DSC4262013
1130 Bluffs Parkway
Canton, GA 30114
P 770-721-7810
www.cherokeega.com
dsc@cherokeega.com
PROJECT
Temporary Construction Power
This electrical permit is issued to provide temporary electrical service to the construction site of the building
or work authorized by an active building permit. Use of the temporary electrical service is limited to:
Residential building permit - 90 Days (following approved rough inspection)
Commercial building permit completion of construction
An extension may be granted, provided the applicant submits request before expiration date to the Building
Official.
Job Site Address
Permit #
Subdivision
Lot#
Suite #
Zip Code
Description of work
NOTE: Owner/Tenant is not allowed to occupy the residence, building or suite on temporary construction
power. Final inspection and a certificate of occupancy are required before occupancy.
CONTACT INFORMATION
Applicant Name
(please print)
Phone #
Electrical Contractor Name
(please print)
Email
State License Number
Expiration Date
Company Name
Business Phone #
Company Address
Company Email
AUTHORIZED SIGNATURES
The service equipment for the above referenced job location has been installed in accordance with all applicable codes. Cherokee
County Inspections Department will be contacted when the service conductor and service switch are ready for inspection. Cherokee
County and its building inspectors are hereby relieved from any liability, damage, or loss associated with connection or disconnection
of this temporary service.
__________________________________________________________________________________
NAME OF LICENSED ELECTRICIAN
SIGNATURE ______________________________________________ DATE __________________
This _____ day of ______, 20____.
____________________________________
(Notary Public Please notarize with official seal)
SEAL