HomeMy WebLinkAboutPower Release 06-09-'21 12:11 FROM- 7728787656 T-152 P0001/0009 F-794
lalanninq & Development Services
Building &Code Regulation Division
1 2300_VkOinia Ave
Fort Pierce, I` 34982
- - 772-462-2165 Fax 772,462-6443
Request for 30-Day Temporary Power release
Dade:
�\,o\ Perrrrtt Number. Q L
Prot Address: ���
THE UNDERSIGNED HEREI3Y 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 HAY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This tenvorary power release is requested for the alcove staff purpose oniy,and tthm wilt be no
occupancy of any type,other than that penitbed by construction during this tirne period.
2. As witness by our signatures,we hereby agree to abide by all terms and conditions of this agreement,
including Building Division Policy, which is incorporated herein by reference.
3. Ail conditions and requirements listed in the attached document entitled"Requrrements for 30 Day
Power for Test9ng"have been fulfilled and the premise is ready for compliance inspection.
4. All requests for an extension beyond 30 days must be made in wrsting to the Building Official slating
the reason for the request. Power may be removed from the 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 rift
the Stop Work Order.
VINE HEREBY RELEASE AND AGREE TO HOLD HARMLESS,ST, LUCIE COUNTY,AND THEIR EMPLOYEES FROM
ALL LIABIL11TES 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,
OWMER SIGVATU DATE
GEN CON T iA R 5 N^ RE DA7f
ELECTRICAL CONTRACTOR SIGNATURE DATE