HomeMy WebLinkAbout30 day power t i
i t
is �, � Planning &`Qeve[oQment:Serv"rces.
ng.&.Code Regulation. l 4VISI
2300Virg n a,Ave,
I, Fort Piercer FL 3498.2
772 462?21.65 Fax.772462#0443
i
i Request for 30-Day Teinporary`PoWer,R'61'i .
. i
Date:; 4/15/2020 Permit Number, 19050117
{ Project Address _ 1-0729 South-Ocean Drive, LOT 32,Jensen Beach, FL
_ .
s
I
THE-UNDERSIGNED HEREBY REQUEST-f2ELEi45E OF EL' RICAL"'POWER,TO THE ABOVE DESCRIBED
PROPERTY; FOR'-A.-PERIOD NOTTO_EXCEED THIRTY (30).DAYS, FOR THE_PURPOSE OF TESTLNG>SYSTEMS
AND:EQUIPMENT IN PREP ARAT'ON'.'FOR.A FINAL INSPECTION.: ;IN.CONSIDERATION`:OFAPPkOVAL.OF THEj
REgl EST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS::
i This:temporary;power release is requested for,the:above-stafed,purpose on(y and therewilL be:no
occupancy of.any type,_othe&-than that permitted by.mnstruction during,:this time period.,;
Ii As witness by our signatures;_.we hereby agreeao abide by all,'terms:_and.conditions_of this;agreement,;
including Building Division Policy, which is incorporated herein,by reference.
I, All conditions-and requirement§!listed in the:.attached_.document.-entitled-"Requirements for.,3,( ay,
P.ow.er:::for'Tesfing"have._been:fu{filied'and theprefN§e ia.-ready for corCipiianee_inspection
4.. All ------ts'for an eXtension beyond 3o day_s must_be-mad'e h,writing to.the Building Official.stating
the reason for the.,request. Po.Wer may be;remoyed from=the siteand/oe a.Stop,Work Order Issued if'
the,FriaPTnspectign_.-as not.been'_approved_withlh go--days: A fee pf;$lOQ O-Q will be req_uired.;toIif'
,the S;top'Work:Order: :.
WE HEREBY RELEASE{AND AGREE TO"HOLD HARMLESS ST::LUCIE COU{VTY ANb.THEIEt Ef�1PLOYEES,FRONT:
__ _ _.
ALL_LIABILITIES'AND CLAIMS.OF ANY TYPE 0E NATUREWHICH_M&(ARISE NOW OR,IN;THE..FUTURE OUT'
OF THIS TRANSACTION,:INCLUDING,ANY DAMAGE.,WHICH MAY.6E INCURRED.DUE.TO9 THE
DISCONNECTION OF ELECTRICAL POWER�I-N THE EVENT OF VIOLATION OF TH15 AGREEMENT;
,I
4/15/2020 '
OW SIG .T.U.RE DATE
GE. RAL�CO r. .
4/15/2020
z
'DATE;, i
2d2C
.ELECT „CAL-00N1`RACTQR SIGNATURE' DATE.
- 4
SI