HomeMy WebLinkAboutInspection Docs/ request for 30 day for power 01-06-'21 11 :29 FROM- 7728787656 T-707 P0001/0001 F-160
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Pteq ud4`far'30-D.ay'•Terttporary'Power Release
Date: \ � P it*Nftber.
Project Address; QJQ a� a
THE UNDERSIGNED HEREBY REQUEST RE E~ OF ELECTRICAL TOWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED T14IRTY.(SO)DAYS, FOR THE PURPOSJE OF TESTING SYSTEMS
AND EQUIPMENT IN•PREPARATION FOR,.A.FINAL.INSPECTTON. IN CONMtRATION OF APPROVAL OF THE
REQUEST WE HM�EHl ACIWOWLME AND AGR2EE AS FOLLOWS:
1. This temporary power release is requested for the above skated pose oriy,and tere Will be no
occupancy of any type,Other than that permitted by coi*trucdon durinq'this time Period.
2. As•withess by our signatures,we hereby agree to abide by all terms and conditions of this agreement,
induft Building Divisiort'.P'olicy,which Is incorporated herein by reference.
3. All conditions'and requirements.listeo.in the attached document entftied'aRequiremen}s for 30 Day
Power for Testing"have been fulfilfed'and the premise-is ready for compliance inspection.
4. All request for an extension beyond 30 days must be*made in writing W the Building Offidal stating
the mason for the request. Power may be removed1 from the site and/or a Stop work Order issued if
the Final,Inspection has not been approved within 30 days. A fee of�. 100.00 will be requited to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD.HARMLESS, ST. LUCRE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILMES AND CLAIMS OF ANY TYPE OF NATURE WN...ICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION;TIVCLUi3ING ANY'DAM -:WHICK••MAY BE INCUI�RED'QUE TO THE
DISCONNECMN OF ELECTRICAL POWER IN THE 1=1aTr OF WOLATION OF THIS AGREEMENT.
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OWNER Si
GaNTOACIOR ?ZE DATE
Ei,ECTRICAL CONTTi =R SIGNATUM DATE