HomeMy WebLinkAboutPower Release 05-03-'21 11 :09 FROM- 7728787656 T-049 P0001/0001 F-651
Planning $`c Development Services
Bull;ding $r bode Reyurition.Divi$iOn
?.3Q0t�ginia Ave,
Fort Piercer FL 34982
772-46 2-'Z165 Fax 772�462-6443
I
Request for 30-Day Temporary PowO-r Release
- Permit f�Omber:
Date: _
Projed Address:
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER M THE ABOVE DESCRIBED
PROPERTY,FOR A PERIOD NOT TO EXCEED THIRTY(3:0)DAYS, FOR THE=PURPOSE OF TESTING SYSTEMS
AND EQUIPMEW IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
P,EQUEST WE H503Y ACKNOWLEDGE AND AGPEE AS FOLLOWS:
3. This teary power release is requested for the above slued purpose o*,and there w9 be no
occupancy of any type,other than that permitted.by construction during this time period.
2. As witness by our signatures,we hereby agree to abide by 4 terms aria oonditions of this agreement,
including Building Division Policy,which is incorporated herein by reference.
3. All conditions and requirements listed in the attached document entkled"`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 Offidal stating
the reason for the request. Power may be removed'from ttte site and/or a Stop Work,Order issued if
the Final Inspection has not been approved within 30 days. A fee of$100.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGRE-E 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 INCUMD DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER - DATE '
Cs CONTRACTOR 96N 4I DATE \
ELECTRICAL CONTRACTOR SIGNATURE DATE