HomeMy WebLinkAboutBLDR-3-11-15983TEMPPOWERONBLD.tif Catawba County Building Services Division
.- PO Box 389, Newton, NO 28658
I F* Permit Center 828- 465 -8399 Newton Fax 828 -465 -8375 Hickory Fax 828-322-6814
SER'V'ICE AGREEMENT TEMPORARY ELECYRICITY
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 - __ .
BL Job Title }RAbi ns _ P1N #_�J 9T 76' 3 Bldg # Unit #
We do h reby 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 diseonnccte . Temporary service is issued solely as a courtesy for the completion of construction and the building i, not to be
occupied until a ee lificate of occupancy is issued. Any violation of the above will automatically void temporary service.
The use o the system before final inspection is anticipated to be 36 days or less. If utility connection remains in se beyond
30 days CC will be billed monthly per County Fee Schedule. The temporary use of the system is necessary to operate the HV AC and to
provide lighting fo the completion of the finish work. Only those circuits that are necessary and/or have been inspected and a jproved by
the electrician and electrical inspector will be energized. Any 125v single -phase circuits temporarily energized for constructio i 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 r newal of agreement, if needed. The electrical contractor shall coordinate this inspection with building jervice
Offlcial. (A CONTIN D'Y '1 E TER SHALL BE PURNISHED B Y ELECTRICAL CONTRACTOR AT TIME- OF SrHEDULED INSYECTION.)
1, hereby apply for mporary use of the permanent 0 amp 10 N - u () ` "Nol I ?III N
electrical service to the structure identified above. I autborize pate ofacknowled @► ✓
billing of all rene als, if required, to the followiu active `�`� 4 �"r -,,
Catawba County billing account number Z 1 _ Official tune ofNtar 0 1Z
� o Y �
Owner or CC Sig atur Notary's rated or Typed Name 7
(Official Seal) `.
Printed Name �fiC. Titl My commission expires: / /- U /�i
As electrical con r, l hereby certify that the electrical system
energized ready d as stated bo ready to be energized. Branch circuits will be Date of ackno ledgm nt ����R P /,q� wry
WrIc s4inature of Notary
Electrical Contrac or Signature
Na Printed or
�Y Typ ed Name
Printed Name ! isle I :;A (official ,cal)
M commission ex ires• I - O -: p 1syk L I t ��
As H VAC contrac r I hereby certify that the HVAC equipment b --, ! - b!!
( ) is ready ( ) is of ready to be placed in service_ am ate ofacknowled went
aware that the electrical systems will be ed as to ab r
Official gnature of Notary
r� ..
Mechanical Contractor Signature w LT w
Notary's Printed or Typed Name ;
Printed Nanio / itle , i fficial cal)
M Commission expires. I I - n - al t
As tumbing contra or 1 hereby certify that the Plumbing equip. J �� - A t " .-U l l ���� 01
is read Date of ackno .led
• y ( ) is of ready to be p! Cd in service. 1 am aware �
hat the electrical systems will be aeti ted as stated above.
Official gnatLire of Notary
Plumbing Contract r Signature m U WA L.TQ k) 7•�-►
�,�+ Notary's Printed or Typed Name,
Printed Name rrt 7o✓ Title "r V l 0 r ���- O icial Cal)
My commission expires: 71- ad -- ao l
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