HomeMy WebLinkAboutpower releaseSTLUCTE
COUNTY
F top I D A
Planning & Development Services
Building & ICode Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Da;e: (�_ � Permit Number: a00--)-0ki
2
Project Address: 1 � � lv�.� I �i -- G--- ------ --- ------
T IE LINDEhSiGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQJIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
fiEQ:iES WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
This temporary power release is requested for the above stated purpose only, and there vliil be no
oupancy of any We, other than that permitted by construction during this time period
A< witness by our signatures, we hereby a;ree to abide by all terms and conditions of this agreement,
mduding Building Division Policy, which is incorporated herein by reference.
3. AIi conditions and requirements listed in the attached document entitled "Requirements for 39 Day
Powe- `or Testing" have been fulfilled and the premise is ready for compliance inspection.
4 Ali -equests for an extension beyond 30 days must be made in viriting to the Building Official staring
the reason far the request. Power may be removed from the site and/or a Stop Work Order issued it
tie r'vial Inspection has not been approved within 30 days. A fee of $100.W will be requirr=t; to !:ft
the Stop Wwk Order.
VJE HEREBY RELEASE AND AGREE 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 INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT
SIGNATUPE
i
GENERAL C0fJPACTDR SIGNATURE
ELECTRICAL CONTRACTOR SISNATIJaE
S - aeL.2 /
DATE
S- )L8 -.1., l
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DATE
C moo,
DATE