HomeMy WebLinkAbout30 day power release Olanning &Development Services
Building & Code Reguiationi Division
LS
2300 Virginia Ave
LEM, .. ort Pierce, FL 34982
772-462-2165 Fax 772-462-6443 ��o°�
Request for 30-Day Temporary Power Release
f'� /J�/
�. ate: 4W1
V
Permit 1,{;uttlfi.rera ._ 0 Y -._..!5
T Peof Address: &CI- ?pt -S -WOC-
THE UNDERSIGNED HER BY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE D..; I is �
;RO :TY, FOP A PEBm'y�S75�.3t€D a�NOT7 T O E)CCEEE�i}THIRTY
g(30)�DAYS,gi�C�RT�+§,F,PURPOSE yOF l SING Stet gFE,MS 1
AND, }IPMENT IN P'S EPA.['A{ION R A FINAL SAL I'NSPE �10N. IN lONSIiai_RA 0 ION �. f Pr•'+P�'�PRO'V L Or E
R �1F.. ::'E HERE13Y ACKNOWLEDGE XND AGP'EE AS FOLLOWS: j
3. Th-,temparary WA er mqease rs requested fir the above stated psrj ty,aW Erre be-rto
6:cupancy of any t°rte..,OthzTitwa ti7at PC rmitted tr/CCnstndidz3 doming this Vnie pe--4ra.
2. As wiVC s j our signat res, 'we fteret7y ag-ree tit abXe b,/a€1 tarns and cogs i ns of thn men,
in ng Eui DM§on Poficy,DM' t;ch N it ted here;n by reference.
A!?conditiom and rejuk'emenLs is in ttr at we dDvj"VnL enter,`Require lr frr 33 Day
Pawer fanTrig'eve been f0i'--d aced the pitfais€,is ready fGr campiia,i?ce inspecian,
41?peticss for an c e. n , 170<a rnntis;b made in wrung to the Sui dir Offa '. �zng
tr*rea�w for if*reqez Pcwier mar be mmyed rtom the site andlor a Stop Wo,*Owff L;sj :,;f
i d I ` "` n nas notn apDrv. wiftn 30 dags. A fee of sIQ0.t0*r�-zi3 regwred to fil`
WE HEREBY RELEASE 949 ASE TO HOLD HARMLESS,ST. LUCIE COUNTY, AND THEIR EMPLOYEES PROI-4
ALL LIA611171E.S AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE ?E CUT
YX T H[5 IR4NS.ACYION,INCLUDING ANY i7f`+-fAGf:WHICH MAY BE INCURRED DUE TO THE
01SC01-4 tECTICN'OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
DATE
*�¢ COl4 dATURE OATS
�Y .`-)7 t
ELECTRICAL C0NTRAC`7 R,SGuA3 uP::-: Df TE
Scanned with CamSCanner