HomeMy WebLinkAboutpower release form 06-09-'21 12:12 FROM- 7728787656 T-152 P0006/0009 F-794
Planning Development Services
Building-$c CIode,Regulati6n l~livision
2300'Virginia Ave
a p Fort Pller�r FL 34982
F
772-462-21:65 Fax 77Z-462-6443
Request for 30-Day Temporary Power Release
Dane: �.
€permit Number: �b \
PMJeCt MdreSS:
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER 7O THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY.(30) PAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HlEREi3Y ACKNOWLEDGE AND AGREE AS FOLLOWS:
I. This ten'rpEarary power release is requesW for the above skated purpose o*and the wil3 be no
occupancy of any type,other than that perrritbed.by aonstrucion during this time period.
2. As witness by our signatures,we hereby agree tp abide by all terms Md conditions of this agreement,
including Building Division Policy,which is incorporated herein by refeEerm.
3. All conditions 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.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason forte request Power maybe removed from the site arxVor 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 fift
the Strop 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 WHIC,H MAY BE INCUAM DUE TO THE
DISCONNECTION OF ELECTRICAL.POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER DATE '
GENE CONTRACTOR STAN DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE