HomeMy WebLinkAboutbldc-7-10-9673 Temp Elec-Heat Appl.tif Catawba County Building Services Division QQQQQ
Q PO Box 389, 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
BLD �.L
- IO''I IOL✓ Job Title (,E PIN# Bldg # zz / 7Z
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 amp
electrical service to the structure identified above. I authorize Date of acknowledgment
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
(Official Seal)
Printed Name Title F Lfflod&C My commission expires:
As ectrical contractor, I hereby certify that the electrical system
( is ready ( ) is not ready to be energized. Branch circuits will be Date of acknowledgment
energized as stated above.
Official signature of Notary
Electrical Contractor Signature Notary's Printed or Typed Name
Printed Name &� � Title &P . — (Official Seal)
M commission ex Tres:
As UVAC contractor 1 hereby certify that the HVAC equipment
( is ready ( ) is not ready to bJepaci n se I am Date of acknowledgment
aware that the electrical systems wil ed a t d above.
Official signature of Notary G.
Mechanical Teo ractor Signature Notary's Printed or Typed Name
Printed Nam f W Title CS G `} (Official Seal)
My commission expires:
As plumbing contractor I hereby certify that the Plumbing equip.
(� ready ( ) is not ready to be placed in service. I am aware Date of acknowledgment
that the electrical systems will be activated as stated above. Official signature of Notary Q(�
Plumbing Contractor Signature Notary's Printed or Typed Name
Printed Name SF — WAAA&4 Title nW /yo5'2 (Official Seal)
My commission expires:
1
V -1 Catawba County Building Services Division
PO Box 389, Newton, NC 28658
F4 Z Permit Center 828 -465 -8399 Plan Review 828 - 466 -5130
,,� Newton Fax 828 -465 -8962 Hickory Fax 828 - 322 -6814
0 4 SERVICE AGREEMENT TEMPORARY HEAT
NOTE: Each separate meter to be connected is considered a separate request and subject to a separate fee.
Please list the total number of gas meters to be installed on this project
BLD Job Title PIN # Bldg # Unit #
In an effort to assist contractors in completing construction projects, this office will implement the following policy. The utilization of
permanently installed gas heating equipment to maintain environmental conditions necessary to facilitate the installation of
environmentally sensitive materials, or finishes in accordance with manufacturer's instructions is permitted by the North Carolina State
Administration and Enforcement Code with the following local requirements. The owner, general contractor, and mechanical contractor
must sign this request form for temporary utility connections. The form must be filled out completely.
The following requirements will also apply:
1. All heating units to be placed in operation shall have the following items inspected for compliance if applicable.
a. Vent system (Products of combustion)
b. Appropriate amount of combustion air is provided.
c. Gas lines shall be pressure tested and inspected.
d. Water lines shall be pressure tested and inspected if geothermal or coil supplied by a hot water heater.
e. Condensate traps and lines in place and inspected.
f. Electrical circuits installed with appropriate disconnect, over - current, equipment grounding, conductors and raceways.
g. Refrigeration lines shall be inspected with appropriate pressure certification tests.
h. All gas tubing shall be labeled per gas code prior to temporary heat inspection.
L Approved temporary electrical power is a prerequisite for temporary heat. (This can be scheduled simultaneously with
temporary electrical.)
2. No occupancy of any kind (persons, furnishings, etc.) shall be allowed during this period, without prior approval of the Code
Enforcement Official.
3. The use of the system before final inspection is anticipated to be days or less. If utility connection remains in use beyond
30 days general contractor will be billed monthly per County Fee Schedule.
4. If there is any violation of this agreement, this service shall be disconnected without prior notice to the participants. This shall be
done without any obligation of responsibility on the part of the Code Official or Catawba County.
5. All processing fees are applicable as set forth in the Catawba County fee schedule.
I have read and agree to this procedure and guidelines as set forth by Catawba County and will abide by the conditions and qualifications
under which it is issued. I further agree that failure to comply with the procedure may result in disconnection of gas, revocation of permit,
and/or the refusal to consider further requests for temporary gas. I also agree to have a billing account set up with Catawba County
Finance Department so that any renewal fees of temporary service can be automatically billed if needed.
I do hereby apply for temporary use of the permanent heating
system located at the structure identified above. I authorize billing Date of acknowledgment
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
(Official Seal)
Printed Name Title lE?S My commission expires:
As mechani 1 contractor, I hereby certi hat the mechanical
, Qa system ( is ready ( ) is not ready laced i e is . Date of acknowledgment
Official signature of Notary
C �G
Mechanical Contractor Signature r
Notary's Printed or Typed Name f
Printed Name Y �n Title �r�, �- (Official Seal)
My commission expires: