HomeMy WebLinkAbout30 day power release F
Planning & Development Services-
_ - Building &,Code Regulation Division
2300 Virginia"Ave
• A • Fort Pierce, FL 34982
772-462-2165 Pax 772-462-6443"
Request for.30-Day Temporary PowerRelease
Dade Permit Number: /f�,��0 V
Project Address: I LI /C - - �_
THE UNDERSIGNED HEREBY`REQUEST RELEASE OF ELECTRICAL POWER TO THE..ABOVE DESCRIBED
PROPERTY, FORA PERIOD NOTTO EXCEED THIRTY(30) DAYS, FOR'THE PURPOSE OF TESTING.-SYSTEMS
AND.EQUIPMENT IN PREPARATION FOR A FIN IN CONSIQERATION 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 will 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 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 fos.30 Day
Powerfor Testing"have been fulfilled and the.prernise-is readyfor.compliance:inspOcbpri.
4. All requests for-an extension beyon.'d;30.days.must be made inwriting to th'e Building Official stating
the reason-for the.request. :Power:m- be removed from the site"and/or a Stop Work Order`issued if
the Ficial Inspection has not-been approved within 30 days. A fee of$100.00 will be required to lift
the.Stop Work Order.
WE HEREBY RELEASEAND AGREE TO HOLD HARMLESS,.,ST. LUCIE COUNTY,AND THEIR EMPLOYEES FROM,
ALL LIABILITIES AND CLAIMS OF ANY TYPE,OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY,DAMAGE WHICH MAY BE INCURRED DILE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
l 8/10/17
O NE , GNATURE i DATE
GNERA CONTRACTOR SIGNATURE DATE,
ELECTRICAL CONTRACTOR SIGNATURE DATE
PlanningDdveiopin-dims 5.eilviC
77 ��aeAe�ang C� a Regu�ati�n �?IV Si®n:
a 2310 Virginia'Ave
a ftft Keii ceo
772-462-216 Fax 7,72--4621-0443
AO'uitstfbr 30-Day. igen"p wary. Power Re�e�se
Date � / ��.1 Permit Number: b; 4�yl
Project Address �66fJZ
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE:ABOVE:DESCRIBED-
:.PROPERTY, FORA PERIOD NOT TO EKCEED THIRTY(34}DAYS,FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN`PREPARATION:FOR A:FINAL INSPECTION. IN CONSIDERATION OFAPPROVAI OF THE
REQUEST WE HERESY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary release is requested-for the above stated:purpose only,and there will be no
occupancy of any type,other than that,permltted by construct,lop,during thisfirrie period
2,. As.witness by our'signatur"es;we hereby-agree to abiae'by ali te(tns and'condfions'of this agreement,
ncciuding building Diyision;Policy,v*hich is incorporated herein byreference
3. All conditions and-reqwrements listed in'the attached docUment.eri i0ed"Requinements:.for 30 Day.
Power for Testing"Have been fulfilled and the premise is-ready for compliance inspection.
4. All requests for an extens on.beyond 30 days must be made�n wrihng.to`the Buiiding'Offidai stating
the reason for the.request:`,Power nay be:removed from,the site;and/or'a Stop Work:Order issued if
the Finalanspection,has not been approved within 30 days. A fee of$li)0:00 vuill 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 CLAiNiS:OF ANY TYPE,OF NATURE:WHICH MAYARISE NOW OR IN THE FUTURE`OUT
OF THIS TRANSACTION, INCLUDING ANY`DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICALPOWER IN TtE EVENT"C1F'ViOLATIgN OF>l HTS AGREEMEI�tT.
OWNE ; GNATtJRE DATE
DATE
G NE OiVTRACTOR SIGNAT
DATE;
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`ELECTRICAL CONTRACTOR SIGNATURE