County of Moore
Planning and Transportation
Inspections/Permitting: (910) 947-2221
Planning: (910) 947-5010
Transportation: (910) 947-3389
Fax: (910) 947-1303
Revised 8/20/2015
Request for Conditional Power
The structure or dwelling located at _____________________________________________
and built for _________________________________________________________________ by
_________________________________(responsible agent) ___________(date), requests the
electrical system be energized conditionally for up to 90 days and the utilization of the
permanently installed HVAC equipment to maintain environmentally sensitive materials
or finishes in accordance with the manufacturer’s instructions. The responsible agent (listed
above) has notified all contractors including, general, electrical, plumbing and mechanical
and made them aware that the electrical system and associated equipment may be
Security and Notification
The responsible agent shall maintain the energized electrical system or that portion of the
building containing the system in a secured and locked manner or under constant
supervision to exclude unauthorized personnel from entering. The responsible agent shall
assume the responsibility to alert personnel working in the vicinity of the energized
electrical system to its presence.
The reason for the request ______________________________________________________
The portion(s) of the electrical system to be energized ______________________________
The responsible agent consents to all provisions of the 2014 N.E.C. w/ NC amendments.
___________________________________ ___________________________________
General Contractor (signature & date) Electrical Contractor (signature & date)
____________________________________ ___________________________________
Mechanical Contractor (signature & date) Plumbing Contractor (signature & date)
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