HomeMy WebLinkAbout30-Day Temporary Power ReleaseCD
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Planning & Devetopment Services
BuNding & £ode Regulafiion Division
2301D Yrrginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-"2-6443
Request inr 30-Day Temporary Power Release
ir Pe mit Number: IY-I2 -O Z_ ff
Project Adams: / V S -Oemw 0,flyg� J�5e-)b �4 t y?
THE UNDERSIGNED HEREBY REQiUST RELEASE OF ELECTRICAL POWER TO WE ABOVE DESCRIBED
PROPERIX FOR A PERIOD NOT TO EXCEED TKU RTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT-M PREPARATMN FORA i-2M INSPECTION. IN CDNSfDERATION OFAPPROVAL OF THE
REQUEST WE HEREBY AC KNOVEED'E AND AGREE A5 FOLLOWS: r
L This berrporary power release Is reyxsted for the above stabed purpose only, and there will be m
oom4anc!' of any bAm, ether than -that permftLed by wnstrudion dudN this time period.
Z As witness by our signabzes, we hereby agree to abide by all htmsand corMans of ft agnmmer4
WUdM g Dlvdw Potty, wttkir Ls btmrporated herein by reference
3. AM omdMws and mciateawft listed it the adadwd doaxnent entitled-Requirermb for 30 Day
Power for Testlngf have been wed and the premise is ready fix comptianoe won,
4. M requests for an extension beipw d 30 days mtnt be made In writing to the SuldkV Official stating
the reason for the mtueZ Power maybe removed ftam the site ancVcra Stop Work Drder Issued if
the R W Trepectim has not been approied within 30 days, A fee of $1M0a wrT be required Go l3it
the 9mp Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, Sr. LIICfE COUNTY, AND THEIR EMPLOYEES FROM
ALL LTABILiTIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF' HISTRAN5 CMN, 2*3-UDM ANY WMAGE WHICH MAY 6E DialRREB DUE TO THE
DISCOWMC PM OF ELECTRICAL PO VER IN THE EVE@1T OF VIOLATION OF THIS AGREEMENT.
DATErr_
-7tZT1IS
RECEIVED tin - 2 8 7015