HomeMy WebLinkAboutMisc Letters/temp power release form ^t
Planning and Development-Services.
Building and Code Regulations
® h V 2300 Virginia Avenue
b,} Fort Pierce,FL 34983 RECEIVED
b O` Q .D£ D p �^.-•- 772462-1553
Fax 772-462-6443 FEB 17 1011
Permitting Dpartmenr
St. Lucie County
TEMPORARY EARLY POWER RELEASE
t°yeY G 1a2�� so
(Name of Tenant or er)
The Tenant or Owner requests St Lucie County Development Services Department to release the
electrical power at Ili AV a— address including"suite number,
as posted on the electric.meter and the building) for building permit# /�-43i~, for the
purpose of construction and testing building systems, including air conditioning, refrigeration,
lighting,power and control circuits with the following stipulations:
1. Incomplete or untested circuits are NOT to be energized without properly licensed electrical
personnel on.the jobsite and no systems are to remain energized beyond the testing/temporary
purpose without proper inspection by the St Lucie County Building Department appropriately
licensed person(s).
2.All panels and disconnects not in use must be locked in the"OFF"position or fuses removed.
3.Proper procedures-for lockout[tagout must be in place.
4.The electrical equipment room(where applicable)will remain locked at all times with the key in
the possession:of the electrical contractor.
5.All final inspections relative to the closeout of this project must be requested and passed in a
timely manner as determined by the Electrical Inspector and/or the Building Official.
6.The building may not be occupied before a:Certificate of Occupancy(C.O.)is issued.
7:No stocking ofmaterialsi other than those required for construction is permitted by this.agreement
8.No on-site occupancy ortraining of personnel employed by the occupant,business entity or owner
is permitted by this agreement
9.No furniture,racks,fumishings or other personal or corporate property is permitted on site by this
agreement.
10. Construction power reinains covered by the.requirements for GFCI protection and all other
requirements of the governing Codes,see National Electrical Code(NEC)Article 590.
Violation of this agreement may result in the immediate termination of the electrical power without
prior notice or tv ag to tbLe affeetcd pcstics. This form requires all of the following signatures
prior to power being released_T'ue undeisign:zd acknowledge that the operation of air-conditioning
equipment while construction is in progress may create or increase the risk of contamination or
premature failure of the equipment.
The undersigned.acknowledoas tZcat}avc lisied.stipalatio=?s,a €.es to tip.ie::, a`t;i s aL.€ u
and agrees to hold St Lucie County ham&l ss from any damiaps that may aLisc as a rcsult of th4
release of power to the premises. The undersigned hereby requests power to be released for this
project.This form does not guarantee power,which is at the discretion and control of the electrical
utility.
1
� 0 �l`.:l�ll�
Important: The occupant of the property (or other appropriate party) shall,have made proper
application to the electric utility, paid any applicable fees or deposits, and requested power in a
timely-and informed manner. St Lucie County is not responsible for any delays in the receipt of
electric power.
We acknowledge and accept tlic terms of this,partriissiOn.We fitrtlter 8cl n OVA edggc that vi01atiOil
of this agreement or a finding of unsafe conditions and/or practices found_on 11ic site or occupancy
of the site may result in immediate.disconnection of this temporary power without warning and
hereby release St Lucie County and all representatives of any and all liability resulting from us not
abiding with this agreement.
G� �. ►etc �'.� �
Print, -Electrical Coutract6:4 Contg=y'_Tam_1 1.17
W- z 116 , Z-r �//� /Z1
Signature- ectrical C' tractor Date Signature-Owner Date
!eNIN C aZJC ryrD (:�i595.0 Lj
P1intName-Electrical'Contractor Print Name-Owner
c T2t ) 52 j' - zt U L(46 - I
Phone Number-Electrical Contractor Phone Number-Owner
L2a0 m i s
License;/Elec icat Contractar
A l� A Arj L&o, ��,
Signature.-P ' e' ontractor Da e P t ame-Prime Contractor Company Name
Ild (e 214
Punt Name- is Contractor Phone N;.mber-Prune Contractor
License#Prime Contractor
Appro.yed.for St.Lucke.County Icy:
Signature-Electrical lnspectorBO lnsp ID# Date
Inspector comments,limitations and restrictions:
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