114 Ocean Gate Dr early power release05/05/2017 11:36 904-2490703 BROOKS AND LIMBUAGH PAGE 01/03
#EARLY POWER AGREEMENT & RELEASE
CITY OF ATLANTIC BEACH
Electric power is requested now under the conditions and terms of this fully a ocoted Agroement & Release
Job Address:
Permit No, �`,(� 4- yawl-' Typo (Circle One):
We, the undersigned General Contractor and Electrician, understand and agree:
l
substitute l�m t'oj Final utanocNans o the � (ou ;'egnte of 0 Occupancy t must bebissued be(•orooccupanccyy,,
=ties such 1s at the eretion o the Bui drug let.
2, The City of Atlantic Eeech will make a ppgpial inspeg6on prior ro, the early power energizing. All rough
inapxNona most hxva prior Approval, including m e connections.
3. Occupancy qr use of the npw Fonstrucdon bcforq p t Mal C/O conydtutes fraud�Irnt use of the wdy
Ole actnc semce.uoh ncnpA tS expressly p�ghtbtt¢tl and penalt'xetl by The City of AtlmGc Boxab
Ordmatwennoes. A vto hour
of this Agreement aha 1 result in a request for prompt removal of electric aervicc
altar a twenty-four hour aotice.
4. "Ealy P at" mime a4thodty i the Elec cian as /or the Con)reglor must not coeur before:
a ag, ani, dcvrc and 13i%Woos arotnnamll (o b ar�ken ort) an
o. Pei is complete with grounding
rou di and cover, ete. r(le long required nr Bnel inspection).
C. Sec a o copneetiontem had safely ng is t tough
d. Tec r On i system has safely poaaed thrdugh electrical chock.
e.
Meter On iA permanently mar. wi, address.
f. Temporary address num on displays (Permanent numbers arc required for C/O).
5. This fully completed form is to be submitted to the Building Department by had, mail or fax.
6. Future such Agreements will not be accepted from those who violate any One of the above Items.
�.
CONTRACTOR DATE
PRINT NAME
ELECTRICIAN 13..7 1JL4.A.,1 DATE
PRINTNAMB n 1 ey, J. I i (nbc' „(�
1--4 (2517
800 Seminole Road, Atlantic Beach YL 32233
Phone. (904)247-0826 pax: (904)247.5845 Irttp://www,coobms revised 01 30 09