303 10TH ST - EARLY POWER From:Mike Lore Fax:(904)373-9018 To: Fax: +1 (904)2475845 Page 4 of 4 06124/2016 1:38 PM
T EARLY POWER AGREEMET & RELEASE
CITY OF ATLANTIC BEACH
Electric power is requested now under the conditions and terms of this fully executed Agreement& Release
Job Address: t
% t C t41' Sir ea-1- A n t- 6 1
Permit No. 1S � C C - 2t � Service Type(Circle One): Overhead ndergroun
We,the undersigned General Contractor and Electrician,understand and agree:
1. "Early Power" is purely for our construction convenience, it is.mit required by Codes and does not
substitute for.Final Inspections.orthe CIO(Certificate ofOccupancy�Tiat must be issued before occupancy,
and as such is at the discretion of the Building Official.
2. The Cid of Atlantic Beach will make a.special inspection prior.to the.early power energizing. All rough
inspections must-have prior Approval, including meter base connections.
3. Occupancy or use Or the new construction before.a' formal ..C/O constitutes fraudulent use of the early
electric service. Such action is expressly prohibitedand penalized by The. City of Atlantic Beach
Ordinances. A violation of this Agreement shall result in a request for prompt removal of electric service
after atwenty-four hour notice.
4. "Early.Powgr"release authority is the Electrician and/or the Contractor and must.not occur before:
a. Equipment,devices and fixtures are installed(or blanked o.ff)safely.
b. Panel is.t.omplete.with breakers and cover,'and(labeling.required at final inspection).
c. Service connection and grounding.is complete.
d, The electric system hassafely passed through electrical check.
Meter can is permanently marked with address.
t. Temporary address numbers displayed(Permanent numbers_are-required for CIO).
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.
CONTRACTOR �Olt kktiNL,LL DATE (
PRINT'NAME � E vLE rJ a)
ELECTRICIAN L6 cam_. Azctr' \Co--.�c'osAd S DATE (0-2..L - 1
PRINT NAME f\tc e\ re.
800 Seminole Road,Atlantic Beach FL.32233
Phone:(904)247-5826 Fax:(904)247-5845 Iittp://www.coab:us revised 01 3009