HomeMy WebLinkAbout30 day power release Piainning•&Developmi tnt Services
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Suilditno &Code ltegulkion Divesion
23001flrglnia l� e
• Fart Pierce, FL, 34982
772-462-2165 Fax 772=462-61443
Request for 30-Day Temporary Powow-Release
Dame; Permit'Number.
Project Address:
TFIE 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 OF APPROVAL OF THE.
REQUEST wE HERESY ACKNOWLEDGE AND AGREE AS FOLLOWS;
1. This tegmrdry pourer release is requestedfor the above stated purpose only,and there"M be no
occupancy of any type,other than that permitted by construction during this tame period.
2. As witness by our signatui-es,we hereby agree to abide by all terms and conditions of this agreemerk
Including Building Division Policy,which is incorparated herein by reference.
3: All conditions and requirements listed in the attached document entitidd\"Requiremen s for 30 Day
Power far"Testing"have been fulfilled and the premise is ready for compliance inspeckion.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason for the request. 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 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 TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNEC 1ON OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNATURE r�- DA
vi
I'GtN t�NTRACTOR DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE `
RECEIVED JUL 17 2017
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