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Home My WebLink AboutBLDC-2-11-15491 Temp Electricity.tif 0 2 Catawba County Building Services Division Q -3 PO Box 389, Newton, NC 28658 Permit Center 828 -465 -8399 Newton Fax 828 -465 -8375 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 200 Job Title 10 i PIN# ark b I I X3(1 gD Bldg # Unit # We do hereby release and agree to m emnify, 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 o 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.) I, hereby apply for temporary use of the permanent �/_n_ amp — 7 — o2 o, GNA KAY 1URDLIAN electrical service to the structure identified above. I authorize Date of ac owled ent Notary Pub0c billing of all renewals, if required, to the following active Carly Catawba County billing account number fficial signa re o otary North carolno EXPNM Jul 12. 2012 Owner or GC Signature Notary's Printedlor Ty / (Official Sea]) Printed Name ��Grl�CA C , &WQ Title "1 �oAEc 1�4 My commission expires: 4 " 14—, As electrical 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 (Official Seal) My commission expires: As HVAC contractor I hereby certify that the HVAC equipment ( ) is ready ( ) is not ready to be placed in service. I am Date of acknowledgment aware that the electrical systems will be activated as stated above. Official signature of Notary Mechanical Contractor Signature Notary's Printed or Typed Name Printed Name Title (Official Seal) My commission expires: As plumbing contractor I hereby certify that the Plumbing equip. ( ) is 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 Plumbing Contractor Signature Notary's Printed or Typed Name Printed Name Title (Official Seal) My commission expires: 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 J 42 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 projec -i I- 1 St-19 ( Bee Job Title & PIN# s �6 1 b C j 3 y9 CBldg # Unit # We do hereby release and agree w indemnity, 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.) I, 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 Printed Name Title My commission expires: (Official Sea]) As electrical contractor, I hereby certify that the electrical system 8 �� (01 is ready ( ) is not ready to be energized. Branch circuits will be Date o acknowled ment energized as stated above. �L�� /�• /,1477 Official signature of Not p, g Ma hua M il l e r Electrical Contractor Si nature � �� SDarrOW Notary's Printed or TypedI Name Printed Name NAB p4irrou Title nfi (( , mil Seal) , N1 M commission expires: �!r,:. .� As HVAC contractor I hereby certify that the HVAC'equipment ( ) is ready ( ) is not ready to be placed in service. I am Date of acknowledgment aware that the electrical systems will be activated as stated above. Official signature of Notary Mechanical Contractor Signature Notary's Printed or Typed Name Printed Name Title (Official Seal) M commission expires: As plumbing contractor I hereby certify that the Plumbing equip. ( ) is 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 Plumbing Contractor Signature Notary's Printed or Typed Name Printed Name Title (Official Seal) M commission expires: 8 Catawba County Building Services Division Q H PO Box 389, Newton, NC 28658 " "`►� Permit Center 828 - 465 -8399 Newton Fax 828- 465 -8375 Hickory Fax 828- 322 -6814 r ,t 2 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 13uOC -a -i 1 -1 l —U69 20 Job TitIcc � � i► e ke PIN# (Q 1 I (o S 3 0 BIdg # Unit # We do hereby release and ngr& LJ'tn'ti'ergMfy, 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 wort:. 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 genera 1 contractor or owner. Tile 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 o f 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 My commission expires: As electrical contractor,) 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 (Official Seal) My commission expires: As HVAC contractor I hereby certify that the HVAC equipment ( ) is ready ( ) is not ready to be placed in service. I am Dale of acknowledgment aware that the electrical systems will be activated as stated above. Official signature of Notary Mechanical Contractor Signature Notary's Printed or Typed Name Printed Name Title (Official Seal) My commission expires: As plumbing contractor I hereby certify that the Plumbing equip. { ) is ready ( } is not ready to be placed in service. I am aware ate of ackna gmen a r that the electrical systems will be activated as stated above. �� 1 icial si ature of otary �•�t.ti Plumbing Contractor Signature �� '�Gr `�� Notary' rinted or Typed Name �; ,� ;) r ; ; i 't C7. C�A�£� Title (�tlicrilucal }�+` n Printed Name 4 My commission expires: oer 08/19/2011 13:34 CUMMINGS CONSTRUCTION � mcampOcummingsconst.com NO.507 901 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 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 _ B144W J I I ~ j S � � Bldg # Unit # $E$;i$6� Job Title - We do hereby release anf agree to A ,''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 FLRNISHM 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 bate 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 Printed Name w _ Title My commission expires: (Official Sea]) As electrical 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 (Official Seal) My commission expires- As HVAC contractor I hereby certify that the HVAC equipment X 19 ?' I ,.•'� v ° +,� D ate— of acknow ed t •. { s ready ( ) is not ready to be placed in sere' �erbove. m t - aware the electrical systems will be activated ' d�;:'' t�T Official signature f No ; ,,i ; "f Mechanical Contractor Signature _ _ , tom Notary's Printed or Typed NaAie Printed Name _ 27 - Title .�1c' r,��c.✓ _ •: �ea My commission expiresg As plumbing contractor 1 hereby certify that the Plumbing equip. •�'` : > • • `'�� ( ) is ready ( ) is not ready to be placed in service. I am aware pate of acknowledgment that the electrical systems will be activated as stated above. Official signature of Notary Plumbing Contractor Signature Notary's Printed or Typed Name Printed Name Title (Official Seal) M commission ex fires: