HomeMy WebLinkAboutPower ReleasePlanning & DevelOPment Services
Building & Code Regulation Division
2300 Virginia Ave
Fart Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for, 30 -Day Temporary Power Release
Cate: _ Permit Number;
Project Address!
THE UNDERSIGNED HEREBY RE'QIIEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (3p) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS;
I. This temporary= power release is requested for the above stated purpose only, and there will be no
OccuParcy of any type, other than that permitted by construction during this time period.
As witness by aur signatures, we hereby agree to abide by all terms and conditions of this agreement,
Including Building Division Policy, which is incorporated herein by reference,
3, All conditions and requirements 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 extension beyond 30 days must be inade in venting to the Building Of ical stating
the reason for the request. Power may be removed from the site and/or a Stoop Werk Order issued if
the Final Inspeocrf has not been approved within 30 days. A fee of $100 00 will be required to lift
the StOP Work Order,
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 TRANSA(—UCN, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTIO I OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
TIER SIGNATURE
GENERAL COl`MPACTOR SIGNATURE
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DATE