HomeMy WebLinkAboutTemp power releaseT. .LLI.CI E
COUNTY
FLO R I D A
Planning & Development Set -vices
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date, _ _ Permit Number:
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 Stated purpose only, and there will be no
oCCupancy pf any type, other than that permitted by Construction during this tirne period.
2. As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
it,duding Building Division Policy, which is incorporated herein by reference.
3. Ali conditions and requirements listed in the attached document entitled "Requirements fvr 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 writing to the 801ding Official stating
the reason for the request. Power may be 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 $ I00.00 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 APJSE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTIC),% OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGRFEMENT,
ER 51GNATURE
GENERAL CONTRACTOR SIGNATURE
kLtLIHICAL CONTRACTOR SIGNATURE
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