HomeMy WebLinkAbout30 day91920
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce., FL 34982
772-462-2165 Fax 772-462-6443
He nest for 30-Day Temporary Power Release
Date: z z �o�za
Perm€t Number;____ � o�
PrnJect Address: 3 4-2- Z-,� .
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL---� PROPERTY, FOR A PERIOD OT TO EXCEED THIRTY (30) YS, FOR TH-� PURPER To OSE OF TANG
AND EQUIPMENT IN PREPARATION 1=0R A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
I. This temporary poer release is requested For the above statedPurpose
occupancy of` any il,4,
Re, other than that Permittedd by constructiodurinthisytime perand iod will be no
2• As witness by ournatures, we hereby agree to abide by all terms and conditions of this agreement,
Including Building f IVlsian Policy, which is Incorporated herein by reference,
3. All conditions and r qufrements listed In the attached document entitled "Requirements for 30 Day
Power for Testing" have been fulfilled and the premise Is ready for compliance Inspection.
4. All requests For an xtension beyond 30 days must Official staking
made In writing to the Building
the reason for the r quest. Power may be removed From the site and/or a Stop Work Order Issued if
the Final inspection has not been approved Within 3O days. A fee of $10a.00 will be required to lift
the Stop Work order.
WE HEREBY RELEASE AND ,
A' REE TO HOLD HARMLESSST, LUCIE COL!
ALL LIABILITIES AND CLAIM OF ANY TYPE OF NATiZE , AND THEIR EMPLOYER OF THIS TRANSACTION, INC UDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE S FROM
WHICH MAY ARISE NOW OR IN THE FUTTIRE OUT
DISCONNECTION OF ELECTR CAL POWER IN THE EVENT OF VIO � iATIDN OF THIS AGREEMENT,
)WNI=R,$IGN
DATE
;EN AL CONTRACTOR�SIGNA�RE
CONTRACTOR SIGNATURE