HomeMy WebLinkAbout30 days for testingDate.,
Planning & Development Services
Building & Code Regulation Division
2300 Virg!X Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
_ Permit Number, �'4:Z7\ \\ —
Project Address;
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER
PROPERTY, FOR A PERIOD NOT Tp EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEM
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION, IN CONS TO THE ABOVE DESCRI$EG
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS; IDERATION OF APPROVAL OP THE
!. This temporary power release is requested for the above stated r
orcupanry of any type, other Ulan chat permitted b r �' POSz a�iy and there v;i!I be no
?. As Witness by our signatures, we hereby agree to abide byrall tterms ion rand coring lriditjoRs of chi; agreement,
including Building Division Policy, which is incorporated herein by reference.
3. AJI conditions and requirements listed in the attached document entit!e,i "R2q �iremenLs for 30 pay
Payer for Testing" have been fulfilled and the premise is ready fpr compliance inspection.
9, the
requests for an extension beyrnd 30 day; must be made in vRiting to the Budding OfFcial statiny
[he reason for the request, Power mar be removed from the site andior a 5t
the Final Inspection has not been approved within 30 days. A fee of o, a st? p
or required �uF dit
the StaP % ork Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST, LUCIE COUNTY, AND THEIR EMPLOYEE'S FRO(4
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
DISOF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCUPRED DUE TO THE
CONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
'NLF, SIGNATURE
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GENERAL CordTR.ACTOR SIGNATURE
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DATA
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