HomeMy WebLinkAbout30 day power releasePlanning & Development Sei►vices
HAIM Building & IICode Regulation Division
• 2300 Virginia Ave
Fort Pierce, FL. 34982
MW 772-462-2165 Fax 772-462-6443
Request for, 30-Day Temporary Power Release
Date, Permit Number: S
Project Address: y y� -_eN-__—ecteIto Pi
-
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TEDSTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
?. 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 during this time period,
As witness by our signatures, we hereby agree to abide by all terms and 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 `or Testing" have been fulfilled and the premise is ready for compliance inspection,
-. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
s
the reason for the request. Power may be removed from the ite and/or a Stop Work
e required to lift Order issued if
the Final Inspection has not been approved within 30 days. A fee of $1o0,00 will b
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE F
OF THIS TRANSACTION, INCLUDING ANY DAMAGE N OF THIS AGREEMENT,
WHICH MAY BE INCURRED DUE TO THE
FROMDISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATIOFUTURE OUT
��--�
Q'' �NEP s%,rJAT—U E
FATE��
GE. IcR J- COrlITPACTOP, SIGNATURE -- - --- ___ _ . o l Z �-
DATE---
ELECTRI CG4L ELECTRICAL SIGNATrRE _ L/ i3 _aoa
DATE