Form Center

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)
    4. Svc. Change
    5. Other

11. TECO layout #

13. Called in TECO

14. by

16. TECO representative spoken to:

17. Date

18. Time

20. Approved by Building Official

21. Date

23. APPLICATION FOR TEMPORARY POWER RELEASE

24. Permit #

26. 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:

28. Address1

29. TECO Layout #

31. 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.

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

35. I hereby agree to the above stipulations

    Electrical Contractor

36. Date

38. I hereby agree to the above stipulations

    Building Contractor

39. Date

Leave This Blank:


40. Print Only

* indicates a required field