HomeMy WebLinkAboutElectrical Release AgreementST. LDCIE COUNTY
BUILDING DEPARTMENT
,yl ELECTRICAL RELEASE AGREEMENT C{
cV
APPLICATION DATE
OWNER Paragon -of rth-Hutchinson 'ISIa_nd PHONE
CONTRACTOR Blue Ridge', -Harbour Coye, PHONE
461-4846
461-4846
BUILDING PERMIT NUMBER 95-03160 RECEIPT NUMBER
ADDRESS 4400 North A1A Hutchinson Island, FL 34949
PERMIT DESCRIPTION Paragon Units 3South thru 13 South
RELEASE OF ELECTRICAL POWER IS REQUESTED FOR:
REASON: Temporary Electric
NUMBER OF METERS REQUESTED 11
ACKNOWLEDGMENT AND AGREEMENT:
Release of electrical power ie,requested for the above stated purpose only. There will
be no occupancy of any type, other than that permitted by construction during this time
period.
i•
As witness by my signature, I do hereby agree to abide by all the terms and conditions
of this agreement, including Building Division Policy, which is incorporated by
reference as herein. I do further agree and permit St. Lucie County tohave electrical
power disconnected for any violation of this agreement.
I (print) intending to be legally bound, hereby release
and agree to hold harmless, St. Lucie County and their employees from all liabilities
and claims of any type or nature which may arise now or in the future; out of this
transaction. Including any damages I may incur due to the disconnection of electrical
power. I further agree to indemnify St. Lucie C nCy and the employees from and
against any claims, damages, losses and expenaee nc ud'ng for y s fees arising out
of, or resulting from the execution of this agree} C6Sfos °1$
Building CodesrSu�ervisbr DATE
,w, y „ CLAUDIA D. COYNE
SZ
?' MY COMMISSION 8 cc 192086
y. �. EXPIFIES:May4.1996 -
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O C C U P A N C Y 1 8 N O T
5-a -41�
DATE
(OWNER/PERMIT QUALIFIER)
Sworn to and subscribed before
me this day of
A.D., 19
Notary Public /
State of Florida
toy commission expires
P E R M I T T E D