HomeMy WebLinkAboutBLDR-8-11-20834TEMPPOWERONBLD.tif A o 6C, =R T
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 projec w'
BLD 2W 1 I x083 y Job Title Di ; a,, n; PIN# 373 33$1n-y 7 Bldg # Unit #
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 INSPEC / ��� '
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1, hereby apply for temporary use of the permanent YQD amp ��`� 1 %,��i�
electrical service to the structure identified above. I authorize Date df a wle ent
billing of all renewals, if required, to the following active A = — NOTARY Z
Catawba County billing account numker, 5nt: Q,25 O fal signature of Notary = n PUBLIC U
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Owner or GC Signature Notao Printed or Typed Name %'9�
Printed Name rtle la S �0�+• —� My commission expires:
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A electrical contractor, I hereby certify that the electrical system �C?
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is ready ( ) is not ready to be energized. B h circuits will be WDate of ckno ledgment tV p s
energized as stated above. NOTARY Z
O�ficial signature of Notary s o PUBLIC V
Electrical Contractor Signature �t/ 2
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Notary's Printed or Typed Name
Printed Name/ V . SFl13t at.l�L Title `��
My commission expires: o1D, alDlz{ �� w'�j
As UVAC contractor I hereby certify that the HVAC equipment d=
is ready ( ) is not ready to be placed in service. I am Date of acknowled ment p
aware that the electrical systems will be c 'vated as s above. _ J NOTARY Z
O cial signature of Notary
Bo PUBLIC U
Mechanical Contractor Signature �^ '�a� �`�' ��j► ''��
Nota 's Printed or Typed Name
Printed Name � 4 Title vi//� � *toa , �
My commission expires: 0,
As� lumbing contractor I hereby certify that the Plumbing equip. l" t D I 1 ,`*� �, �i
( ./) is ready ( ) is not ready to be placed in service. I am aware Date o wled ent O'er f
that the electrical systems will be act i ted qs s ted ab ve. Offi gal si NOTARY Z
gnature of Notary
C) PUBLIC
Plumbing Contractor Signature -7 y 2
No 's Printed or Typed Name ;
Printed Name Tim Ao-r L a Title r N � i C 5 0
My commission expir es:
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