HomeMy WebLinkAboutPower ReleasePlanning & 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
Date: lam_ a _. _ Permit Number, a O 1 CrJ I L�
S34qProject Address: A► � QNec��l 1�-____-- __----------
T'iE UNDERSIGNED 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
ANL' EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUE55T WE HERESY ACKNOWLEDGE AND AGREE AS FOLLOWS;
This tempc:rary power release is requested for the above stated purpose only, and there_ viiil 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 term; and conditions of this agreement,
inciuding Building Division Polity, which is incorporated herein by reference.
3. 0 con6tiors and requirements listed in the attached document entitled "Requirements for 30 Day
Power for Testing" have been fulfilled and the premise is ready for compliance inspection.
-1 Ali requests for an extension beyond 30 days must be made in writing to the Building Official stating
tte treason for the request. Power may be removed from the site and a Stop Work Order issued it
the Final Inspection has not been approved within 30 days. A fee of $100.00 will be required tc l.ft
_t,e Stop Nark Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROAM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR 1N THE FUTJRE 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.
SIGNATURE
6-1- a
DATE
3—
GENERAL CONTRACTOP, SIGNATURE DATE
.___._..6 a- aoa\
ELECTRICAL CONTRACTOR 51GNATIJR.E DATE