HomeMy WebLinkAboutPower Release 06-09-'21 12:13 FROM- 7728787656 T-152 P0008/0009 F-794
Planning &Development Services
J= Building Code Re
gukktion Division
2300 Virginia Aye
For Pierce; FL 34,,982
772-462-2165 Fax 772 462-6443
Request for 30-Day Ternpori ary Powier,.Release
Date: \ ' Permit Num,ber, �:��T-V —
r <
Project Address.:
THE 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
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACMOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpme o*,and there wHJ be no
OCCIMMY of anY tme,other than that permitted.by col struc0on during this time period.
2. AS witness by our sigretutes,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 docurnent entitled Requirements for 30 Day
Power for Testing"have been fulfilled and the premise is ready for compliance inspection.
4. All requests for an ectension beyond 30 days must be made in writing to the Building OtFidal stating
the reason for the request. Power maybe removedffrom:the site and/or a Stop Work Order Issued if
the Fnai 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 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 EVEN"OF VIOiA71ON OF THIS AGREEMENT.
OWNER SIGNATURE DATE '
GLEN CONTRACTOR RE DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE