HomeMy WebLinkAbout30 day temporary power release M nning &Devilopment Services
Building & Code Regulation Division
2306 Virginia Ave
p Fore Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date: Permit'Nlimber.
Project Address:
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 OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
i, This temporary power release is requested for the above shred purpose only,and there well 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,
includlhg Building Division Policy,which is incorporated herein by reference.
3. Ail 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 welting to the Building Official suing
the reason for the request. Power may be removed from the site and/or a Stop workâ˘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.
VILE 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
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AG
OWNER SIGNAMIRE DATE n
Gi=1NT42AC'fOR DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE
3a REcE/VED
Allr, 0 9
RECEIVED AUK 09 V7 RECEIVE'
i
900-d Z000AOOOd 68t-i 999L8L8ZLL d.ioO suiplin8 euuAM -WOdJ L0=8L Ll 60-80