HomeMy WebLinkAboutInspection Docs, req for 30 day temp power release form 12-10-'20 15:40 FROM- 7728787656 T-621 P0004/0010 F-048
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1=ar Pi''r4t FL
771-46242E Fe�c 77 =46 �6
Reque 'f*f-30-DSy'Terinp:6 ry Power Release
Pmject Addrem S S�a L (2•A `
e
THE UNDERSIGNED HEREBY REQUEST RELEASE of ELECMICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOTTO EXCEED-.T iRTy k30)DAYS,FOR Tf45 PURp70s1_OFTEsmG SYSTEM$
AND EQUIPMENT IN PREPARATION FOR A.FINAL.INSPECMN. IN ODNSTDERAMON OF APPROVAL OF THE
AEQLe!=F WE •il Y AC(5Nt1WLW.GE AND A6tE-AS FOLLOWS:
3. Trds temporary power r!iease is requested for#fie above stated pWcL4e Monty,acid there Wi b'e no
actapancy of any type,other than that pean tbad by tonstrucHon.during tivs firm period.
2. AS witness by..our signabur s,Wa,.hereby,agree t6..abide by all terms and coridlttans of this agmemerk
ietclu;uilg$ullding DiMslorl Policy,which is incorpdrated herein by reference.
3. All conditYonS:and requirementsiisted in the.attathed domment.eritfded"Requirements for 30 Day
Power for TeOng"hbve'been fulfilled avid the p mLle is ready f ,complianee inspe(ton.
4. Alt requesW for dh aderKlon b'eypnd 30 days must be:made in writing to the Building Official•stat9ng
the reason fbr the request. Power maybe remmred'from the site.andfdr a•Stop Work0rder issued-if
the Knatznspection has not been approved within 30 days. A fee of$100.00 wilt be required to lift
the Stop Work Order.
WE HERESY RELEASE-AND AGREE TO HOLD HAIPMLM S . LU,O£E COUN3Y,AND THEIR EMPLOYEES FROM .
ALL C BTL1TfES Ai\1D_GL4IM5 OF AI�1Y TYF`E aF NA' URE WHICH MAY ARISE Nf��!W OR I{�t THE FUTURE OUT
of TES TRANSA!M911,INCL;UTAG ANY D l�lAGE 11 HlC i fvlAY BE INCUR�D U.UE-M THE
DMC011fWC 01'+i 01`Ei E CAL P R l THE N'EV OF�liOLAT�ON T i4GREEP 911T: ,
OWN8R'SM' A'TURE DATE
+CONTl21 DA E
ELECMCAL COI TRACMRt SIGNATtJR)= DA'fF