HomeMy WebLinkAbout30 day temp form l fanning &development Services
Building & Code Regulation Division
:: 2300 Virginia.Ave
Fort'Pierceir FL 34982
772-462-2165 Fax 77Z-"2-6443
aequest for 30-Day Tetnporary bower Release
Date; � Perrnit Ntimber. � L �
Project Address: `\ A
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 OFTESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HERi BY ACKNOWMGE AND AGREE AS FOLLOWS:
i. This temporary power release is requested for•the above stated purpose only,and there vw i be no
occupancy of any type,other than that permitted by constriction during this time period.
z. As witness by our signatures,we hereby agree to abide by all terms and conditions of this agreement,
induding Building Division Policy,which is incorporated hereon 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 for the*ueSt. Power maybe removed•from,the site and/or a Stop Work.Order issued if
the Final Inspection has not been approved within 30 days. A fee of$100.00 will be required to i'dY
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUM 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 TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNEMON OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER'SIGNATURE
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.GENE �NTPACTOR. l2E DATE
.ELECTRICAL CONTRACTOR SIGNATURE DATE
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