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HomeMy WebLinkAboutelectrical doc� irl L T-CCUJ 4 ®,. ® s Important: The occupant of the property (or other appropriate party) shall have made proper application to the electric utility, paid any applicable fees or deposits, and requested power in a timely and informed manner. St Lucie County is not responsible for any delays in the receipt of electric power. We acknowledge and accept the terms of this permission. We further acknowledge that violation of this agreement or a finding of unsafe conditions and/or practices found on the site or occupancy of the site may result in immediate disconnection of this temporary power without warning and hereby release St Lucie County and all representatives of any and all liability resulting from us not abiding with this agreement. Ar e / ✓4� Print Name - Electrical Contractor Company Name v 4�gnaurc�KElectr�icalontractor Date S' ature - Owner Date CL Print Name - ectrical Contractor Piid Name -Owner Phone Number - Electrical Contractor Phone Number - Owner Print Name - Prime Contractor /`4 'License # Prime Contractor Approved for St. Lucie County by: /f -.z d 'oo� k Printame - Prime Contractor Company Name `7©33 Phone Number - Prime Contractor Signature - Electrical InspectorBO Insp ID # Date Inspector comments, limitations and restrictions: 2