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City of Oldsmar Record of Power Release

2. RECORD OF POWER RELEASE
   POWER RELEASE RECORD OF TECO NOTIFICATION

   POWER RELEASE RECORD OF TECO NOTIFICATION

4. Permit #

5. Contractor/Electrician:

7. Address

8. Owner name

10. Request

    1. T-Pole
    2. TUG
    3. CO (issued-transfer account from contractor to Owner)

    1. Svc. Change
    2. Other

12. TECO layout #

14. Called in TECO

15. by

17. TECO representative spoken to:

18. Date

19. Time

21. Approved by Building Official

22. Date

24. APPLICATION FOR TEMPORARY POWER RELEASE

25. Permit #

27. Dear Sir/Madam
    The City of Oldsmar will release the electric meter for the purpose of checking equipment and controls at the following address:

    The City of Oldsmar will release the electric meter for the purpose of checking equipment and controls at the following address:

29. Address1

30. TECO Layout #

32. With the following stipulations:
    1. No circuits except those approved by the Building Official shall be energized. 2. All panels and disconnects shall be locked in the off position when electrical Contractor is on the site, except as otherwise approved by the Building Official. 3. A final electrical inspection must be passed.

    1. No circuits except those approved by the Building Official shall be energized. 2. All panels and disconnects shall be locked in the off position when electrical Contractor is on the site, except as otherwise approved by the Building Official. 3. A final electrical inspection must be passed.

34. Any deviation from the above will result in termination of the electrical power without notice.

36. Electrical contractor: ______________________________________________________
    I hereby agree to the above stipulations

    I hereby agree to the above stipulations

37. Date: __________________________

39. Building contractor: _______________________________________________________
    I hereby agree to the above stipulations

    I hereby agree to the above stipulations

40. Date: __________________________

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