125 Ocean Gate Dr - Early Power : ' -. :A A EARLY POWER AGREEMENT & RELEASE
CITY OF ATLANTIC BEACH
4
Electric power is requested now under the conditions and terms. of this fully executed Agreement & Release
Job Address: I g s OC €cA fn Ga-k--e- i
le One
Permit No. 1 �- E�C - I � �1 3 S ervice Type (Circle One): Overhead ndergre nd )
We, the undersigned General Contractor and Electrician, understand and agree:
1. "Early Power" is purely for our construction convenience, it is not ar qu t bs u d beloae do no t
ands such is at d on of the Bu li di Official of Occupancyjffi
2. lns ectlons Atlantic ut ve prior Approva�.leincludulg inspection r base prior early power energizing. All rough
onnections,
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3. Occupancy or use of the new construction before a formal C/O constitutes fraudulent use of the early
electric service. Such action is expressly prohibited and penalized od prompt b The al of electric servi
O A violation of this Agreement shall result in a request
after a twenty -four hour notice.
kir
4. "Early Power" release authority is the Electrician and/or the Contractor and must not occur before:
a. Equipment, devices and fixtures are installed (or blanked off) safely.
b. Panel isltomplete with breakers and cover, and (labeling required at fmal inspection).
c. Service connection and grounding is complete.
d. The electric system has safely passed through electrical check.
e. Meter can is permanently marked with address.
f. Temporary address numbers displayed (Permanent numbers are required for C /O).
5. This fully completed form is to be submitted to the Building Department by hand; mail or fax.
6. Future such Agreements will not be accepted from those who violate any one of the above items.
DATE �( -` 1 I i(jil;:; CONTRACTOR
PRINT NAME Les P,e.-` l-..._ , 1 1. i/ DATE 1 1 � I
ELECTRICIAN V,�a ==. I h .
PRINT NAME j , 'Pi SS. 1 ` i a -`
800 Seminole Road, Atlantic Beach FL 32233
Phone: (904)247 -5826 Fax: (904)247 -5845 http: / /www.coab.us revised 01 30 09