HomeMy WebLinkAboutPower release 02-26-' 21 13:00 FROM- 7728787656 T-842 P0005/0007 F-359
D .V—ft- ttre�Services Bi 0 ft c t6de A on Division
fl ;> gia Ave'5 FOB. ' , F� 34 &2
7,72=462-2 65 Fax 772-462-6443
Requestfor 30-Day TeshootR6ry Power Retease
Date. Permit Number:
Project Address.
THE UNDERSIGNED HFRE13Y 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 CONSWERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requesied for the above stated pose only,and there wiB be no
occupancy of any type,ocher than that permitted by constru(t- on during this time period.
2. AS witness by our signatures,we hereby agree to abide by all terms and conditions of arts agreement,
Including Building Division Policy,which is incorporated herein by reference,
3. All conditions and requirements fisted 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 musk be made in writSng to the Building Official skating
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$100.00 will be required to lift
the Stop Work Order.
WE HEREV RELEASE AND AGREE TO HOLD HARMLESS,Si'. 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
DISCONNEMON OF ELECMCAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIGMA — DRIE
GFECONR OESIGNATURE
RE DATE DATE