HomeMy WebLinkAboutELSFR2026-002996 (2)CITY OF GRAPEVINE
TEMPORARY ELECTRIC RELEASE
Temporary electricity has been requested for the purpose of construction,
remodeling, addition or improvement to the following described property. It
is understood that this release in no wav authorizes occuoancv of the
building. It is further understood that this temporary release is for a thirty
(30) day maximum time period and the undersigned releases all claims that
may occur through accidents or spoilage of any type resulting from said
electric power being turned off at the end of the thirty (30) day maximum
time period.
ADDRESS LOCATION OF TEMPORARY ELECTRIC RELEASE:
ADDRESS:
PERMIT NUMBER:
�_ _CONTRACTOR INFORMATION
INZ. AME OF APPLICANT: =�a 21411l - " (_
ADDRESS OF APPLICANT: //yy� 'ia
CITY, STATE, TIP: �>4meu'M' (X %0-5'
TELEPHONE NUMBER:6y
INSPECTIONS FOR TEMPORARY POWER MUST BE REQUESTED
AT (817) 410-3010
�OA'L �c�cw r �l -23^26
0—NATURE: PRINT NAME: DATE:
Z�23/2 (o
fLD NG OFFICIAL ~SSG DATE:
6FORM5w CONTRCTOR FORMSTEMP ELEC do
,gizmo Remsro anoroz