HomeMy WebLinkAbout30 day power release �. Planning .&Development Servkes
Building,&Codie•Regulaiion Division
2300'V'rginia Ave•
q Foie Pierce; FL 34982
772-462=2.16.5 Fax 772-462-6443
Request•for 30-Day Temporary Povirer Release
Date: Permit'Ntipnber:
Project Address:
THE UNDERSIGNED HEREBY REQUEST REBASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED.
PROPERTY,'FOP,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
REQuEs r,WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
I. 7Hs temporary power release is requested for the above stated purpose only,and them w#1 be no
occupancy of any type,Other than that permitted by construction during this time period.
2. As witness by our signatures,we hereby agave 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 entided"Requirements for 30 Day
Power for Testing"have been fulfilled and the premise is ready for compliance inspection.
4. Al requests for an a 6ansion beyond 30 days must be made in writing to the Building Offlriai stating
the reason for the request Power may be removed from the siteand/or a Stop Work-Order issued if .
the Final Inspection has not been approved within 30 days. A tee of$100.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO 1i01.D HARMLESS, ST. LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILMES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARSE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE'WHIC,H MAY BE INCURRED DUE TO THE
DISCONNEMON OF ELEC7MCAL POWER IN THE EVENT OF VIOLATION OF THIS AGR MEN7.
OWNER SIGNATURE DAlt
GEN CONTPACT k N DA
ELECTRICAL CONTRACTOR SIGNATURE DATE'.
RECEIVED JUL 18 2017
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