HomeMy WebLinkAbout30 day for testing RECEIVED
APR,- 6 2021
Permitting DCpartmem
St. Lucie Count—
Planning &Development Services
Building &Code Regulation Division
�"COLINTY 2300 Virginia Ave
• ) A Fort Pierce, FL 34982
772-462-2165 Fax 772- 62-6443
Request for 30-Day Temporary Powe Release
Date: y�1/zO u Permit Number: ��a// —C>3 7J
Project Address: 3319,9 Tti/-a/T)p !�_/Izz-4—� (�^_ Aig�.etck-_
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY,FOR A PERIOD NOT TO EXCEED THIRTY(30)DAYS,FOR THE F URPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION 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 entitle"Requirements for 30 Day
Power for Testing"have been fulfilled and the premise is ready for com Aance 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/dr a Stop Work Order Issued If
the Final Inspection has not been approved within 30 days. A fee of$�00.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS,ST.LUCIE COUNT".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.
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OWNER SIGNATURE DATE
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GEN RAL CO,TRACTOR S GNATURE DATE
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i r Apte—, Goldstar Electric, Inc.
ELEC.F1tICAL CONTRACTOR SIGNATURE DATE
RECEIVED
APR - 5 2011
Permittirg Capartment
St. Lucie Cc:J:.�t'P