HomeMy WebLinkAbout30 day power request 10-12-'20 10:58 FROM- 7728787656 T-402 P0001/0001 F-773
01- ptannf g..&beihAopiment Services
b; . Butiltlrn &Cvdd Re+4utefiion Division
:: >I 2300- irginia Ave
Fort Piercer PL 34952
.
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power'Re1°ease
Date: � �\' ,� Permit Wimberh
Project Address;
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCPJBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY(30) DAYS,FOR THE PURPOSE OF'TEST'ING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A.FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE-HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpose only,and there wffl be no
occupancy 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 coFiditions 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 made in writing to the Building Official stating
the reason fbr the request. Power may be removed from the site and/or a Stop Work Order issued if
the Final Inspection has riot been approved within 30 days. A fee of$100.00 will be required to lift.
the Stop Work Order.
WE HMBY RELEASE AND AGREE TO HOLD HARMLESS,ST, LUCE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILrMS AND.CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE'WHIGFi-'MAY SE INCURRED DUE TO THE
DISCONNECTION O ELECT CAl_POWER ml THE EVENT OFV#OLATIQN OF TRIS AGREEMENT.
Yl�llr��l1 ��� 11
OWNER SIGNATURE DATE
,GENERPXC0NMCT0R E DATE
Ei.ECTRICAL COKiRR=R SIGNATURE DATE
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