HomeMy WebLinkAbouttemp power release form 03-18-'21 09:23 FROM- 7728787656 T-904 P0007/0008 F-452
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THE UNDERSIGNED HERE13Y REQUEST RELEASE OF ELECTRICAL POWER TO T KE;ABOVE DESCRIBED
PROPERTY,FOP,A PERIOD NOT TO EXCESCYT WRTY(30)DAYS,FOR THE PURPOSE OFTESTING SYSTEMS
AND EC UIPMENT Ii1i Pt EP'1 7IQN FOR i4 RNAL.INSPEMON. Ill CONSIDF1 71ON OF APPROVAL OF THE
liiiE i�i 3 'AC O�?6E 3INf)AG 'At iftowS:
I. This bovorary powr rWease is requested for the above wed pprpose only,and tbm WO be no
aoCupancy of any tVpA,OUWr than that perniitted by coon during this time period.
2. A 'witness by our*gnat s,tA)s,,hereby agrw th abide by'all terms and conditians of this agreement,
9nduding fUding Division.Policy,which is inoarpdrtWd heWh by ref�?reno&
3. All oonditiOns.and rewirentdnts kgILM ire the Md-xd deaffheAt entitled"Rdqulrements-lbr 30,Day
Fower For Testing"have i fulfiiled aril the preanIse-is raW for-oomphance,inspecbon.
4. All rc�qvesi_s for an extension beyond 30 days mud be:made in wrWhg W the Building O f iai stating
the re84ori fbr the requests Fower'may be removetl-Trom-the sate.andf br a Stop V�-Wrder issued of
the i a �nal Impor�hats riot been approved wiMin 3d'days. A fee of'$3.Oo.Ob will be re4utred to lift
the Stop Work Order.
I
WE HSZEB'Y RELEASE'AND.AGREETO HOLD.HARMLESS ST LUCIE QDUNTY,AND THEIR EMPLOYMS FROM
ALL I.IAl i1 MS AND.CLAIM 'OF ANY TYRE OF P ATtII W19£H MAY AME NaW OR IN THE FUTURE OUT'
OFF TR-M-$ACTION,INCLUDING�tY•'QAMAGF=)N1:1I `MAY IRE INCU E7 f UE TCJ''i'iiE
#7iS=NECMN OF fLE I£AL 7 OF'ii L i;9N i»T S AGii Mi
�2,
01, $IO DAM
FOR DATE
Ef.#aGTRfcAL coNi1 Ac oR SIGNATtIkE Di4`rE
I R
MAR 1 9
2021
Permitting De
St. Lucie Gartment
Cou►ity, FL