HomeMy WebLinkAbout30 day power release PI,-OP1109..S['Qeve.Qpment Services
Blui(d ng &'Code Itegulafion DivIsWn
OUNTY
230��r§Inia Aire
I . } AFoit'Piero,'FL 34952
772�462-2165 Fax 772-462-6443
Requestfor 30-Day.Telnporary'Power'-Rel'ease
DiAe: ` Peirrft'Nfjmbef:
ftiect Address. Nc cz ..
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD MOTTO EXCEED THIRTY(30) DAYS, FOR THE PURPOSE OF'TESTING SYSTEMS
AND EQUIPMENT IN PREP ARA71OXi FOR.A FM.L INSPEcrm. IN CONSIDERATION OF APPROVAL OF THE
9EQuFE6r wE-mEREBY ACKNO DGE AND AGREE AS FOLI.OIiI&
1. This temporary power release is requesied for the above stated purpose only,and there vd]be no
ocatpancy of any type,other than that permitted by construction during this time period.
2. As witness by our signatu, es,we hereby agree tb abide W all terms and conditions of this agreement,
including Building Division policy,which is incorp"orabed her°in by reference.
3. All conditaonS:and r r irerne�s listed in the aUi hed document entitled"Requirements for 30 Day
Power for Tesdng"have been YuSed'and the premise is ready for compliance inspoainn.
4. All
requests for an e)dension beyond 30 days must be:made in writing W the Building Official stating
the reason for the request. Power may be*removed mm.the site and/or.a Stop Work.Order issued if
the Fmal'Inspection has not been approved within 30'days. A fee of$100.00 wiill be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD.HARMLESS,ST..LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF''ATURE WHICH MAY ARISE NOW OR IN THE.FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICA MAY BE INCURRED DUE TO THE
DISOONNECnON OF ELECTRICAL POWER IN THE-EVENT OF VIOLATION OF THIS AGREEMENT
OWNER SIONATURE DATE
GiTI eoNTRAC-POR. DATE
y
ELECTRICAL CONTRACTOR SIGNATURE DATE
�,Ec tv
JAN 0 9 20�$
p.epartMent
permitting
LuCie County
St.
LO L-A £000%£OOOd 9 2-1 999L8L8ZLL -WNA Z£=U 8 L 60-L0