HomeMy WebLinkAboutInspection Docs , 30 day temp power release form 12-10-'20 15:40 FROM- 7728787656. T-621 P0003/0010 F-048
jtwii,Me
Phil
Idifull DiMian
Ila AAVe
rya{(yam ,ye(rF�. �z �Jj.7 6
Dates: 0� .�1. omit-Mmber
Pr*dAdd : t
THE UNDERSIGNED HEREBY REQUEST RELEASE or-ELECTRICAL POWER TO THE ABOVE DESCRMW
PROPERTY,FOR A P'E UOD NOT 7Q EKelip TwRTY(3i0)D. FOR THE PURPOsE OF TES'.tING SYSTEMS
ANTS EQUIPMENTIN PREPARCION FOR A.FINALINSPE�N. .IN CONSI.DMTION OF APPROVAL.OF THE
REQUEST WE•liF Y ACKNOWLED-GEA1D ACE ASMLLOWS:
I. 7I3i5 temporary power Tekase is eequmted for the above d p aose ant and them v�die no
owupangr of any type,ogler than that parmfflrad by=sftoon during this time period.
2. AS*Witness by our$ign�iwres,we herift agree P6 abide b rM term and oa6ftons of this agreement,
IrtclUdir►g Building Dlvigion.Policy,Whlcii is irtCotp r heWn by reference, '
3.. All conditibns:and regtririrner►ts listad In the atI*d ed dpcument er=ed-R6WIrerrrents for 30-Day
Power for Testngp have been fuffilled.arid the prgn.1se is ready for complibnce inspeWon.
4. All remuests for an.east rigon beyond 30 days'muA ba:made in,wribng'tD t-v BtAlding OffldW sing
the region`forte mqqesL IYawer may be mmWed'frrcc m'fhe site andTor a Stop Work Order Issued-if
the Kenai InspeWon has riot been approved vuit In 36daM A fee of$100.00 will be regtnred to il!t
the Stop Work Order.
WE HERMY RELWE-AND.AGREE TO HOLD.HARMLESS ST,LU TE couNTY,AND nim EMPLQYEES PROM
AL4 VA IVIES AND,=Ms 017 ANY TYPE OFNATUR�WIRICH MAY AWE NOW OR IN THE FUTUI9E OUT
OF 7- AN6ACR(}Nr INCLUDI,1 G AN'Y UA Aa VMIQWkY BE INi U�WW 0-UE TO TKE
Dzsaw&cft0N cF ELELTMRICAL`POWER IN`THEE NT OF 0LKl70N-0FTHIS AGFtEEM !",
0WN_ R'SI DATE
'CON DAIS
'E&CATCAL CONTRACTOR SIGNATURE DATE