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Form B21 Page 1 of 1 Revised 10/10 TEMPORARY POWER AFFIDAVIT STATE OF FLORIDA COUNTY OF BAY Permit Number: Project I, the Contractor of Record, agree and accept all responsibility to have Temporary Power turned on at the above listed project address. At any time prior to issuance of a Certificate of Occupancy, I authorize the County to have power disconnected from the building or premises noted above. I acknowledge that authorization for Temporary Power is for a period of 90 days from the date permanent power is applied and an extension of 90 days may be granted if requested. I affirm that this building, nor any portion thereof, shall not be occupied without the issuance of a Certificate of Occupancy. Violation of this will result in cancellation of Temporary Power. Contractor Bay County Builders Services 840 West. 11th St. Panama City, FL 32401 [PHONE REDACTED], Fax [PHONE REDACTED]