HomeMy WebLinkAbout30- day for temp power release05-14-' 21 09:21 FROM-
7728787656 T-072 P0001/0001 F-690
Prcled Address:
P14001 ho 1:6ei 6lopment: Services.
Buiinod' Rgurai6n0ion
23Q10:�'1 is tria A;Ve ' .
772-4671- 21,65 Fax 772i462-6443
Requestfor 30-bay Terrtpt iiia ry. Powe' r: Ret`ease
N
PerrotTltt ter a
THE UNDERSIGNED HEREBY REQUEST RELEASE OF 8XCWCAL POWER TO THE ABOVE DESQU15ED
PROPERTY, FOR A PERIOD NOT TO >_xCEE0 THIRTY(30) -RAYS, FOR THE PURPOSE QF'TESMNG SYSTEMS
AND EQUIPME rr IN 'PREPAwnoN FOR. A T 1INAL INSPECfTON. IN MNSMERATION OF APPROVAL OF THE
REQUEST WE HE Yiaa gpliud.l b? Z AND AGREE -AS FOLLO NS:
1, This Crary power release is requested for the aiwye sW Rd purpose only, and there vdi be no
occupancy of any type,.6dier doh that permuted. by ooiissr Oon dunng'this time period.
2. As witness by our signatures, we hereby ague tb 4Ade 4y all terms aril conditions of this agreement,
including Building Division Policy, which is fndorporated herein by reference.
3. All conditions and regWrerhents listed in ttZe attached doement entitl6d -Requirements for 30 Day
Power for Testingly have' been fulfilled'and the' premise is ready for-eompllance inspection.
4. All requests for an extension beyond 30 days must be:made in w ,Mbd to the Building 'Off dal stating
the reason for the request. Power may be rerimovedfrom.the site anon& a Stop Work.Order issued if
the Fh3l'inspeWon has not been approved Whin 30 days. A fee of$100.00 will be required to lift
the Strop Work Order.
WE HAY RELME AND AGREE TO HOLD HARMLE ,• ST.. Luae COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES ARD CLAIMS OF ANY TYPE OF NATURE WENCH MAY ARISE NO. W OR IN THE FUTURE OUT
OF THIS TRANSACTIQN; INCLUDING ANY DAMAGE 1NHIck MAY BE INCURRED DUE TO THE
DISCONNEC ION OF ELECT ti DOWER IN THE ANT ,OF VIOLATION OF THIS AGREEMENT
OWNER SIG ' ' - - DATE'
1 7 r ONTRAMR DATE
ELi=CMCAL CONTRACMR SiGNA'1URE DATE