HomeMy WebLinkAboutPower Release 07-24-'20 11 :17 FROM- 7728787656 T-116 P0004/0004 F-369
pmmint vices
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>ittg,"&- 603,��R t a�in f vi i n
23 •° a Ave
Ft>rlr Piper A IM2 .
772-402-Z165 FaX-772-4f Z-63443
Requeid or 30-�6ay-Tem. oo�.zi11V Pdwelr•Reie'alse
Date. �iZ, lerifilt Wirrtber. "
Project Address
THE UNDEMGNED HEREBY REQUEST RELE k_OF ELElY'I•RICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PE OD NOT TO EXCEED THM Y(30)DAYS,FOR THE PURpow OFTEsmG SYSTEMS
AND EQUIPMENTIN PREPARATION FOR A.RM.INSPECrION. •IN CONSIDERATION OF APPROVAL OF THE
gQUSI'WE-H8:T9Y ACKNOWLEDGE AND AGREE AS MLLO :
1, Ti3is temporary power release is request for the above stated pprpose only,and there AM be no
orc upancy of any type,other than that permitted by constructton during this time period.
2, As witness by our signatures,we:hereby agree tb abide by ail terms and conditions of tilds agreement,
including Building Division Policy;which is incorpordt herein by refamce.
3. All c6nditions;and requir fn"Bsiehd in the WZ6ed document dn#itted"Requirements for 30 Day
Power for Testing'have been Mifilled nd the premise is ready for comp3ianmjnspecdon.
4_ All requests for an.mftnsion beyond 30 days.mud be'made in writing tD the SWI ing-Official•troting
the reason for the request. Power may be removed`From the sta and/or a Stop Work.Order issued.if
the Final Insperizon has not been approved within 30 days. Mee of$100.YO will be required to lift
the Stop Work Order.
WE HEREBY RELEASE-AND AGREETO BOLD HARMLESS,ST. LUCK COUNTY,AND THEM EMPLOYEES FROM
ALL t.WD TI IES AND CLAIMS*OF ANY TYPE 05NATURE=WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION,INCLUDING ANY•YAMAGE WHIM'MAY BE INCURREb DUE T07HE
DISCO•NNEC aON OF EL CAI_POVVER IN THE EVENT OF VIOLATION OF VIES A,GREEM 3
OwNeR SIGN n DATE —
VI'A
GE 'CONTRACTOR CMDAT�\
ELECTRICAL CONTRACTOR SIGNATURE DATE