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Jun 13 07 11:47a
HOMETEC BUILDERS
772-288-2139
p.1
REQUEST FOR 30 DAY TEMPORARY POWER ~ELEASE
DATE:~_i/ -0'7-
PERMIT NUMBER:
(!J~/~- O~
ST. LUCIE COUNTy BLDG. & ZONlNG-
- 2300 VIRGINIA AVE
FORT PIERCE, FL 34952-5652
Ph. (561) 462-2165
FAX (561) 462-1148
PROPERTY ADDRESS:
~()~ ~46~ b~ (r"r--. Prt!t2cf r' PI
THE UNDERSIGNED HEREBY REQUEST RELEAsE OF ELECTRICAL POWER TO
THEABOVE DESCRIBED PROPERTY. FOR A PERIOD NOT TO EXCEED TBIRTY ~3(þ)
DA YS, FOR THE PURPOSE OF TESTING SYSTEMS AND EQUIP:MENf IN
PREPARATION FOR FINAL INSPECTION.. - IN CONSIDERAnON OF APPROVAL OF
THE REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1.. This temporary power release in requested for the above stated pUrpose only,
and there will be DO oecupUcy of any type, other than that penuitted by
eonstrnetioD duJjng this time period.
2. As witness by oar signatares, we hereby agree to abide by aD terms ~D~
conditionS of this agreemeat, iud1lding Building Division Poley, which is
incorporated herein by refereaee.
3. All eonditioDS ~d requiremeå.ts fisted ÙI the ft~ed dceumeDt eatJ'tIed
°RequiremeDÞ for 38 D2Y Power for Testiag- h~e bem fulfilled ~nd the
premises is ready for compliaDee .Î8SpeetiOD. ·
WE HEREBy RELEAsE AND AGREE TO HOLD HARMLEss, sT'-'LUCIE COUNTY,
AND TBElREMPLOYEES FROM ALL LlABILlT.IEs AND CLAIMs OF ANY TYPE OF
NA11JRE WHICH MAV ARISE NOW OR ~ THE FUTURE OUT OF THIS
TRANSACI10N, INCLUDING ANY ,DAMAGES WHICH MAY BE INCURRED DUE TO
THE DISCONNECTION OJ'ELÈCTlttCAL Pd"WERINTiŒ EVENT OF VIOLATION OF'
THIS AGREEMENT.
c.. BUt I ~~ -I~c-
M~ c:(. ß,!~ l/)ens' 'I:.vc
RAL CONTRJ.\.crOR
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SIGNATURE
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SIGNATURE
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ELECTRICAL CONTRAcroR
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SIGNATURE
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