1805 Atlantic Beach Dr - Early Power r1�; �-' _� EARLY POWER AGREE] T & R �_._�•7� -.�s. .
CITY OF ATIANTIC BEACIT''.'.
Electric. power is requested now under the conditions and terms of this fully executed Agreement & Release
Yob Address: .
Permit No_ tS'S — 2,901 Service Type (Circle One). Overhead ndrrgro m.
We, the undo s%gned General Contractor and Electrician, understand and agree;
1. "Power uior our oonstnzction convenience, is na Rtu ' da and does n x
s for ous or #ha:.GQ.( care oFQceu F sn Diu autst be by issu befog oce upati` y
a5 Suoh is at a scretion of the Euildmg�cial.
2. The Ci f of,q tlantic Beach vvill make, a special invention prior to the . ly power energizing. ATI rough
inspections must have pnor Approval, including rooter base c ornections.
3. Occupancy or use of the new ranstruetioa before a formal C/0 coil? .rtes fraudulent use of the
O Ordinances. A violatio o f f rbus expressly _prohibited_ Abu r n u fa: • amp ier o 1 C C s wee
alter a twenty-four hour non
4. "Early power" release authority is the Elecaisian and/or the must not occur before.:
t ". Arent, ices and xtue ar nztaJled or lank
uqis caaxplot breake rs and. a m aa b beiiI rrqui a inspection).
c. Service connection and grounding is comp
d. The electric system has safely passed through ele icsl check.
t . Meeter m care is�crrn� Toyed zt7yy d vrith adt3�s.
T p o rary a3 (Permanent numbers. are P ;nixed for C/O).
5. This fully completed form is to be submitted to the Building Department y hand, mail or fax.
6. Future such Agreements will not be accepted from those who violate any on,e of the above items.
CONTRACTOR DATE V/ e4
PRINT NAME
ELECTRICIAN 01,4,.4 ' DATE
PRINT NAME f e ' � •
800 Seminole Road, Atlantic Beach a 3223:.
Phone: (934)247 -5826 Fax: (904)247-5845 Isttse//www..coab..ls sacvised 0'I 30 09
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