HomeMy WebLinkAboutPower Release 12-14-'20 10:34 FROM- 7728787656 T-627 P0001/0001 F-056
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Bt i fib W C :Ragu iitila►rs Division
2341ixiia Awe: .
772-462-21-65 >r ax 772 462-6443
Request for'30-Day Tempomry'Power Release
Date. \ -�
Pry Address.
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL.POWER:TO THE ABOW DESCRIBED
PROPERTY,FOR A PERIOD NOT TO EXCEED THIRTY.(3�,a),PAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN'PREPARATION FOR..A'FINAL INSPECTtON. IN CONSibERATIOPI OF APPROVAL OF THE
REQUEST VVE HEREBY ACKNOWLEDGE Alb AGE AS FOLLOWS;
t, This tBmPoiary povuerrelease is requested fbr the above s3@Wd pose only,and belt:wm be no
occupancy of any tYpe,ether than that p.e"ltted by con.sArWion duo6g1his time period.
21 As-witness by our signOuts,we hereby agreee W abide by all tL-ms and-conditions of this agreement,
including Building Division ftliCy,which is.incorporated herein by reference.
3. All conditsons'and requireiieriL-,lisred.in the attached doolment entetltd"Requirements for 30 Day,
Power for Testingff have beery fiAt'ilred and the premise.is ready for cofnpliance inspection.
4. All requests for an extension beyond 30 days MM.be'made in writing to the Building Official stating
the mason far the guest. Power may be relboved from the site and/or a Stop Wo*.Order issued if
the Fnal'Inspection has not been approved within 30 days. A fee of 100.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE.TO HOLD HARMLESS,57; LUGIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABTLI[ZES AND CLAIMS OF ANY TYPE OF NATURE V4,►FKH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACT10N,INCLUDING ANY DAMAGE WHICH'MAY BE I NCURED DUE TO THE
DISCOMECTION OF ELEC CAL POWER 94 T14F EVENT'OF VIO AMON OF THIS AGREEMENT.
77� �-
OWNER SI DATE '
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CONTRACTOR DATE
ELlrCTRICAL CONTRACTOR SIGNA'f-IRE DATE