HomeMy WebLinkAboutRequest for 30-Day Temporary Power ReleasePlanning & Develop Services
Buildin & Code Re ul ion DiviSio
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2300 Virginia Ave
Fort Pierce, FL 34982�
772-462-2165 Fax 772-462-6443
Request for 30 - Day Temporary Power Release
Date: /�--/)S Permit Number: d d- O
Property Address: __ l 00 �Ayo A PJ 4 C-c: L 1A �, ; "�, G-zc,(5
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 EQUIPMENTS
IN PREPARATION FOR FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE REQUEST WE HEREBY
ACKNOWLEGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above state purpose only, and there will be no
occupancy of any type, other than that permitted by construction during this time period.
2. As witness -by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
including Building Division Policy, which is incorporated herein by reference.
3. All conditions and requirements listed in the attached document 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 writing to the Building Official stating
the reason for the request. Power may be removed 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 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
ELECTRICAL POWER IN THE (:,VENT OF VIOLATION OF THIS AGREEMENT.
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ELECRICAL CONTRACTOR SIG'NATU