HomeMy WebLinkAboutPower ReleaseST Lt.1CIE
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Planning & Development Services
Building & IICode Regulation Division
2300 Virgitlia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Permit Number: ��
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 OR THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpose only, and there wti;l tie no
occupancy of any type, other than that permitted by constructioi dunrig this time period.
?- As witness by our signatures, we hereby agree to abide by all term; 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 enht!ed "Requirements fur 30 Day
Power for Testing" have been fulfilled and the premise is ready for compliance inspection.
1. Ali requests for an extension beyond 30 days must be made in venting to the Building Official staling
the reason for the request. Power may be removed from the site and/or a Stow Work Order e5suod ,t
the Final Inspection has not been approved within 30 days. A fee of 100 00 Will tr2 required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST, LUCIE COLIND, 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,
IGNATURE
1
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ELECTRICAL CONTRACTOR Slr:rueTr roc
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