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BUMIft&Code Re t11 DblafOA
�+kmi FL 34982
` OR 04 208
` .ST, k,ucleCounty,Perr 1tting
Request for 36-Day Temporary pew w-Rel5fte-
04/01/20 Permit Number: 1 2-0�479
pnv t At dress-' '5809 Spruce brive, Fort Pierce Florida34982.
THE UNDERSIC REBY#iE REQUEST�E'LeA E OF ELECTRICAL POV R TO THE ABOVE DES MIkD
PROPERI Y,FOR A PERIOD NOT TO Exam THIRTY(30)DAYS,FOR THE PURPOSE OF TESaNG SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPEC110N. IN CONSIDERATION OF AP,PROVAI.OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FMQY#S: i
,r
I. IM terr►porary power release is. for the above stated Purpose only,and tyre-WE be lw
t7r of acrir type,othtr UM
ti�et ptred by aunont dtrrirsg thts#irtte period.
I As wlb less by-out ftwbm,we lieriby agree to abide by all germs and conditions of this agreeraerk,
tridud'utg.&Mng Division may,vi hkh'Is InwrporaW hereeirt by reference.
3. A I norMWorrs and re*uramft lsted in the aftxtied document for X Day-
Pow, i
for Testing'have been Willed and the prem �ise is ready for kmecftL
4. ..AR
ram,for an e> siorr bey orrd days.mua be made in wing to the ElcrltrJ V Ottidai st�irig i
ttie reascan�r the+request. !fir tmy be renrowed'From die ste w4Ac r a SbopWak Orcier issued If
#w fired Ir>specdon has not been approved within 30 days. 'A fee of$100 00 WE be recpmrect to lit �
the work orb, _
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS,Sf.LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LLAB IES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE R URE t7UT
OF THLS M Ai'#Sf cnoN,INCLUDIM ANY DOME WHICH MAY BE WWKD DUE TO THE 1
DISC0fifft4CTION.OF ELECTRICAL POWER IN 7HE EVENT OF VIOL ATIt14 OF TM AGREEMENTS
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