HomeMy WebLinkAboutPower Release 02-04-'21 14:18 FROM- 7728787656 T-794 P0011/0011 F-280
Planning &Develgpmlent Services
Building &Code geguiafi6 Division RECEIVED
!ill;l. 2300 Virginia Ave.
s
Fort Pier:, FL 34,982 FF8 0 5 1011
772-462-2165 FaX 772=462-6444mitting Departmem
St. Lucie County
Request for 30-Day Temporary Powier Release
Date: \r�J Permit'NaMber: — C�(10
Project Address:
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL_POWER;TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY(30) DAYS,FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A'FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQuEs7r WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpgse only,and there vial be no
occupancy of any'type,other than that permitted by construction during this time period.
2. As witness by our signat xes,we hereby agree to abide by all t artns and conditions of this agreement,
Including Widing Division Policy,which Is incorporated herein by reference.
3. All conditions and requirements listed in the attached doannent entitled"Requirements for 30 Day
Power for Testing"have been fulfilled and the premise is ready for compliance inspection.
4. All requests for an extension beyond 30 days must be made in wriUng tD the Building of dal sm'dng
the reason for the request:. Power may be removed from the site and(or a Stop Work Order Issued if
the Filial 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,ST.,LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGNATURE DATE'
GENEWCONTRAaOR. DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE