HomeMy WebLinkAboutPower Release 06-09-'21 12:11 FROM- 7728787656 T-152 P0004/0009 F-794
Planning .& Devielopment ,Services
sUilding-& Code keglulAtion Division
2300 'Vir_91nia Ave
Fort Pierce, FL 34982
- -- 772-46 2-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Date: ����� Pera t Number•
Protect Address:
THE UNDERSIGNED HERESY 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 CONSlDERAT[ON OF APPROVAL OF THE
REQUEST WE HEREBY AMOWL DGE AND AGREE AS FOLLOWS'
1. This temporary mower release is requested for the above stated purpose only,and there w01 be no
occupancy of any type,other than that permithed.by construction during this time period.
2. As witness by our signatures,we hereby agree to abide by all tOMs and conditions of this agreement,
including Building Division Policy,which is incorporated herein by reference,
3. All conditions'and requirements listed in the attached document enti ed"Requirements for 30 Day
Power for Testing"have been fulfilled and the premise is ready for coinprrance inspection.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
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 Uft
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 RMJRE OUT
OF THIS TRANSACTION,INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNEMON OF EECTRICAL POWER IN THE WNT OF VIO1 A71ON OF THIS AGREEMENT.
OWNER DATE '
GEN£R CON DATE
ELECTRICAL CONTRACTOR SIGNATURE GATE
I