HomeMy WebLinkAboutReq for 30 day temp power releasePlanning St aevelopment'Sei vices
Bultdin j & Code. Regulatitin Divisidn
2300 W--ginia Ave
fort• Piem6,. FL 34982
772-462�-2165 Fax 772;-462-6443
Request for SO -Day Temporary Pov ier -Rel`ease
PermitNumber:--
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 ACICNOWLWGE AND AGREE AS FOLLOWS: i
I. This temporary paver release is requested for the above stud purpose only, and there Will be no
occupancy of any type, other than that permitted by construction during this lime 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 me attached document entitled "Requirements for 30 Day
Power for Testing" have been fulfilled and the premise is ready for compliance inspection.
4. Ail requests for an extension beyond 30 days must be made in wnVng to the Building Official stating
the reason for the reque. Power may be removed •from the site and/or a Stop Work Order Issued if
the Fnal'Inspection has not been approved within 30 days. A flee 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 INCIARED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE VENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNA DATE
&,V�
:GENT_ CONTRAC OIZ N' DATE
>:I.EGTRICAL CONTRACTOR SIGNATURE DATE
RECEIVED
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