HomeMy WebLinkAbout30 day power release Planning & Development Services
µy. Sullding &Code Regulation Division
e 2300 Virginia Ave RECEIVED
• Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443 APB zoza
Permitting Department
St.Lucie county
Request for 30-Day Temporary Power Release
Date: 4-ISao PermitNumber:
Project Address: 53 5 S e_ �Q��
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY(30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HERESY ACKNOWLEDGE AND AGREE AS FOLLOWS: s
1. This temporary power release Is requested for the above stated purpose only,and there will be no
occupancy of any type,other than that permitted by construction during this time period. t �'
2. As witness by our signatures,we hereby agree to abide by all terms and conditions of this agreement,
including Building Division Policy,which is Incorporated herein by reference. k
3. All conditions and requirements listed in the attached document entlUed"Requirements for,30 Day
Power for Testing"have been fulfilled and the premise is ready for compliance Inspection. f
4. All requests for an extension equ 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 3
the Stop Work Order. .
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WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE F
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT. 1
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Q t lk SIGNATURE DATE
GENERAL CONTRACTOR SIGNATURE DATE
y-14 .30a.o
ELECTRICAL CONTRACTOR SIGNATURE DATE
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