Early Power Form 2011 04/19/2011 17:27 904 - 2490703 BROOKS AND LIMBUAGH PAGE 02/02
, >i%: EARLY POWER AGREEMENT & RELEASE
CITY OF ATLANTIC BEACH
•
Electric power is requested now under the conditions and terms of this fully executed Agreement & Release
Job Address: 9 a C ) I 2
Permit No. t V3 g Service Type (Circle One): Overhead F'fnderg
We, the undersigned General Contractor and Electrician, understand and.agree:
I. "Early Power" is purely for our construction { convenience, it is not required by Codes and does not
s ud t i t t such Final hInspections rei o
nf the e ip (Ce Ofi'la a of OccupaEcyriliat must be issued before occupancy,
2. The City of Atlantic Beach will make , u
a special inspection base connections,
to the, early power energizing. All rough
inspections must have prior Approval,
3. Occupancy e i service. e1 Suab action isnexprecslybprohibite nd C/O aeai constitutes T fraudulent i f Atlanti
Bead)
Ordinances. A violation of this Agreement shall result in a request tor prompt removal of electric service
after a twenty -four hour notice.
4. "Early Equipmen release es an is the
fixtures ar installed or blaContractor e f afellymust not occur before:
b. Panel is complete with breakers and cover, and (labeling required at :final inspection).
c. Service connection and grounding is complete. i electrical check,
d, The electric system has safely p through
e. Meter can is permanently marked with address.
f. Temporary address numbers disp (Permanent numbers are required for CJO).
5. This fully completed form is to be submitted to the Building Department by hand, nail or fax.
6. Future such Agreements will t be accepted from those who violate any one of the above items.
"D QQS� ) (s \h. ° DATE C. �' 1ci- - 1
CONT ACTOR ,
PRIM NAME 1 T ``
I I �• r DATE
ELECTRICIAN 11.091 N1'! dam,
PRINT NAME r Jt
800 Se uinole Road. Atlantic Beach 71.32233
Mote: (904)247 -5826 Fax: (904)247 -5845 http: / /www.coab,us revised 11.29.06
l'd Z89809Zi706 KLLY1130 dLe:901161•adV