Conditional Power, Water & Gas Application (Fillable)

10 Conditional Utility Form Phone 919 989 - 5060 Email Inspections @ johnstonncgov Applicant Name _____________________________________________________________ Contact Number ______________________ Email _______________________________ Project Address ______________________________________________________________ Permit Number _______________________ To qualify the following conditions must be met ? A completed application shall be approved and a 75 fee per trade fee applies to residential only paid to the inspections department prior to inspections ? The applicant shall maintain the energized electrical system or that portion of the building containing the energized electrical system in a secured and locked manner or under constant supervision to exclude unauthorized personnel The applicant shall alert personnel working in the vicinity of the energized electrical system to its presence ? The grounding electrode system shall be complete and all grounded grounding conductors shall be terminated in the service equipment ? The portions of the electrical system that are to be energized are complete and physically protected ? The service wiring and equipment , including the meter socket enclosures , are installed , the service wiring terminated , and the service equipment covers installed ? At least one receptacle outlet with ground fault interrupter protection for personnel is installed with the circuit wiring terminated ? The integrity of the electrical , mechanical and plumbing systems shall be maintained in a safe condition ? The structure shall not be occupied until all final inspections have been approved , all fees have been paid , and a Certificate of Occupancy Completion has been issued ? Temporary electrical service , water and fuel gas connection may be granted for a period of up to 90 days If final inspection is not made within the 90 day allotted time , the Power Gas Water provider will be notified for utility disconnection ? The electrical contractor shall list on this application specifically which electrical circuits shall be energized ? The mechanical contractor shall list on this application specifically which equipment shall be operational ? Any gas appliance or plumbing fixture not installed at conditional shall have a cut - off and be capped ? All interior and exterior finishes must be installed before conditional inspections can be scheduled Please check the following that apply Conditional Power Electrical Contractor Name Print __________________________________ Electrical Contractor Signature _____________________________________ Utility Provider _________________________________________________ Electrical Circuits to be Energized ______________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________PageConditional Gas Mechanical Contractor Name Print __________________________________ Mechanical Contractor Signature _____________________________________ Utility Provider ___________________________________________________ Mechanical Appliances to be Utilized ______________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Conditional Water Plumbing Contractor Name Print __________________________________ Plumbing Contractor Signature _____________________________________ Utility Provider __________________________________________________ It is the responsibility of the applicant to inform ALL personnel on the project site that the meter is energized Installations shall be in compliance with the current North Carolina Administrative Code and the North Carolina Technical Codes See NCEC Amendment 108 for Temporary Power I acknowledge that I have communicated , secured , and notified as required in the above and agree to all terms as set forth in this application If UNSAFE conditions are noted any time after temporary approval , utilities may be disconnected immediately _____________________________________ ________________________________ Signature of Applicant General Contractor Date Sworn to and subscribed before me this_________ day of___________________ , 20______ Notary Public_____________________________ My Commission Expires ____________________ SEALPage