HomeMy WebLinkAbout30 day tempST W-C-1 E
COUNTY
F t O R I o A
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, Ft. 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date- _ Q Permit Number:
Project
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 pF APPROVAL OF THEREQUEST WE HEREBY ACKNOWLEDGE ANO AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpose 0111y, and there will be no
oc"Pancy of any tYpe, other than that permitted by construction during this time period.
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.
3. All conditions and requirements listed in the attached document entitled "Requirements For 30 Day
Power for Testing" have been Fulfilled and the prernise is ready for compliance Inspection.
I. All requests for an extension beyond 30 days must be made in writing to the Bu11ding Official stating
the reason for the request. Power may be removed from the site andjor a Stop Work Order issued if
the Final Inspeogf) has not been approved within 30 days. A fee of $100.pp will be to l
the Stop Work Order. required ift
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF MATURE WHICH MAY ANISE NOW OR IN THE FUTURE OUT
OF THIS TRANSAC"l70N, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
IGNATURE
GENERAL CONTRACTOR SIGNATURE
Ci-LL-i ruuMt 4UfN I KA(-IQR -SIGNATURE
DATE l
------LC
DATE
l o
DATE
2
I2—