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FROM :Construction Team D G
FRX NO. :772 429 0742
Ma~ 7 2006 02:52PM Pi
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Request for 30..Day Temporary Power Release \"0", //
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Permit Number: Sc....c. -en (:J.. 0 'Zll '1
St. I.,ucle County
Building & Zoning Ðepar
2300 Virginia A venue
Fort Pierce, FL 34982
772-462-2165
Fax 772-462-6443
Date: $ / 7/C)?
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Property Address: (Q$o--~~~e ~,æl<..
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE
ABOVE DESCRIBED PROPERTY, FOR A PERIOD NOT TO EXCEED mlRTY (30) DAYS, FOR
THE PURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARA nON FOR FINAL
INSPECTION. IN CONSIDERATION OF APPROVAL OF THE REQtÆST WE HEREBY
ACKNOWLEDGE AND AGREE AS FOLLOWS:
J. This tempon.ry power release JI requested for the .bove stated purpose only.
.nd Jbere .ill bf no oCèQPàncy IJf any t)'pe, other than that permitted by œllStruetlon
durlnl tills time period.
2. As ,,'Itn_ by our signatures. we he~b1 _,ree tQ .bide by aU tenas..d andldollS ,
or thlt a,.mentt Includfnø BuJlclfnl Dlylslon Policy, wllldl J, JOef)rporated 1t_la by retereDee.
3.. All (ondltlo... and reqalnmentlllsted ta tbe atllched documenl entitled
"RequlNllellts for 30 Day Power tor Testl.·' Ia.~ betn fulDllecI and die pftlhJse Is ~y tor coDlplla~ce laspectlon.
4. AU requests for an exteDsJOII be10nd 30 cia", must be made in wrltlnlla the BulldlaJ OIl1d.lstadaJ the reason
for thè request. Power may be removed from tile .ite .ad/or a SlOp WOIt Order '_eeI If die Na.,I.spectlo.
has nof been approved within 30 days. A fee of $100.00 ~JII be required to un &he Stop Work Onlft'.
WE HEREBY RELEASE AND AGREE TO HOLD HÁRMLESS. ST. LUCIE COUNTY, AND
THEIR EMPLOYEES FROM ALL, LIABILITIES AND CLAIMS OF ANY TYPE OF NA TURE
WHICH MAY ARISE NOW OR IN THE F1JTURE OUT 0' THIS TRANSACTION, INCLUDING
ANY DAMAGE WHICH MAYBE INCURRED DUE TO THE DISCONNECTION OF
ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.