HomeMy WebLinkAboutBLD2008-01467 TEMP ELEC AGREEMENT.TIF� °lw
Catawba County Building Services Division
0 B 389, on, NC 28658
Permit Center 828-465-8399 Newton Fax
828- 465 -8375 Hickory Fax 8 28- 322 -6814
SERVICE AGREEMENT TEMPORARY ELECTRICITY
Each separate meter to be connected is considered a separate request and subject to a separate fee.
Please list the total number of electrical met t
ers o be installed on this projec
BI.D 200 - t�l �E Job Title �u4y �udur:
PIN#
Bldg g Unit #
We do hereby release and agree to indemnify, save and hold harmless Catawba County and it's employees and Duke Power
:.ompany from any and all liability due to or arising from Catawba County causing the electrical service to the above - mentioned premises
)eino disconnected. Temporary service is issued solely as a courtesy for the completion of construction and the
,ccupied until a certificate of occupancy is issued. Any violation of the abov building is not to be
will automatically void temporary service.
The use of the system before renal inspection is anticipated to be K6 days or less. If utility connection remains in use beyond
10 days GC will be billed monthly per County Fee Schedule. The temporary use of the system is necessary to operate the HVAC and to
uovide lighting for the completion of the finish work. Only those circuits that are necessary and/or have been inspected and approved by
Ic electrician and electrical inspector will be energized. An y '
,ill be erom:d fault interrupt protected, with the exception oflightingcircuiphin Ise rcuit n eta/ corduilp Thc zivilll be f �,n ` tl
r t i n Purvis «I
u• will be securely locked when it is not supervised. The electrician, HVAC, and Plumbing contractors are ready for the systems to be
nergized as attested below.
The responsible agent for the purpose of signing this form may be the general contractor or owner. The GC is responsible
or Administrative fees unless otherwise arranged and agrees to set up a billing account with Catawba County Finance
lepartment for renewal of agreement, if needed. The electrical contractor shall coordinate this inspection with building service
tTrcial• IA CONTINUITY TESTER SHALL BE FURNISHED BY ELECTRICAL, CONTRACTOR AT TrME OF SCHEDULED INSPFCTION.1
hereby apply for temporary use of the permanent OU amp
ectrical service to the structure identified above. I authorize
illing of all renewals, if required, to the following active
atawba County billing account number . J
wrier or GC
•inted Names A S � &"-")i iP Title tk h uy'(
r electrical contractor, I hereby certify that the electrical system
1 is ready ( ) is not ready to be energized. Branch circuits wil I be
crgized as stated above.
ectrical Contractor Signature. L
inted Nam e��c., ��, Title c n o t-
'(VAC contractor I hereby certify that the HVAC equipment
) is ready ( ) is not ready to be placed in service. I am
are that the electrical systems will be activated as stated above.
:chanical Contractor S_ign
/'l.
nted Name Lam+ /r ROSS Title E4
Plumbing co actor I hereby certify that the Plumbi equip.
is ready .) is not ready to be placed in serve I am aware
the electrical systems will be activated as sta above.
robing Contractor Signature,'
ited Name it Title
11
Da Al tnowledgment
O a] signature of Notary
Notary's Printed or Typed Name
MX commission ex ires: � 1 (Official Seal)
1
11-1� -eti6
Da a of ac nowledgment
O t i signature of Notary
\*kkL
Notary's Printed or Typed Name
c _ 1 LA c1 (Official Seal) .
M commission expires: l
i1 -15 -og
Date of cknowledgment
Offict st nature of Notary
Y� e
Notary's Printed or Typed Name
c _ , C (`
M commission ex fires: (Official Seal)
Date.of ack wledgment
Offi cial gnature of Notary
Notary's Printed or Typed Name
My commissi expires: �_ 1 _O (Official Seal)