energized. Branch circuit will be
energized as Stated above.
Official signature of Koury
EhxfrMsl Contractor Slgmdure N
Notery's Printed or Typed Name
Printed Name Title (
(Official Seel)
— M
M mmissione ires�.
As VAC eontractur I hereby certify that the HVAC equipment
kn dgm n
(if ready ( ) is tax ready to be placed In service. I am e
eP' k
0 PICIAL BEAT
aware that the electrical syst � will be IY e$ stated $bDV0. N
N01&y PUtiC, Norm L'9r011119 I
Of'ci na of No „ M
M L TAYLOR
Mechanical Contractor Sigtm N
Nmery's Printed or Typed N C
CanmisasnF - N. it
Printed Nataer -Io NO J }t d W viz M
M �� 1
1 l
M rommissionex Tres:
As plumbing contractor l hereby ocitify, that to Plumbing equip. D
Dee of acknowledgment
( ) is ready ( ) is not ready to be placed in service. I am aware
that the elecrical systems will be activated as stated above. O
Official sigmture of Notary
Plumbing Contractor Signature ___, --._— N
Notary's Printed or Typed Name
(Official Sal)
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