577 COASTAL OAK LN - EARLY POWER •
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U ' ..• n �4RLY POWER,1 +IYIEIVT`& LASE
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1 CITY OF ATLANTIC BEACH
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Electric power is requested now mnder the conditions and terms of this fitR
y executed Agreement<elettse !
Jab Addreer. !
'572 . �� ./ .:.4 lam/
Permit No. _ e,5 /8—O/S'? E
i Service Type(GYrcicOnc); Overhead nrgoiind J
We.the undersigned Gencrnl Contractor cu d$lectrician
underataad-and Pgree;
!, 'tarty Power". is Emrd fm oitr c pessi� 1
substttta Net:Ik�1 Tngpeetions or t?C/Q(C if a e ofOc cttpancyr at�n�ust be iisssueddbeforre.oce pu�nti not i
and as-such is Mille discretion of the Bu11ldimng Official.
2. The City of Atimitic Beach wit/make a special-inspc ion prior to the early payer energizing, All rough '
inspections must have pnorApprovat,iac udingmeter asecamtections. t
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3. Occupancy'r use Of the new construction before a rots»el C/O constitutes fraudulent'use or the I'
eidetic service. Sitch action. is expressly _ hibitec!Nuel pentdlzed by The.City of Atlantic Beach !
4twent -Tour tuiorlo t)tisQb'iee'tneiits3tnl result in request-tor.
after •
a n,enty iovrhouraottc8. E
4. "Serly Power"release.e.)ttbority s the Electrician and/or the Contractor and,nustscot occur.before:
i qui rnent,devices d fixtures-are installed(or blanked oft)safely.
b: Paneis cbtnple)e tvith breakers'and cover,and(labeling regtat final inspection). •ilred
• C. Service t;ornieciiou arid grounding is cemple a, I
e.d. The electric sySteai.has safely,passed through eieetricil check.
• Meter can is ttermr.uently marked withkddress
F Temporary ti dress nuinbets displayed(Permanent nunifiers are required for CIO).
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.5. Thls'rlttly completed form is to be-submitted to the Building Department by hand,mail or;nx. t
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' 6. ItnnLre•such Agreements•wIll liar benccopt¢ii from fhosa3yhoAdo/nteanyone of the boy items,
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CONTRACTOR. l',
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_____, ,_743___________ ! i
PRIt7TNAME . /'fQ�,fz—
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Air
ELECTRICIAN /4 _,[ ' 1
'PRINTNpNa_'Lc �
` /' DATE
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soaSenifnote head,AtlanlfeEetieh PL-32233
Phone:(904)249-532.6 Fax;(900247-04s liltp://www.ceinli.us revised Of 30'09
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