Conditional Power Application

10 CONDITIONAL POWER FORM Johnston County Inspections Department 309 E Martket Street Smithfield , NC 27577 Phone 919 989 - 5060 Fax 919 989 - 5431 Date Utility Company Permit No Premise No Owner Type of Project Project Township Address Before the authorization to the utility company for electrical power to the above structure , a thorough inspection and checkout has been made by each of the trade contractors listed below to ensure to the best of their ability that the electrical , plumbing , and mechanical systems in this structure are complete enough and in safe working order to safely energize power for temporary use as attested by the signatures below Conditional power will be disconnected if Certificate of Occupancy has NOT been issued within the the days approved Owner General Contractor Name Signature Electrical Contractor Name Signature Mechanical Contractor Name Signature Plumbing Contractor Name Signature This conditional power certificate does not exempt a final inspection by the building code official for the issuance of Certificate of Occupancy and Compliance and the main disconnecting means may be deactivated in order to disconnect the power to safely perform the final electrical inspection If the final electrical inspection is approved and a Certificate of Occupancy and Compliance is issued in accordance with GS 153A - 363 , the conditional power certificate will be considered the approval for permanent electrical power to the structure OFFICIAL USE ONLY Date of Inspection Inspector Commercial 60 Days 90 Days Residential Project 30 Days ONLY Project Payment 75 Paid On Paid by _________________________________________________ __________________________________________ Cash Check Visa Master CardPage