G:\Zoning 2009\Forms and Sample documents\Website Documents\Building\Forms\ electric30daytemp.pdf Modified: 10.22.2012
City of Pompano Beach
Department of Development Services
Building Inspections Division
100 W. Atlantic Blvd Pompano Beach, FL 33060
Electrical 30 Day Temporary Permit
Phone: 954.786.4670 Fax: 954.786.4677
FLORIDA BUILDING CODE, BROWARD COUNTY AMENDMENTS- SECTION 112.2 SERVICE UTILITIES
112.2 Temporary connection. The Building Official or Chief Electrical Inspector may authorize the temporary connection of the
building or system to the utility source of energy, fuel or power for the purpose of testing building service systems or for use under a
temporary Certificate of Occupancy.
112.3 Energizing Systems: It shall be unlawful for any person, firm or corporation to energize any wiring system or portion thereof
until the electrical work has been inspected and approved and the responsible person, firm or corporation is authorized by the
appropriate governmental jurisdiction to energize the system.
The following statement is to be executed by the owner, firm, corporation or electrical contractor (electrical contractor must sign if no
electrical final has been given) of the premises on which the (30) day temporary electrical service is requested. (FEE $50.00)
THERE WILL BE A CHARGE FOR THIS INSPECTION.
It is understood that the (30) day electrical approval by the electrical inspector given in connection with the
building being constructed under Permit # _________-____________________ at the following location:
____________________________________________________________________________________________________________
Name
____________________________________________________ __________________________________________________
Address City/ State/ Zip
_____________________________________________________________ _________________________ ______________
Subdivision Block Lot
_____________________________________________________________ ___________________________________
Folio # Phone Number
Is being approved only for construction purposes of for testing the following equipment:
_________________________________________________________________________________________
Such approval is in no event to be considered a release of said structure for purposes of use and occupancy.
Check one:
□
Electrical Contractor
□
General Contractor
□
Owner
STATE OF FLORIDA ________________________________________________
- COUNTY OF BROWARD
Signature (of Electrical Contractor, General Contractor or Owner)
Sworn to (or affirmed) and subscribed before me this
______ day of ___________________, 20 _______ by Date ____________________________________
___________________________________________________.
Type/ Print Owner's Name
___________________________________________________
NOTARY (print or stamp) as to Owner or Agent (Signature)
Name & Title ________________________________________
Personally Know ___ OR Produced Identification _____
Type of Identification Produced _________________________
