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HomeMy WebLinkAbout30 Day for testing form RECEIVED APR — 6 za21 Permitting Department St. Lucia Count; Planning &Development S rvices Building &Code Regulatior Division 'ICOLINTY 2300 Virginia Ave • R I D A Fort Pierce, FL 34982 772-462-2165 Fax 772- 62-6443 Request for 30-Day Temporary Power Release Date: / Zd e-/ Permit Number: I Z�d Z —o©.ro Project Address: /7- THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER T THE ABOVE DESCRIBED PROPERTY,FOR A PERIOD NOT TO EXCEED THIRTY(30)DAYS,FOR THE FURPOSE OF TESTING SYSTEMS AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSID RATION OF APPROVAL OF THE REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS: 1. This temporary power release Is requested for the above stated purpose only,and there will be no occupancy of any type,other than that permitted by construction durin�this time period. 2. As witness by our signatures,we hereby agree to abide by all terms an conditions of this agreement, Including Building Division Policy,which is Incorporated herein by reference. 3. All conditions and requirements listed 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 must be made in writing to the Building Official stating the reason for the request. Power may be removed from the site and/0 a Stop Work Order Issued If the Final Inspection has not been approved within 30 days. A fee of$I 00.00 will be required to lift the Stop Work Order. WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS,ST.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 INCURF LED DUE TO THE DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION 0 THIS AGREEMENT. A'CAAL :� LIZ `f / OWNER SIGN RE DATE M; da, � r(�g Y/ / Zaz/ GEN RAL CONTRACTOR GNATURE DATE Goldstar Electric, Inc. 'Y / Zv Z ELECYRICAL CONTRACTOR SIGNATURE DATE RECEIVED AIR - 51011 Permitting D�l3 S ertrnQ,�� = Luc,, i �v,;t„