110 Ocean Gate Dr early power release05/05/2017 11:36 904-2490703 BROOKS AND LIMBUAGH PAGE 02/03
EARLY BOWER AGREEMENT & RELEASE
41,
CITY OF ATLANTIC BEACH
{' u
Electric power is requested now under the conditions and terms of this fully executed Agreement & Release
Permit No.
We, the undersigned General Contractor and Electrician, understand and agree:
I. "uggarly Power". is u[oly for our cons crnGon,convcoie cc, it is nom¢ required by Codes and does no
ands eblvtuvc6 ti's eitcpft R�r�9cmtion of the Bui�6iVnCg Of i tits 0 �ccupancyjtnat must be issued b0 ON occupancy,
2. lnspacti"onefmust hev ep or A+)pproval, me d¢ig moor bfaosree cenneccttions.cetruly power energizing. All rough
3. GOO upatecaivic@�eu h aetimgp isasex�p coaly btrcoohib4tod end prnelizednbteff'hC+tyanof use of
mMacnnscs. p vie adon of this Agreement a all result in a request for p mpt removal of electric service
er a twenty-four hour notice.
4. "Early Power" releeae authority is the Electrician and/yyr the ontr�etor aappd must not occur before:
EE r ent, 4evlcea a d 13ztures are insmllod (or ott) safely.
a. PBeie ea connection and graundang tacrogvl (la o tag required at final IasPeedon).
d. The electric s tem had afcly asscd th RTc' lecMcal chock.
e. Meter can s pyeatmanend mUl d with e7VI ss.
f. Temporary e8dress numbers displayed (Permanent numbers are required for C/O).
S. This fully completed form is to be submitted to the Building Department by hand, mail or in.
6. Future such Agreements will not be accepted from those who violate any one of the above items.
CONTRACTOR , _ DATE
PRR4T NAME .—
ELECTRICIAN DATE ^ q12JS l I 1
PRINT NAME �V%��• fn
800 Seminole Read, Atlantic Beach PL 32233
Phone: (904)247-5826 Fait: (904)247-5945 hnp:/Iw w.coab.us revised013009