1763 ATLANTIC BEACH DR EARLY POWER REQUEST 08/22/2016 22:50 9042609608 TRICOUNTY PAGE 01/01
EARLY POWER AGREEMENT & RELEASE
7 CITY OF ATLANTIC BEACH.
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ElettAc power is requested now
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under the conditions and terns of this fully aveauted Agreanent I Relcose
Jobaddress: � 7(83 4tn-6C 13,eack P2, LOT 35
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Permit No, I I A —L;L{:C —Q2`7 Service Type(Circle One): Overhead Underground
We,the undersigned General Contractor and Electrician,understand and agree:
I. "Early Pofworsr",is Y. ' t
for our thcoosnuctlan convenience, it is .d¢ required iry Codes, and does rA�
sand u swh is et�thagmscmNonafthe Buf01d6mg M91 o'O"upanay)that muni he rasped before occuparrdY
2. The Ci
on,Musthave prior Apomuvalk�igcludinQ m hex comieMimu.early power energiemg. All rough
3. Occuvancy or use of the new construction before a d CIO constit�es fraudulem are of the em1Y
e4lleoh9c sernae. 9uph action i expressly alubite and penalucd by The City of At1aMc Be*
fter1 ancceiity violation
iour hl aur nonce$irei em sliPa�l result In a request zor prompt remo4et of elecMe service
4. "Ealy Power"release authority is the Electrician", or the Contractor and must not occur before:
s Equipmc=devices and f tr ues are inetm)le f blrmkad off)safely.
b. penal LS complete with breaheg�ss and cover,and ling requited at final inspection).
C. Sere'�a connection and grounamg lacpmpte'te,
d. at electric system has safal) assed Uauugn elechical check
e. Mweta caa ie ermenentlY reamed with address.
F. Temporary address num m played(Permanent numbers are requited for C/O).
S. This fully completed form is to be submitted to the Building:Depattmem by hand,mail or fax.
6. Future such Agreements will not be accepted from those who violate any one of the above home.
CONTRACTOR L%?e DATEcY /��o
PRINT NAMEv.' GYJ_
ELECTRICIAN DATE a a'3 I
PREJTNAbffi L __
600 Swiivole Road,Atlmtio Beach Fl,37.233
Phew:(904)2474826 Fez:(904)247.5645 h4://www.00ab.w rn66,101 30 09 i
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