HomeMy WebLinkAbout07010216
Mel- R~
772-223-8228
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St. Lucie County
BuiJding & Zoning Departmenk
2300 Virginia Avenue ,.., ~ C ~
Fort Pierce, FL 34982 II;; I t/ ~ ......
772-462-2165 ~ U
Fax 772-462-6443 JUN 2 0 2001
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Request for 30-Day Temporary Power R.e. lease t. ((¡".'ie wO"''-
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Date: Permit Number: ~ r 0 ) - ö:; 0 ' F:L.
Properly Address: \ {;/ ¿';{ S ~ CI C.. -c::.¿~ .A....,-.. h ~. 1 ~ l~ 1 's
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THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE.;;:',~;,
ABOVI: DESCRIBED PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOt~~;!j
THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FOR FINAL"'~:'~,.~.,/;,
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INSPECTION. IN CONSIDERA TION OF APPROVAL OF THE REQUEST WE HEREBY "
ACKNOWLEDGE AND AGREE AS FOLLOWS:
:1. This temporary power release is requested for the above stated purpose only,
and there wiJI be no occupancy of any type, other than that permitted by construction
during this time period.
;! · As witness by our signatures, we bereby agree to abide by all terms and conditions
of this agreement, including Building Division Policy, which is incorporated herein by reference.
3 · All conditions and requirements listed in the attached document entitled
"Requirements for 30 Day Power for Testing" have been fuJfilled and the premise is ready for compliance inspection.
4 · AU requests for an extension beyond 30 days must be made in writing to the Building Official stating the reason
for the request. Power may be removed from the site and/or a Stop Work Order issued if the Final Inspection
has not been approved within 30 days. A fee of $100.00 will be required to lift the Stop Work Order.
WE HE:REBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND
THEIR EMPLOYEES FROM ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE
WHICF MAY ARISE NOW OR IN THE FUTURE OUT OF TIDS TRANSACTION, INCLUDING
ANY DilMAGE WmCH MAYBE INCURRED DUE TO THE DISCONNECTION OF
ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
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GENERÃLCONTRAC 'OR SIGNATURE
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DATE
DATE
ELECTR.::CAL CONTRACTOR SIGNATURE
DATE