1698 Maritime Oak Dr - Early Power � : :t�
EMILY PUwE t AG��+TT & j.J i1S
CrrY OF Amt... ITCIc BEACH' . .
Electric power is requested now under the conditions and temps of this fully executed Agreement el Release
Job Address { � i �iwr cat
Permit No. Service Type (Cir.& One): Ov ndergrouud
We the undersigned General Contractor and Electrici2n, understand turd agree:
1. `Early Power is purely for our consfr ction convezuenca. it is par squired by Cod and and does n
t
artd ol is at , etro o7 i3uildtr gg D ." OacuP�y trust be tssucd b are oe pan'c ,
2. The City of Atlantic Beach will make a spcciat insper;tion prior to tb • ly power energizing. All rough
inspections must have prior Approval, incluuo rg er vase ,co wecuons.
3. Occupancy or use of the new conatruotion before a formal C/O co& rtes fraudolent use electric servtcesr lati actig�t� rs expressly prohibited and pen$li y A of the earl
after twenty-four A via on of t et �s �lgreem A 11 r in a xequest'fo: mtpt removal of eec C
after a boor notice.
4. "Fatly Power' release authority . the Electrician /or the or and must not occur before:
igeupmeu4 s nd �es ar instul (or a surly.
b, aae is comi a wit b ' and e t
cover tact (] g regelred arliaaI
c. Service cannon and grow mg is comp'I e. r oq)
d. The elect ric system has safely passe#! thro i electrical check.
e. Mcan i5 anen miarke wr r aeaa
Tem porary e a n ers displayed (Pe anent numbers are r• *auired.for C/O).
5. This folly completed form is to be submitted to the Building Department ••,v hand, mail or feet.
Future such, Agreements vela not be accepted from those a who violate any one .of the above items.
CONTACTOR DA's /!4
PRINT NA. fy((4 e—
d"
ELECIRICLAN 1
/ �_.. DATE
AR1NT NAlI£ zar J - e
800 Se rninolc Road, Atlantic Beach PL. 3223 ".
Phone: (904)247 -5826 Fax: (904)247 -5845 http /Jwwtivsoab. :4 revised 0130 09
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